What are the categories of amblyopia?
Amblyopia can be classified according to its cause: strabismic amblyopia; refractive amblyopia; form deprivation amblyopia; refractive error amblyopia and congenital amblyopia.
What are the practical methods to treat amblyopia?
The main methods of treatment for amblyopia are.
1.Optical correction.
2.masking therapy.
3.Suppression therapy.
4.Adjunctive treatment methods: visual stimulation therapy (CAM), red filter therapy, Hedinger endoscopic brush, posterior image therapy, fine eye work, etc.
Why should I wear glasses in the first place to treat amblyopia?
An important cause of amblyopia is refractive error, such as hyperopia, astigmatism and refractive aberration. Wearing proper glasses can focus the light on the macular central hollow, so as to correct vision and treat amblyopia, which is the basis and key of treating amblyopia.
What is masking therapy and how to mask it?
As the name implies, masking therapy is to block one eye so that it cannot see normally. Refractive parity or two lines of difference in corrected visual acuity in both eyes requires masking of the relatively good eye. The amblyopic eye is forced to look at things so that it is stimulated and exercised, gradually removing the inhibition and making the vision improve.
According to the length of daily masking time, masking therapy can be divided into all-day masking and part-time masking, generally daily masking time accounting for 70%-100% of non-sleeping time (10-14 hours) is called all-day masking, masking time less than 70% is called part-time masking, and part-time masking is at least 2 hours of masking per day. The choice of masking time mainly refers to the patient’s age and the difference between the two eyes’ visual acuity, the older the age and the more the difference between the two eyes’ visual acuity, the longer the masking time, and vice versa, the shorter the masking time.
Infants and young children are more sensitive to masking, so partial masking is often used. When starting masking, you can start with a small amount and observe the efficacy at regular outpatient visits and adjust the masking time at any time.
For children over 3 years old, the most commonly used coverage is all-day coverage, the tighter the coverage the better, but the duration of daily coverage varies from person to person.
As they grow older, school-age children need to be covered for a longer period of time each day. If there is a huge difference in the visual acuity of the two eyes, they need to be covered for the whole day, and if there is a difference of 4-5 lines, they can also be covered for part of the day.
How often should I be seen again after the masking treatment?
Usually the follow-up time can be extended as age increases.
When should I stop masking treatment?
Masking should be discontinued in the following cases.
1. When the visual acuity of both eyes is equal or similar (the difference in visual acuity between the two eyes does not exceed 2 lines), stop the masking or gradually reduce the daily masking time to consolidate the treatment effect.
2. When the two eyes can alternate freely, it indicates that the visual acuity of the amblyopic eye has recovered to the level of the dominant eye. Stop masking or gradually reduce the daily masking time to consolidate the treatment effect.
3.Patients with good compliance can stop covering the amblyopic eye without any improvement in the visual acuity of the dominant eye after 3-6 months of continuous covering.
4.After masking, the gaze dominance of the two eyes is reversed, the masking should be stopped.
What is fine eye work training?
Fine visual work, also known as close visual activity or homework. It is a form stimulus, and the stimulus pattern includes stripes with different directions and spatial frequency levels. Stringing beads, threading needles, drawing children’s sketches, embroidery, paper cutting, computer games, reading, and puzzles are also considered fine visual work.
What is Hedinger Endoscopic Brush Therapy?
Hedinger endoscopic brush therapy uses special optical principles and retinal endoscopic phenomena to produce a light brush that stimulates the central macular sulcus and improves the nature of gaze.
What is red filter therapy?
It takes advantage of the sensitivity of the visual cone cells to red light to selectively stimulate the function of the macula and improve the function of the central recess to improve the nature of gaze. The application of this method is very narrow, only applicable to relatively heavy amblyopia and a few patients with moderate or mild amblyopia. After the transformation of the nature of gaze, masking therapy is preferred.
What is posterior image enhancement therapy?
The application of a strong light stimulates the paracentral gaze point to produce a posterior image and put it in a state of inhibition, while training the visual function of the central sulcus.
What is visual stimulation therapy (CMA)?
The cellular system in the macular sulcus is more sensitive to gratings with different directions, high spatial frequencies and high contrast. the CMA visual stimulator consists of black and white, square wave bar grids with different spatial frequencies, which constantly rotate and change direction so that the retina in each meridian of the macular sulcus can receive stimulation.
When is the best time to treat amblyopia?
Many parents think that amblyopia should be treated after school, when the child understands what is going on and it is easy to cooperate with the treatment. This is actually wrong. Since the critical period for children’s visual development is 0-3 years old, the sensitive period is 0-12 years old, and binocular visual development matures at 6-8 years old. Therefore, the effect of amblyopia treatment is best before the age of 6, and the efficacy is very poor beyond the age of 12. During the critical period of children’s visual development, their plasticity is the greatest, and through correction and timely treatment, most amblyopia can be completely cured. The earlier the detection and treatment, the better the outcome.