Amblyopia Gwap As I Gela

AMBLYOPIA
Shania Angela Superio

Amblyopia
• Also known as lazy eye, is a vision development disorder
in which an eye falls to achieve normal visual acuity, even
with prescription eyeglasses or contact lenses.
• Amblyopia begins during infancy and early childhood. In

most cases, only one eye is affected. But in some cases,
reduced visual acuity can occur in both eyes.
• If lazy eye is detected early in life and promply treated,

reduced vision can be avoided. But if left untreated, lazy
eye can cause severe visual disability in the affected eye
including legal blindness.
• Although many types of amblyopia exist, it is believed that
their basic mechanisms are the same even though each
factor may contribute different amount to each specific type
of amblyopia.
• In general, amblyopia is believed to result from disuse from
inadequate fovea or peripheral retinal stimulation and/or
abnormal binocular interaction that causes different visual
input from the fovea.
• Functional amblyopia is used to describe amblyopia, which is

potentially reversible by occlusion therapy.
• Organic amblyopia refers to irreversible amblyopia; the term used in
certain cases of reduced vision in which ocular pathology is not
obvious. (e.g., nutritional, tobacco, alcohol, and others.)
• Psychogenic amblyopia is another type of reduction in VA due to
causes such as hysteria or malingering. Common in children,
adolescents and adults in stressful situations.
Signs
• Head tilt Symptoms
• An eye wanders • Poor visual acuity
inward or outward • Separation difficulty
• Poor depth • Anopsia
perception
• Sensitivity to contrast
• Squinting and
• Problems of stereo
shutting an eye
vision
• Restlessness
• strabismus
What causes Amblyopia?
Strabismic Amblyopia
Strabismus is the most common cause of amblyopia. To
avoid double vision causes by poorly aligned eyes, the
brain ignores the visual imput from the misaligned eye,
leading to amblyopia in that eye (lazy eye).
Refractive Amblyopia
• Ambyopia is caused by unequal refractive errors in two
eyes, despite perfect eye alignment. Caused by a
difference in refractive error between the eye and may
result from a difference as little as 1.O D sphere.
• The eye with less refractive error provides the brain with a
clearer image; and is favoured by the brain.
• Refractive amblyopia is diagnosed when there is a wide
disparity in VA between 2 eyes.
• If anisometropia is presents, it’s refractive.
• Treated by correcting the refractive error early with
prescription lenses. Vision therapy and/or eye patching
can also be used to improve visual abilities, BV, and depth
perception.
Deprivation Amblyopia
This is the lazy eye caused by something that obstructs

light from entering and being focused in a baby’s eye, such
as a congenital cataract. Prompt treatment of congenital
cataracts is necessary to allow normal visual development
to occur
Management
• Prevention and early detection
• Best way: vision screening programs right from birth.
• Inspection of symmetry of face and eyes, & head tilt.
• Visual acuity –fixation.
• Treatment of amblyopia
• Elimination of cause of visual deprivation
• Correction of refractive error (before starting occlusion
therapy)
• Correction of ocular dominance: ocular therapy, penalization,
active stimulation, and pharmacological manipulation.
• Surgery for Strabismus
Occlusion therapy
• Patch on skin, gauze pad and tape, occluder, opaque contact
lens, etc.
• 3-7 y/o with severe amblyopia
• Full time patching produced a similar effect to that of patching for 6 hrs a day.
• 3-7 y/o with moderate amblyopia
• 2hrs of daily patching produced same improvement as to that of 6hrs.
• 7-13 y/o
• 2-6hrs of patching can improve VA even if amblyopia has been previously
treated.
• 13-18y/o
• 2-6hrs of patching might improve VA, but not if amblyopia Rx has already been
tried previously.
• Active vision exercise by amblyopic eye during occlusion may
enhance visual improvement.
•
Penalization
To force the amblyopic eye to greater use by penalizing the good eye with the
help of glasses and cycloplegic drug.
• Prerequisite: eye should be straight.
• Indications: as good as patching in moderate amblyopia
• Methods:
• 1. Atropine penalization
• a. near penalization: normal eye atropinized and fully corrected with +2 or +3D.
• b. distance penalization: normal eye atropinized and over corrected by 4-5D,
amblyopic eye at full correction.
• c. total penalization: normal eye atropinized and undercorrected by 4-5D,
amblyopic eye fully corrected.
• 2. Optical penalization –
• prescribing more pluses to good eye to force amblyopic eye to fix for distance
targets.
• Endpoint: spontaneous alternation of fixation or equal VA in both eyes.
• Pharmacological manipulation
• Levadopa, a precursor for catecholamine dopamine has been
studied as an adjunct to patching, but remains controversial.
• Prognosis
• Improvement or recovery of VA depends on the type of amblyopia,
its duration and age of onset, the type of treatment and patients
cooperation.
• The younger the child, the better prognosis.
• Deprivation amblyopia carries poorest prognosis.
• Strabismic amblyopia has best prognosis.
• Hyperopes has poorer prognosis that myopes.
• Occlusion therapy is better that other methods.

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AMBLYOPIA

Shania Angela Superio

• Amblyopia begins during infancy and early childhood. In

• If lazy eye is detected early in life and promply treated,

• Functional amblyopia is used to describe amblyopia, which is

This is the lazy eye caused by something that obstructs

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