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Pediatric Ophthalmology

What is amblyopia (Lazy Eye)?

Amblyopia is decreased vision in one or both eyes due to abnormal development of vision in infancy or childhood. In amblyopia, there may not be an obvious problem of the eye. Vision loss occurs because nerve pathways between the brain and the eye aren’t properly stimulated.

Will glasses help a child with amblyopia to see well?

Glasses may improve visual acuity to some degree but usually not completely. With amblyopia, the brain is “used to” seeing a blurry image and needs to learn how to see better with that eye.. With time, however, the brain may “re-learn” how to see and the vision may increase. The normal eye is treated to make the amblyopic (weak) eye stronger.

Children who are born with cataracts may need surgery to take out the cataracts. After surgery, the child will usually need vision correction with glasses or contact lenses and patching.

How old is TOO old for amblyopia treatment?

A recent National Institutes of Health (NIH) study confirmed that SOME improvement in vision can be attained with amblyopia therapy initiated in younger teenagers (through age 14 years). Better treatment success is achieved when treatment starts early, however.

How can I get early treatment for amblyopia?

Some forms of amblyopia, such as that associated with large-deviation strabismus, may be easily detected by parents. Other types of amblyopia (from high refractive error) might cause a child to move very close to objects or squint his or her eyes. Still other forms of amblyopia may NOT be obvious to parents and therefore must be detected by Vision Screening.

How is amblyopia treated?

One of the most important treatments of amblyopia is correcting the refractive error with consistent use of glasses and/or contact lenses. Other mainstays of amblyopia treatment are to enable as clear an image as possible (for example, by removing a cataract), and forcing the child to use the weaker eye (via patching or eye drops to blur the better-seeing eye)

When should patching be used for amblyopia treatment?

Patching should only be done if an ophthalmologist recommends it. An ophthalmologist should regularly check how the patch is affecting the child’s vision. Although it can be hard to do, patching usually works very well if started early enough and if the parents and child follow the patching instructions carefully. It is important to patch the better seeing eye to allow the weak eye to get stronger.

How many hours per day patching is enough when treating amblyopia?

The mainstay of treating amblyopia is patching of the dominant (good) eye, either full or part-time during waking hours. The prescribed number of hours of patching will depend on the visual acuity in the amblyopic eye and whether treatment has been successful in the past. Your doctor will prescribe the appropriate time for you.

During which activities should patching be performed?

There is no particular activity that will improve the vision more than another activity. The most important part of treatment is keeping the patch on for the prescribed treatment time. As long as the child is conscious and has his or her eyes open, visual input will be processed by the amblyopic eye. On the other hand, the child may be more cooperative or more open to bargaining if patching is performed during certain, favorite activities (such as watching a preferred television program or video).

Should patching be performed during school hours?

In many instances, school is an excellent time to patch, taking advantage of a non parental authority figure. Patching during school hours gives the class an opportunity to learn valuable lessons about accepting differences between children.

What if my child refuses to wear the patch?

Many children will resist wearing a patch at first. Successful patching may require persistence and plenty of encouragement from family members, neighbors, teachers, etc. Children will often throw a temper-tantrum, but then they eventually learn not to remove the patch. Another way to help is to provide a reward to the child for keeping the patch on for the prescribed time period.

What happens if amblyopia treatment does not work?

In some cases, treatment for amblyopia may not succeed in substantially improving vision. It is hard to decide to stop treatment, but sometimes it is best for both the child and the family. Children who have amblyopia in one eye and good vision only in their other eye can wear safety glasses and sports goggles to protect the normal eye from injury. As long as the good eye stays healthy, these children function normally in most aspects of society

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