Approximately 2 to 3 percent of children in the United States are affected by amblyopia. This is one of those types of eye disorder that does not only affect vision ability, but may also lead to more serious complications when left untreated. This problem of the eye is also known as “lazy eye” and can be observed quite easily.
How does amblyopia develop?
To produce vision, proper coordination between the eye and the brain is required. The eye will focus light on the back part of the eye called retina, which will trigger nerve signals that travel along the optic nerves to the brain. When someone is suffering from amblyopia, the vision is disrupted as one of the eyes fails to work cooperatively with the brain. Although this eye may look visibly normal, the brain is not able to send these nerve signals required for proper vision. The brain tends to send nerve signals to merely one eye, making another eye less active and thus assumed as the “lazy eye”.
Who are susceptible?
Both children and adults may suffer from the problem of lazy eye, although this problem is mostly originated during childhood. Based on a number of previously-done researches, amblyopia triggers vision impairment in 2 to 3 out of 100 children. This eye disorder begins during infancy and early childhood and if not treated properly, may persist to adulthood.
Is amblyopia permanent?
The appearance of eye affected by amblyopia can be improved through cosmetic surgery. However, vision imparity caused by this disorder might be permanent if it is not corrected immediately during childhood. This can be harmful if the eye disorder affect both eyes, as without proper treatments, this may lead to total vision loss.
Children with amblyopia may complain about their difficulty in reading, writing, and other detail-requiring activities. Young children may feel something is wrong about their vision without being able to explain what it is.
Risk of complications
The most common and potential risk of complication triggered by amblyopia is vision loss in one eye. This means, it is possible for those suffering from amblyopia to get blind in one eye, while another one may still work properly. In fact, amblyopia with its variety of manifestation has been one of the leading cause of vision imparity in children and middle-aged adults.
Common causes of amblyopia
Lazy eye develops when the weaker eye receives fewer visual signals from the brain and thus, decreases the ability of both eyes to work together. Eventually, the brain ignores input from the weaker eye, turning it into a lazier eye compared to another one. Common causes of this problem include:
- Muscle imbalance that is undergone by muscles positioning the eyes. This causes the yes to cross in or out and prevent them from tacking them together in a good coordination.
- Difference in sharpness of vision between the two eyes. Farsightedness, nearsightedness, or astigmatism that involve refractive problem of the eyes may result in amblyopia. In some cases, glasses or contact lenses can be used to treat this type of amblyopia.
- Deprived vision that is caused by cloudy area of the lens or cataract. Deprivation amblyopia in infants require immediate treatment to prevent permanent vision loss.
Major symptoms and signs
Symptoms and signs of amblyopia may be difficult to reveal as in most cases, this problem occurs as an infancy problem. Thus, the eye disorder occurs when children are not able to explain about something not normal related to how they perceive objects. Despite this, there are some common major symptoms and signs of amblyopia that can be observed to help diagnose the problem. These include:
- In babies, amblyopia can be one of those possible causes that make them do not crawl for objects during their active months, which is six to ten months.
- In infants or young children, amblyopia is often signed by the appearance of eye misalignment. This problem is often referred as crossed eyes and can be an initial sign of infancy amblyopia.
- When one of their eyes is covered, young children with amblyopia usually cry, because there is a possibility that they cannot see clearly with the uncovered eye, as it is the lazy one.
- Frequent squinting or shutting one of the eye to gain better focus for clearer vision. In addition, head tilting is often also observed in children with lazy eyes, as this is one of their way to fix the focus of the eye so that they are able to perceive objects more properly.
Treatments for amblyopia in children
Amblyopia occurs as a one of the result of “lazy brain” and “lazy eye”, which refers to weak connection between these two parts of the body. To prevent an eye affected by amblyopia to cause permanent vision impairment, it is very important to have it treated immediately after the problem is diagnosed. In children, there are a couple of common ways that are used as early treatment of amblyopia, which includes:
The purpose of eye patching is to “force” the children to use the eye with weaker vision more frequently. This is important in that when the affected eye is used more frequently, it forces it to send nerve signals to the brain more frequently, so that the brain is expected to send optic signal to this eye, instead of merely to the “stronger” eye. Patching will help determine the entire vision ability, so that the lazy eye will not cause significant difficulty in perceiving objects.
There are some tips to be considered when using this patching techniques for improving amblyopia in children:
- Make them wear the eye patch for certain agreed treatment period. To make children eager to wear an eye patch, you can help by making it fun. There are various colorful eye patch stickers on the market intended for children. These fun eye patches will make amblyopia treatments more fun for children and thus, they will be able to be asked for wearing the patch as long as they need to.
- It is important to check their eye health after some regular sessions of eye-patching. Make sure you have the eye checked by children eye practitioner to have a thorough review about its health.
Certain eye drops can be beneficial in improving lazy eyes. This is a type of eye drops that will trigger temporary blur vision to the stronger eye, so that the patient will use the lazy eye to focus on an object, especially near objects. This will improve the lazy eye and therefore, permanent visibility impairment of this affected eye could be inhibited.
