How can different types of amblyopia be prevented and treated?

  I. Amblyopia treatment (a) Treatment of central gaze amblyopia 1. Conventional masking therapy: The masking method mainly covers one eye with better visual acuity, i.e. the dominant eye. When using masking therapy, the time required for amblyopia treatment varies from person to person, the younger the age, the shorter the time required. The treatment should be reviewed periodically during the course of treatment, because inappropriate masking of the dominant eye in the treatment of amblyopia in infants and children can lead to masking amblyopia in the dominant eye. Therefore, when performing masking therapy on young children, they should be closely observed and the interval between follow-up visits should not exceed 2 weeks. Li Hua, Ophthalmology Department, Yongchuan Hospital, Chongqing Medical University 2. Suppression therapy: The principle is to use overcorrected or undercorrected lenses and daily atropine drops to suppress the function of the dominant eye, while the amblyopic eye wears normal corrected lenses for distance or overcorrected lenses for near vision. The advantage of suppression therapy is that it is not necessary to cover the eye, which is easily accepted by the child and parents, and can prevent masking amblyopia, but the disadvantage is that it is only suitable for moderate amblyopia, and the course of treatment is long and expensive.  3, visual stimulation therapy: the basic principle is to use the contrast, spatial frequency of different bars as a stimulation source to stimulate the amblyopic eye to improve visual acuity. This therapy is simple, short course of treatment, easy for children and parents to accept and cooperate.  (B) Treatment of paracentral gaze amblyopia 1. Posterior image therapy: also known as vision enhancement therapy. This method is suitable for slightly older children who can pay attention and cooperate with the treatment, and for paracentral gaze amblyopia that is ineffective with other treatments.  2.Red filter method: The treatment method is to cover the healthy eye normally and add a red filter with certain specifications to the amblyopic eye correction lens, so that the paracentral gaze is changed to central gaze spontaneously.  3. Conventional masking therapy.  (c) Binocular monovision training: When both eyes look at an object at the same time, the visual process of perceiving a single object is called binocular monovision. For the evaluation of complete visual function, not only good visual acuity, but also sound binocular monovision is required. Commonly used methods of binocular visual function training include the simultaneous vision machine method, home visual function training, etc.  (iv) Comprehensive therapy: Comprehensive therapy can be used in a variety of different amblyopia treatment methods in order to shorten the course of treatment. For central gaze amblyopia, while wearing corrective glasses, cover the healthy eye and cooperate with visual stimulation therapy and fine work. If the paracentral gaze amblyopia cannot change the nature of gaze after 3 months of the above treatment, the amblyopic eye can be treated with posterior image, red filter and other therapies while covering the healthy eye, and suppression therapy of the healthy eye, monocular function training of both eyes and eye position correction can be considered when the visual acuity is improved.  (E) Multimedia training: multimedia training methods are set up according to different situations, with a variety of training functions and training levels, and training parameters can be adjusted according to the specific situation of the trainer, with a wide range of application, strong interactivity, simple operation, easy to use, and a relaxed and lively training process. This method can train amblyopic patients with different items such as visual stimulation, visual refinement, simultaneous function, fusion function, and stereo vision. Nowadays, multimedia training method has been widely used in clinical practice and can effectively improve amblyopia visual acuity and improve binocular vision function.  The efficacy of amblyopia and the factors affecting it have been shown that the overall cure rate of amblyopia can reach 73.72%. In the younger age group (3~5 years old), the rate was as high as 84%~86%, and 81.07% obtained stereopsis. However, there are many factors that affect the outcome of amblyopia. Clinical data show that the type of amblyopia, original visual acuity, type and degree of strabismus, age at first diagnosis, and nature of gaze all affect the prognosis of amblyopia.  Relapse of amblyopia Before the development of vision is mature, every cured patient may have a relapse. Therefore, each cured amblyopic child should be followed up and observed, once a month for the first 6 months, and once every 6 months until 3 years.  Prevention of amblyopia Regular visual examination of children plays an important role in the prevention of amblyopia. The timely detection and correction of refractive error, refractive aberration, strabismus and removal of visual deprivation factors within the critical period of visual development (before 3 years old) and sensitive period (6~8 years old) is the fundamental way to prevent the occurrence of amblyopia.