From the Guidelines
Amblyopia is a developmental disorder of the central nervous system that results from the abnormal processing of visual images, leading to reduced visual acuity, and is classified by cause into refractive, anisometropic, high bilateral refractive, strabismic, visual deprivation, media opacities, ptosis, and occlusion types. According to the most recent study 1, amblyopia is a unilateral or, less often, bilateral reduction of best-corrected visual acuity that usually occurs in the setting of an otherwise normal eye. The condition is characterized by a reduction in visual acuity that cannot be attributed solely to a structural abnormality, and patients may also experience deficits in contrast sensitivity and accommodation.
Some key points to consider about amblyopia include:
- It is a developmental disorder that results from abnormal processing of visual images
- It can be classified into different types based on the cause, including refractive, anisometropic, and strabismic types
- Patients with amblyopia may experience reduced visual acuity, contrast sensitivity, and accommodation
- The fellow eye may not be normal and may have subtle functional deficits
As noted in the study 1, the clinical objectives for managing amblyopia include identifying children at risk, examining them at the earliest possible age, informing patients and families about the diagnosis and treatment options, and treating infants and children to improve visual function and reduce the likelihood of vision-related disability. Early detection and treatment, ideally before age 7, are crucial to improve visual function and reduce the likelihood of permanent vision loss. Regular eye exams for children are essential for early detection, as children rarely complain about vision problems and may not realize their vision is abnormal.
From the Research
Definition of Amblyopia
- Amblyopia is a common cause of visual impairment in children and young adults, also known as "lazy eye" 2
- It is characterized by poor vision in an eye that did not develop normal sight during early childhood 2
Causes of Amblyopia
- Strabismus (misaligned eyes) 2
- Unequal focus (refractive error) 2
- Cloudiness in the normally clear eye tissues 2
Treatment of Amblyopia
- The cornerstone of treatment is increasing visual stimulation of the amblyopic eye by occlusion, atropine, or optical penalization of the dominant eye 3, 4
- Treatment options include patching, atropine penalization, and pharmacological treatments 4
- Refractive adaptation alone can significantly enhance visual acuity, but the duration of optical correction varies between studies 4
- Adherence to occlusion affects the outcome, with a dose-response relationship between adherence and visual acuity 4
Treatment Outcomes
- Treatment efficiency declines with age, but recent evidence indicates cortical plasticity beyond the "critical period" 4
- Novel approaches targeted to the restoration of binocular functions, such as perceptual learning, video gaming, and dichoptic training, have shown small effects on visual acuity 4
- Significant evidence for the successful management of amblyopia with occlusion therapy and atropine has been found, but the management of amblyopia remains challenging due to compliance issues and suboptimal treatment outcomes 4