The hazards of amblyopia in children are as follows.
1. Visual function damage. Amblyopic children who are not detected and treated early will suffer from low vision in one or both eyes, which will seriously affect their visual function.
2. The greatest danger of amblyopia is the inability to form stereoscopic vision. Children with amblyopia are bound to grow up with poor stereoscopic geometry, and cannot choose professions such as architecture, engineering, medicine, mechanics, and artwork.
3, no stereoscopic imagination. Because the brain can only get the visual signal input from the unilateral healthy eye, the brain can not form a three-dimensional image, which will lead to patients without stereo imagination.
4. Amblyopia can also cause strabismus, which affects aesthetics and physical and mental health. Children with amblyopia often have low self-esteem and autism.
Therefore amblyopic eyes will affect life, learning and work for a lifetime for patients. In their eyes, stereo vision is blurred, and thus they cannot accurately judge the orientation and distance of objects. Daily activities such as driving a car have to be greatly affected.
There are many treatment methods for amblyopia, which must be selected correspondingly under the guidance of a specialist. The key to amblyopia treatment is accurate optometry, and children also need dilated pupils and appropriate glasses, based on which the most appropriate treatment method is chosen according to the nature of the amblyopia and the patient’s specific situation. The treatment course for children with amblyopia is long and expensive, so it is most convenient and economical to give preference to home treatment, which can reduce the burden of parents and also adhere to the treatment. There are many home treatment devices and methods, which can be applied under the guidance of an ophthalmologist.
1.Firstly, dilate the pupil to examine the light, then wear suitable glasses
2, to the dominant eye masking therapy: is the treatment of children’s amblyopia is one of the simplest, most economical and most effective methods.
Strictly monocular masking method: Applicable to children with refractive amblyopia and strabismic amblyopia. These children often have good vision in one eye and poor vision in the other eye due to deep inhibition. The method is to cover the better eye with an eye patch and force the amblyopic eye to look at things so that it is stimulated and exercised, gradually removing the inhibition and improving vision. For children with amblyopia under 3 years old, the mask can be released for 1 day after 3 days of continuous coverage, and for children over 3 years old, the mask can be released for 1 day after 3 to 5 days of continuous coverage. During the treatment process, the change of visual acuity in the amblyopic eye should be checked, and the visual acuity should be rechecked every half month, while the visual acuity of the healthy eye should be paid attention to prevent the occurrence of vision loss caused by masking.
Bilateral alternate masking method.
It is suitable for refractive amblyopia and monocular strabismic amblyopia. If the amblyopic binocular vision is equal, alternate masking with equal amounts of both eyes can be used, the left and right eyes are covered for 3 days; if there are differences in binocular vision, the method of 4:l or 5:1 can be used according to the specific situation, that is, the eye with better vision is covered for 4 days, and then the eye with poorer vision is covered for 1 day, so that the eye with poorer vision can see more to exercise and promote faster vision improvement, in order to achieve a balanced rise in binocular vision The semi-coverage method: This method is suitable for amblyopia.
Semi-covering method: Applicable to children with amblyopic eyes whose visual acuity has risen above 0.7. The use of translucent plastic film to cover the healthy eye artificially causes the vision of the healthy eye to be lower than that of the amblyopic eye, so that the amblyopic eye has more opportunities to see, which is conducive to the establishment and perfection of binocular vision function.
Short covering method: Applicable to the amblyopic eye whose visual acuity has returned to normal but is still lower than the amblyopic eye, in order to consolidate the effect, the amblyopic eye can be covered when doing homework or reading books, but usually not covered.
3, repression therapy: the principle of repression therapy is the use of changing the degree of the lens and drugs to dilate the pupil and suppress the vision of the good eye, forced to use the amblyopic eye, in order to promote the recovery of visual function. The theory is based on the fact that when using one eye to see near, the other to see far, because they are using a single eye, so do not need to produce two eyes to compensate for changes in visual function. If the refractive aberration of the two eyes is artificially caused, it is possible to prevent the formation of amblyopia and abnormal retinal correspondence.
4, amblyopia training: according to the different types of amblyopia, the nature of different gaze and stereo vision have different training methods.
For central gaze.
(1) Fine vision training: It is a special application exercise for amblyopic eyes, which is beneficial for visual development and improving visual acuity. There are many methods of fine vision training, which should be chosen according to the age, intelligence and visual acuity of the amblyopic child, and the training methods can be changed frequently, e.g., using red silk thread to thread a sewing needle, the size of which can be decided according to the visual acuity. You can also string beads, practice embroidery, tracing, painting, calligraphy, etc. Fine vision training must be done with the amblyopic eye, once a day for 10 to 15 minutes. Fine visual acuity training is an important part of successful amblyopia treatment for children, so parents should pay attention to this easy-to-use training and keep it up.
