According to the latest statistics, amblyopia is diagnosed in 2% of adults in our country, but among children the situation is somewhat different, as evidenced by frequent visits to eye clinics or specialized medical institutions. According to experts, the vast majority of young parents do not know what amblyopia is in children, and are not aware not only of its symptoms, but also of its possible consequences. Therefore, today's article is dedicated to answering this question.
What is amblyopia
This pathology, which is called the "lazy" eye, is characterized by a reversible decrease in vision in one or less often both eyes. This happens due to various functional disorders, such as strabismus, pathology of the bottom of the eye, clouding of the lens. Because of this, the transmission and perception of an adequate image is disrupted. As a result, a person sees two completely different pictures instead of one three-dimensional one, as a result of which the work of one eye begins to be suppressed and deteriorate over time. As you know, if at least one organ does not work in a person, then it will atrophy over time. Thus, the sooner treatment begins, the greater the chancefor the full recovery of the child. But about this in order.
Types of amblyopia
Answering the question of what amblyopia is, it should be said that this disease can be confused with other pathologies that also lead to a decrease in visual acuity. Therefore, to avoid such a mistake, consider the types of amblyopia.
Distinguish between primary and secondary forms. Primary include:
- Refractive amblyopia, which appears in children with untimely correction of ametropia. Allocate unilateral, bilateral, symmetrical and asymmetric.
- Dysbinocular amblyopia. As you might have guessed, this pathology is based on a disorder of binocular vision, which is provoked by strabismus and the lack of timely treatment. As practice shows, such a pathology is more clearly manifested in the eye that mows.
- Mixed amblyopia, which is expressed both in manifestations of refractive and dysbinocular forms.
- Hysterical amblyopia. Decreased vision in this case occurs with violations in the work of the central nervous system. The most common cause is psychological trauma.
About secondary amblyopia, you should know that the pathology of the visual organ, which has been successfully eliminated, can serve as the cause of such a disease. But because of this, a decrease in vision could occur.
It includes:
- Obscurational amblyopia, which appeared as a result of a pathology of the visual organ that prevents the appearance of an image on the retina. Of the most common manifestationsisolated congenital or acquired cataract. The obscurative form can appear in one or both eyes.
- Neurogenic amblyopia. The cause may be diseases of the optic nerve. To date, cases of complete recovery have been recorded. It should be noted that the treatment of such a pathology begins after surgery.
- Maculopathic. It develops after suffering diseases of the central and paracentral zones of the retina.
- Nystagmic amblyopia. Called when the time interval of the image stays in the central zone of the retina decreases.
- Combined amblyopia. Manifested by a combination of the above forms.
Amblyopia Strabismus
But with all the variety of causes leading to amblyopia, strabismus still prevails among them. As you know, normally the muscles of the eye move simultaneously, thus ensuring the normal functioning of the organ. But if there is a malfunction in the work of at least one muscle, a problem arises with the control of movement, that is, strabismus develops, after which amblyopia of the eye occurs. So, we can state the fact that strabismus and amblyopia are two sides of the same coin.
From the most common causes that lead to muscle weakness, there are:
- Hyperopia.
- Mental disorders.
- Eye injury.
Symptomatics
The most common symptoms of this disease include:
- Decrease in visual acuity inone or both eyes.
- Frequent dizziness associated with poor perception of voluminous objects.
- Difficulties during training.
- Deviations of the eye in the opposite direction from the direction of gaze.
Diagnosis
As mentioned above, the answer to the question of amblyopia - what is it, and this article will be devoted to. Therefore, let's move on to the story of diagnosing this disease. So, children do it in different ways.
Visiometry
As a rule, at every age the child has a kind of visual acuity bar. But the task of the optometrist should be to determine the greatest visual acuity without correction and with correction. The features of the conduct of visiometry in children include:
- Checking before the start of the examination whether the child is familiar with the pictures that are shown on the table.
- Conducting a survey with constant praise of the child if he answers correctly.
- If a low visual acuity is detected, it is recommended to repeat the examination in a few days, and you need to start with the eye that showed the worst result.
An important point of the examination is careful observation of the child in order to keep him from possible squinting.
Refractometry
She is able to show whether children have amblyopia or not. Such an examination takes place using a refractometer or keratofractometer. An important role in the diagnosis is played by the correct placement of the child behind the device. It should be borne in mind that the primary indicators of the device may differ slightly from the subsequent ones, therefore it is recommended to re-diagnose several times to confirm the diagnosis of "eye amblyopia".
Degrees
Today, doctors distinguish the following degrees of amblyopia:
- Very low grade - visual acuity 0.8–0.9.
- Low - 0.5-0.7.
- Moderate amblyopia - 0, 3–0, 4.
- High - 0.05–0.2.
- Very high - visual acuity is below 0.05.
High grade amblyopia is usually accompanied by impaired binocular vision.
Amblyopia in children: treatment
When diagnosed with amblyopia, treatment can be both conservative and operative.
Important! The degree of amblyopia affects the index of visual acuity after surgery.
So, what to do if amblyopia is diagnosed in children? Treatment usually begins with occlusion, optical correction, penalization and visual therapy.
Optical correction
When diagnosing amblyopia in a child, which is accompanied by ametropia, one of the conditions for successful treatment is the appointment of permanent wearing glasses or lenses. Particular attention in the presence of high degrees of ametropia should be given to the choice of high quality lenses, preferably with an aspherical design, since these lenses have an extremely effective optic zone, which is important in the treatmentamblyopia.
Applying occlusion
The use of occlusion is today the standard in world medicine. Occlusion happens:
- Direct (when the normal seeing eye closes).
- Reverse (when the eye that has less visual acuity closes).
- Alternating (alternating eye closure).
According to the frequency it happens:
- Constant.
