What is it?
Amblyopia or “lazy eye” is one of the most common vision problems in children. It consists of a decrease in visual acuity of functional origin. Amblyopia happens because the brain receives different information (two different images) from each eye, so the brain “disconnects” the information that receives from one of the eyes and the vision of that eye does not develop normally.
Causes
The most frequent causes are strabismus, very important refractive errors, and the difference in optical graduation between one eye and the other (one eye focuses well, while the other sends a blurred image that the brain overrides). Other causes of amblyopia are congenital cataract, lesions in the cornea that affect the visual axis or present an eyelid ptosis (droopy upper eyelid) that hinders vision.
Symptoms
The main symptom is poor vision in one of the eyes. If the amblyopia is not caused by a strabismus, being generally asymptomatic, it can go unnoticed, both by the parents and the child, so it is very important to carry out an ophthalmological check-up on all children between 3-4 years of age.
In most cases, amblyopia affects only one eye (in the case of strabismus, the deviated eye. If it is a refractive error, the eye with the greatest refractive error). Some children with very high refractive errors may have bilateral amblyopia, which usually improves with the use of corrective lenses (glasses).
Having decreased visual acuity in one eye does not have to mean that the child has amblyopia. In some cases, the visual defect can be corrected with the use of corrective lenses (glasses).
Other symptoms related to amblyopia are headaches when reading or problems watching movies or using 3D electronic devices.
Diagnosis
Many cases are diagnosed in routine pediatric check-ups. Diagnosis is made through a complete ophthalmological examination, with special attention to visual acuity, possible presence of strabismus, refractive errors, evaluation of stereoscopic (3D) vision, examination of the anterior segment of the eye and fundus.
As mentioned above, not all amblyopia are due to strabismus and / or refractive errors, so it is important to rule out other causes of poor vision such as cataracts, inflammation, or tumors.
Prognosis
Early diagnosis is essential to obtain good clinical results. If not treated early and properly it can leave a permanent visual defect. Therefore, it is important that all children undergo a visual check between the ages of 3 and 4 to prevent the defect.
The prognosis depends on the type of amblyopia and the age of initiation of treatment, as well as individual factors.
Treatment
Treatment for amblyopia will depend on its cause. Initially, the goal of treatment is to recover as much vision as possible. Subsequently, it is very important to continue with a maintenance treatment to consolidate the visual recovery obtained, until at least 9-10 years of age, to avoid a worsening of vision.
If the amblyopia is due to a refractive defect, the first step is to correct the defect. Sometimes, if it does not heal properly, it may be necessary to perform an occlusion treatment (patches).
The most common treatments are eye patches, filters in penalized glasses or lenses, and eye drops (eye drops). They are intended to prevent or hinder the vision of the “good” eye (with better visual acuity) and help stimulate the vision of the “bad” eye (with less visual acuity). The recommended hours of treatment will be established individually based on the characteristics of each case (age, cause, and degree of visual defect).
In cases where the amblyopia is caused by a congenital cataract (present at birth) or an eyelid ptosis (drooping upper eyelid), the convenience and / or need for surgical intervention will be assessed.