(2) Visual grating stimulation therapy: It is a visual stimulator based on the physiological principle that a series of grating with strong contrast and different spatial frequencies can fully activate all neurons in the visual area cortex during rotation. When the grids are rotated, they produce square waves with different spatial frequencies (low frequency for the model stripe and high frequency for the narrow stripe) to stimulate the amblyopic eye and improve visual acuity. After covering the healthy eye, the child paints pictures on a transparent plate for 7 to 10 minutes each time, 2 to 4 times a week, 10 times a course. This method is effective for central gaze amblyopia and less effective for paracentral gaze. This method is simple and easy to use, with short treatment time and quick results, and is especially suitable for refractive amblyopia.
Amblyopia treatment instrument: such as pulsed red light therapy, suitable for all kinds of amblyopic children, 3 times a day, 15 minutes each time, 3 months as a course of treatment.
1, after image therapy: we all have this experience, in the strong light with eyes to look at an object for dozens of seconds, close your eyes also feel the object image in front of your eyes, this image is medically called after image. The afterimage therapy is to use the strong light stimulation of the afterimage mirror (generally irradiated for 10 seconds to 1 minute) to produce afterimage in the retina around the macula, so that the paracentral gaze point receives inhibition, and then training to improve the visual function of the macula central recess, playing a role in the treatment of amblyopia. This therapy is only applicable to paracentral gaze amblyopia. The main disadvantage is that the treatment course is long and each treatment time is long.
2, red filter method: This is based on the principle that the cone cells are sensitive to red light while the rod cells are not sensitive to red light, cover the healthy eye and add a red filter film (red light shorter than 640nm cannot pass) on the amblyopic corrective lens, so that the amblyopic eye spontaneously changes from paracentral gaze to macular central gaze.
3, Hedin format light brush training: light brush can selectively excite the macular area cone cells, so that the paracentral gaze into central gaze; light brush width and constantly changing direction of light shadow, but also can excite the visual center cells, can also indirectly improve visual acuity.
Combination therapy.
Since the mechanisms of various treatments are not identical, comprehensive therapy is superior to single therapy. In children with one-eyed amblyopia, the first step is to routinely cover the healthy eye and give the amblyopic eye more gaze exercises, together with fine visual training and pulsed red light stimulation. After several months of treatment, if the visual acuity of the amblyopic eye improves, the child can go to the hospital for further treatment (e.g., the visual acuity rises to 0.6 when fusion training is available with the same vision machine).
Those who do not have tertiary visual function can use the same vision machine for simultaneous vision, fusion and stereo vision training respectively. After the treatment of amblyopia, the visual acuity returns to normal, and most parents think that there is no need for further treatment, which is wrong. The restoration of normal visual acuity in the amblyopic eye is only the first step in the treatment, and later on it is necessary to train monocular, fusion and stereopsis functions in both eyes. Since the mechanisms of various treatments are not identical, comprehensive therapy is superior to single therapy. In children with amblyopia in one eye, the first step is to routinely cover the healthy eye and give the amblyopic eye more gaze exercises, together with fine vision training and pulsed red light stimulation. After several months of treatment, if the visual acuity of the amblyopic eye improves, for example, when the visual acuity rises to 0.6, fusion and stereopsis training can be performed with the same vision machine.
The duration of each of these exercises is 10 to 30 minutes twice a day. Each training should be done step by step from easy to difficult, and the child should be given psychological and behavioral interventions, encouragement or rewards, and punishment if necessary, so that the amblyopia training can be maintained. Regular review at the hospital should also be done to change glasses or change the treatment plan in time.
The aims of amblyopia treatment are to
Improve visual acuity and establish binocular monovision and stereo vision. In conclusion, there are many methods of amblyopia treatment, each of which has certain efficacy and has its own advantages and disadvantages, and there is not yet a perfect and ideal method that works for all types of amblyopia. Treatment methods can be selected according to the nature of amblyopia, the degree of amblyopia, the age of the child, the type of strabismus, and the refractive status. The younger the amblyopia is treated, the better, preferably before the age of 3 to 5 years.
Prevention of amblyopia.
1. Avoid behaviors that can cause amblyopia, such as prolonged eye coverage during infancy.
2. timely treatment of diseases that can cause amblyopia, such as strabismus, refractive error, refractive aberration, congenital cataract, eyelid hemangioma, etc.
3, for infants and young children who cannot cooperate with the vision check, a masking test can be done to understand the vision of both eyes: intentionally cover one eye and let the child see with one eye, if it is quiet but the other eye is crying and restless or tearing the mask, it indicates that the vision of the uncovered eye is very poor, so go to the hospital for examination as soon as possible.
4. Regular vision tests after the age of two. Early detection of the first signs of abnormalities. Children with amblyopia often have other manifestations besides low vision, such as strabismus, head tilting, squinting or sticking very close to the eyes, etc. Once a child is found to have strabismus, he or she should be examined and diagnosed by a hospital ophthalmologist as soon as possible because about 1/2 of all strabismus is combined with amblyopia. Other abnormalities mentioned above should also be taken seriously and noticed, and should be checked by the hospital ophthalmology department to see if they are caused by eye disorders.
In conclusion, early detection of amblyopia depends on the close cooperation of parents, kindergartens, schools, hospitals, and most importantly, parents themselves who spend time with their children.