Amblyopia is a common clinical ophthalmology disease in children. Amblyopia is defined in 2011 as: amblyopia caused by monocular strabismus, uncorrected refractive error, high refractive error and form deprivation during visual development, and the best corrected visual acuity of one or both eyes is lower than the standard of visual acuity of the corresponding age: or the visual acuity of both eyes differs by more than 2 lines, and the visual acuity of the worse eye is amblyopia. The eye is amblyopic. According to relevant studies, the lowest normal value of visual acuity for children aged 3 to 5 years is 0.5, and the lowest normal value of visual acuity for children aged 6 years and above is 0.7.
Symptoms of amblyopia.
1. poor visual acuity: both bare eye and best corrected visual acuity with refractive correction glasses are lower than normal.
2. Crowding phenomenon: When examining visual acuity, children with amblyopia will have better visual acuity when examined with a single visual marker than when examined in rows. The reason for this may be due to the imperfect visual development of the amblyopic patient, as shown by the insufficient inhibition of the visual markers around the target of gaze by one eye, which interferes with the clarity of the visual markers being gaze at.
3, the nature of the gaze may be abnormal: some amblyopic eyes may not use the most sensitive area of the fundus vision gaze, but other parts of the retina, thus affecting the level of vision, the treatment of such patients to be more difficult.
4. Stereopsis abnormalities. Patients with amblyopia due to uneven development of both eyes, thus affecting the development of stereopsis, as manifested by the impact on stereo perception and fine work ability.
5. reduced contrast sensitivity: reduced contrast sensitivity in amblyopia, especially poor contrast sensitivity to fine targets (high spatial frequency).
6. abnormal adjustment function: the adjustment ability of the amblyopic eye is lower than that of the normal eye.
Amblyopia examination methods.
1 . Visual acuity examination: including naked eye visual acuity and best corrected visual acuity; sometimes it is also necessary to check the visual acuity of individual visual standards and the visual acuity examination of rows of visual standards to clarify whether there is crowding.
2 .Refractive examination: amblyopic patients all need a full refractive examination, including post-ciliary muscle paralysis optometry (commonly known as dilated optometry), which is an important basis for the diagnosis and treatment of amblyopia.
3, complete eye examination: to clarify eye pathology and exclude any other disorders affecting vision.
4, fundus gaze nature examination: clarify the amblyopic eye gaze area.
5, strabismus degree examination: patients with strabismus need to be examined for strabismus degree and strabismus situation.
6, binocular visual function examination: to clarify the status of binocular visual function and to assess the prognosis of amblyopia.
7, some laboratory tests: such as ERG, VEP; some patients may need orbital and cranial imaging to exclude other disorders.
Treatment of amblyopia.
The treatment effect of amblyopia has a significant time limit. Amblyopia treatment is more effective during the sensitive period of visual development; while beyond the sensitive age, the treatment is difficult and ineffective. Therefore, amblyopia treatment should be carried out as early as possible, and the earlier you start treatment, the better the effect and the shorter the recovery time.
1, first correct the cause of amblyopia, such as wearing appropriate glasses to correct high farsightedness or myopia, so that the retina imaging clear, so as to promote the continuous development of visual function; for congenital cataracts, corneal white spots, severe ptosis and other organic pathologies, it is necessary to first surgically treat the original disease, so that the eye to restore transparency to facilitate clear retinal imaging, and then further treatment of amblyopia.
2, monocular masking: For monocular amblyopia, it is necessary to cover the healthy eye to promote the development of visual function in the amblyopic eye on the basis of appropriate refractive correction glasses. The specific duration of masking will be considered by the doctor according to the child’s age, the degree of amblyopia, the cooperation of treatment, and the impact of masking on life.
3, some children do not accept the masking treatment, can consider the use of suppression film (wear can play a masking effect, but the appearance is not like the blindfold conspicuous special optical film) or eye drops (dilating medicine) to achieve similar masking treatment effect.
4 .Visual function training, etc.: On the basis of the above treatment, some patients may receive some amblyopic visual training apparatus and instruments according to the situation, such as training with amblyopic training instruments, or tracing, stringing small beads or even computer games, etc., which can speed up the treatment progress and shorten the course of treatment to a certain extent.
5 . Binocular visual function training: Binocular visual function training can promote amblyopia treatment and recovery, and also improve the level of visual function after amblyopia treatment.