Amblyopia is a common cause of low vision in children. With early detection and early treatment, amblyopia can be cured in many patients. The goal of treatment: the visual acuity of the amblyopic eye reaches normal; the visual function of both eyes and other visual functions reach normal.
1. Correction of refractive error
Farsightedness, myopia and astigmatism are collectively referred to as refractive errors, which means that they cause external objects not to be clearly imaged on the retina and need to be corrected with lenses. Refractive error is generally caused by the development of the eye, so it can only be corrected by prescription lenses, not treatment. The developmental pattern of refractive errors is that farsightedness gradually decreases and stabilizes after the age of 9, astigmatism may fluctuate but generally does not change much, and myopia gradually increases until the age of 18 or even in the 20s.
Since amblyopia is closely related to refractive error, correction of refractive error, i.e., glasses, is the basis of amblyopia treatment, combined with masking or suppression therapy on top of that. If there is no further improvement in vision after a period of time with glasses, then consider adding other treatments.
2.Masking therapy
This is the standard treatment for amblyopia. There are various types, and their treatment strategies vary from person to person. If masking therapy is effective, it should be continued. If there is no improvement in visual acuity for 5-6 consecutive weeks, only then consider adding the use of other therapeutic measures.
Side effects: possible occurrence of deprivation amblyopia; disruption of visual function in both eyes; occurrence of strabismus.
Due to the side effects of masking therapy, masking therapy should only be used in cases of monocular amblyopia or large differences in visual acuity between the two eyes, and alternate masking of both eyes should be avoided and monitored under the guidance of a physician.
3.Suppression therapy
As an alternative to masking therapy, it may be less effective than masking therapy, but may be easily accepted by the child. The following methods are available.
Film suppression: by applying a certain amount of resin film to make the non-amblyopic eye visual acuity decrease and be at least two lines lower than the amblyopic eye.
Pharmacological repression: The use of atropine paralyzes the regulation of the contralateral eye, blurring its near imaging and forcing the child to use the amblyopic eye.
Optical suppression: Wearing certain lenses to blur the non-amblyopic vision.
4. Perceptual learning
Perceptual learning refers to training to improve the ability to perform specific perceptual tasks. Training the amblyopic eye on the basis of masking the contralateral eye may shorten the duration of treatment. Perceptual learning can significantly improve the visual function of amblyopic patients.
5.Medication
The medications currently used for amblyopia treatment are: levodopa, carbidopa, and cytidine diphosphate choline. Medication is a complement to the previous treatments, especially for older children with amblyopia or refractory amblyopia. They are not effective alone.
6. Timing of surgery for strabismus with amblyopia
(1) Short-term recovery of visual acuity to normal.
(2) Visual acuity improvement into the plateau period.
(3) The difference in visual acuity between the two eyes is less than twice.
(4) Longer amblyopia treatment is ineffective.
7.Binocular vision training
Binocular vision function is an important function that human beings depend on for life, learning and work. Especially nowadays, driving has become a basic means of life, and enjoying 3D movies and TV has become an important way of life. Without binocular vision function is completely impossible. When amblyopia treatment vision improves to a certain level or normal, binocular vision function training should be performed. Normal binocular visual function also helps to prevent the recurrence of amblyopia.
8. Nutrition
Since no relationship between nutritional deficiencies and amblyopia has been found, supplementation or the use of other nutritional supplements will not help in the treatment of amblyopia. If the child is malnourished due to a systemic disease, the child should be under the guidance of a pediatrician.
9. Other
There is no evidence that any eye drops, herbs, acupuncture, or massage are effective for amblyopia. Nor is there any scientific evidence that these methods can treat myopia, hyperopia, and astigmatism. Relying on these methods of treatment without glasses to correct refractive errors will only delay the treatment of amblyopia in children.