- Partial.
- Minimum.
The principle of this method is to enhance the functionality of the poorly seeing eye by excluding the he althy eye from the work. As practice shows, the effectiveness of this method in children under 6 years of age is significantly lower than in older ones. This is explained by some difficulties associated to a greater extent with the psychological factor.
An important element for successful treatment is the correction of eccentric fixation.
But it would be right to mention some of the negative aspects that the occlusion method may entail. These include:
- Decrease in the level of vision in the he althy eye. This happens, as a rule, due to negligent attitude on the part of both parents and doctors.
- Development or strengthening of strabismus.
- Diplopia (doubling of objects).
- Problems with the skin.
- Various allergic reactions.
It is especially worth noting that one of the main reasons for the failure of occlusion treatment is the disinterest of the children themselves in long-term wearing of the bandage.
Penalization
Penalization is called a methodtreatment of this disease, in which artificial anisometropia is created using various combinations of optical correction and the joint (as prescribed by a doctor) use of atropine for the eye, in which the percentage of vision is higher. The principle of action of atropine is to create fuzziness in a he althy eye after its instillation, as a result of which the work of the eye, which sees worse, is activated. This method, unlike occlusion, is more suitable for children and much more effective.
But do not forget that he also has negative points. These include:
- The appearance of redness on the skin.
- Irritation in the eye.
- Frequent headaches.
- Intensive vision care.
This technique is used for intolerance to occlusion. It combines methods aimed at restoring or improving the fixation and movement of the eyeball, perception in space, accommodation of vision. For this purpose, special devices, such as a synoptophore, can be used. One of the advantages of this technique is considered to be a significant reduction in the treatment period with sufficiently high visual acuity.
Amblyopia and strabismus treatment
As mentioned earlier, the treatment of amblyopia can be started only after the elimination of its causes. And if amblyopia has developed against the background of strabismus, then first of all we eliminate it. To date, several treatment options for this pathology are known. These are surgical and therapeutic methods:
- Pleoptics. Treatment is to strengthenload on the eye that mows. To achieve this effect, both a special laser and PC programs are used.
- Orthoptics. In this case, synoptic instruments and PC programs are used to restore vision and eliminate strabismus.
- Diploptics. Restoring vision at home.
- Special exercises are used to improve the functioning of the muscles of the eye.
It is important to realize that strabismus will not go away with age, as some mistakenly believe. In addition, if it is not cured in a timely manner, it can lead to very sad consequences. Remember that the maximum age at which strabismus treatment works best is 25 years old.
Treatment at home
The insidiousness of this disease lies in the fact that with insufficient diligence during its treatment, relapses are possible. Therefore, it is especially important for parents to persevere, since often a child diagnosed with amblyopia does not understand what it means to see well, since his level of vision seems normal to him. Therefore, it is necessary to combine procedures in medical institutions and treatment of amblyopia at home. After all, only the joint work of the whole family can bring such a desired and long-awaited result as good vision. A special program for the treatment of amblyopia at home will help in this. Although each program is selected by the doctor individually, there are several exercises that are suitable for everyone.
Electric lamp exercise
To do this, take a thick black sheet of paper and a light bulb with a power of up to 80 V. Next, cut out a circle of paper with a diameter of 8 mm and glue it on the light bulb. After that, the child should close the eye that sees better, and for 30 seconds look at the light bulb, and then at a blank white sheet of paper previously glued to the wall. You need to watch until the image of the light bulb appears on paper. The exercise should be repeated for 1-2 months several times a day.
Text exercise
We cover the child's well-seeing eye with a bandage. We pick up a pre-prepared text with small print and bring it to the second eye to the maximum allowable distance at which the child can read it. After that, we begin to move the text very slowly until it becomes difficult to read. Repeat this exercise several times.
Exercise with a higher power electric lamp
Choose a lamp with more power and a thick black sheet of paper. We cut out a cap from it with a hole (diameter 6 mm) in the middle and put it on the lamp. After that, the hole is closed with a red film. We put the lamp at a distance of at least 40 cm from the child and turn it on. The task of the child is to look at the lamp for 3 minutes without being distracted by anything, and the parents must turn the lamp on and off every 3 seconds.
Using the flash
To do this, you will need a camera with a flash and a piece of paper on which you can draw images or letters. The procedure is as follows: a flash is brought to the level of the child's eyes (at a distance of at least 50 cm) and a series of flashes is made (up to 10). After each of them, the child should look at a piece of paper and try to make out what is written there (place a sheet of paper within a meter or two). The recommended number of lessons per day is up to 3 times, the total duration is up to 2 months.
Small manual work or games where precision is needed has proven itself well.
A few tips
In order not to have to look for an answer to the question of amblyopia - what is it, you must adhere to the following rules:
- Perform periodic preventive examinations with an ophthalmologist.
- If even the slightest hint of strabismus is detected in a child, you must at least confirm or refute this diagnosis by performing the necessary studies in an ophthalmological clinic or a specialized medical institution.
- Do not provoke the development of strabismus by placing toys or bright objects near it.
- Provide your child with good nutrition and eliminate stressful situations.
- Constantly engage in his self-development.
- At the first manifestations of vision problems, immediately consult a specialist.
As practice shows, the prognosis for amblyopia is favorable with timely treatment, but the following is important here:
- Strict observance and implementation of all recommendations of the attending physician.
- Typeamblyopia.
- Eye position.
- Initial visual acuity.
- Age category of the patient.
- Method of treatment.
The main thing to remember is that if you set a goal and go towards it, then nothing is impossible in the world. But it should be noted that an undertreated patient may face complete loss of vision in the future. Therefore, it is recommended to prevent the development of this disease, to know in advance the answer to the question: "Amblyopia - what is it?"