Types of amblyopia
Based on the main risk factors, amblyopia eye disorder is classified into:
- Strabismic amblyopia, which is the most common type of amblyopia.
This type of lazy eye is visible as an ocular misalignment. This occurs as a result of suppression of the deviating eye. Double visions are often resulted from this ocular misalignment, and so for preventing these double visions, the brain ignores the visual input from the misaligned eye. Strabismic amblyopia can be either intermittent or constant, and an untreated constant strabismic amblyopia may lead to more severe effects of amblyopia, including blindness of the misaligned eye.
- Refractive amblyopia.
Refractive amblyopia, in contrast to strabismic amblyopia, does not necessarily cause visible eye misalignment. This type of amblyopia, instead, is resulted from refractive errors in the two eyes, despite the well-aligned eyes. Refractive lazy eye may occur due to farsightedness or astigmatism at a very young age. As a result, visual images in both eyes are degraded and this leads to an abnormal visual processing.
- Deprivation amblyopia.
This type of amblyopia is very common in babies, and resulted from obstructed light from entering and being focused in the eye. Deprivation amblyopia develops mostly with congenial cataracts and hence, prompt treatment of this congenital cataract is necessary in order to allow normal visual development to occur.
Amblyopia in adults
Amblyopia commonly occurs during childhood. However, untreated problem of lazy eye may develop and stay to adulthood when left untreated. As amblyopia will not go away by itself, treatments to the problem is essential in preventing permanent vision problem. Thus, amblyopia commonly does not spontaneously occur in adults. Instead, it is resulted from prolonged complicated connection between the eye and the brain during the crucial development period of visual system development during the age of six or nine.
Can amblyopia be treated in adults?
Amblyopia can commonly be treated and thus, its effects can be minimized as long as the treatments are performed immediately after the problem is diagnosed. In young children, eye patching is the most frequently used treatment to improve lazy eye problem. Covering the affected eye with an eye patch for certain hours is believed and researched to be able to improve the connection between this eye and the brain, so that visual or optic signal can be sent and vision ability will be improved earlier.
Despite this, eye patching is recently known to be able to provide amblyopia treatment in adults. It is studied that treatments of amblyopia after the age of 17 does not merely depend on the age but require more effort including vision therapy. Although experts have not found the exact recovery rate in adults receiving treatments for their amblyopia, these treatments can be performed as media to improve their eye ability to promote better visibility.
Is surgery required for amblyopia?
Eye development reaches its significant stage during the ages of 6 to 9. Thus, eye disorder that is corrected before or within these age ranges may prevent permanent vision problem in adulthood. As an eye problem that occurs during childhood, even soon after birth, amblyopia requires an immediate treatment procedure to be corrected. With proper initial procedures, worsened vision impairment can be prevented and thus, the limited ability of the lazy eye can be improved quite significantly.
Consequently, if the problem was not corrected during childhood, it is possible that it leads to permanent lazy eye, which causes the affected eye to not be able to perceive objects and focus on them properly. Unfortunately, lazy eye problem that is not fixed before the age of 9 will not be easy to eliminate. In fact, it causes a permanent vision loss of one of the eyes. Therefore, no surgeries can be done to make the affected eye able to see normal vision in adulthood if amblyopia was not treated as a child. Even so, surgeries that are done to the affected eye may still have cosmetic purposes to improve the appearance of the misaligned eyes.
Are there tests for amblyopia?
There are some reasons why disclosing the risk of amblyopia as soon as possible is very important and beneficial. Firstly, this muscular eye problem often occurs during early childhood, when children may have not been able to tell something is wrong with their parts of the body yet, so that parents’ observation tend to have a significant role in providing proper treatments. Secondly, treatments for amblyopia that are not performed during childhood can hardly be effective in preventing the potential permanent damage. Thus, disclosing the problem as early as possible in order to perform suitable treatments immediately is essential.
To diagnose amblyopia, an ophthalmologist will conduct an eye exam, checking for the eye health status and the difference in vision between the eyes or poor vision in both eyes if presents. If he finds out one eye with poor vision compared to another, he will need to conduct more thorough test for this suspected amblyopia. Before performing the test, the doctor will use some eye drops to dilate the eye. This will make the eye test easier to conduct and the inner part of the eye can be thoroughly observed. The types of tests conducted by an ophthalmologist depend mostly on the child’s age and development.
- In preverbal children or infants, a lighted magnifying will be used for detecting cataracts. The test can also be done by examining his or her ability to fixate his gaze and to follow moving objects. Both eyes will be tested for this in order to tell whether or not there is an eye that works more poorly than another one.
- Children aged 3 and older. Eye tests with pictures is suitable to check any poor vision in children aged 3 and above. To specifically perform an amblyopia test, an eye patch is used to cover one eye simultaneously, so that vision difference between the two can be diagnosed. The doctor will also know which eye is used more by the patient.