Amblyopia - what is it? Amblyopia in children: degrees and treatment

According to the latest statistics, amblyopia was detected in 2% of adults in our country, but among children the situation is somewhat different, which is confirmed by frequent calls to eye clinics or specialized medical institutions. According to experts, the overwhelming majority of young parents do not know what amblyopia is in children, and are not aware of not only its symptoms, but also of the possible consequences. Therefore, today's article is devoted to the answer to this question.

What is amblyopia

This pathology, which is called the "lazy" eye, is characterized by a reversible decrease in vision on one or less of both eyes. This is due to various functional disorders, such as strabismus, pathologies of the bottom of the eye, clouding of the lens. Because of this, the transmission and perception of an adequate image is disrupted. As a result, a person sees two completely different pictures instead of one volume, so that the work of one eye begins to be suppressed and deteriorates over time. As you know, if a person has at least one organ that does not work, he will atrophy eventually. Thus, the faster the treatment begins, the greater the chances for a complete recovery of the child. But about this in order.

Types of amblyopia

When asked about amblyopia - what is it, it should be said that this disease can be confused with other pathologies, which also lead to a decrease in visual acuity. Therefore, in order to avoid such an error, consider the types of amblyopia.

There are primary and secondary forms. To primary carry:

1. Refractive amblyopia, which appears in children with untimely correction of ametropia. Allocate one-sided, two-sided, symmetrical and asymmetric.
2. Disbinocular amblyopia. As you can already guess, at the heart of such a pathology is a disorder of binocular vision, which is provoked by strabismus and the lack of timely treatment. As practice shows, this pathology is more clearly manifested on the eye that mows.
3. Mixed amblyopia, which is expressed both in manifestations of refractive and disbinocular forms.
4. Hysterical amblyopia. The lowering of the vision in this case occurs when the central nervous system is disturbed. The most common cause is psychological trauma.

About secondary amblyopia should be aware that the cause of this disease can serve as a pathology of the visual organ, which was successfully eliminated. But because of this and could fall a vision.

It includes:

1. Obscuration amblyopia, which appeared due to the pathology of the visual organ, which prevents the appearance of a picture on the retina. Among the most common manifestations are congenital or acquired cataracts. The obscurant form can manifest itself in one or both eyes.
2. Neurogenic amblyopia. The cause may be optic nerve disease. Cases of complete cure are fixed for today. It should be noted that the treatment of such a pathology begins after surgery.
3. Maculopathic. It develops after the transferred diseases of the central and paracentral zones of the retina.
4. Nystagmic amblyopia. Called when the time span of the picture is reduced in the central zone of the retina.
5. Combined amblyopia. Is manifested by a combination of the above forms.

Strabismus with amblyopia

But with all the variety of causes leading to amblyopia, the strabism prevails among them all the same. As is known, normally the muscles of the eye move simultaneously, thus ensuring the normal operation of the organ. But if there is a malfunction in the work of at least one muscle, there appears a problem with the control of movement, that is, the strabismus develops, after which the amblyopia of the eye arises. So, we can state the fact that strabismus and amblyopia are two sides of the same coin.

Of the most common causes that lead to a weakening of the muscle, distinguish:

1. Farsightedness.
2. Disorders in the psyche.
3. Damage to the eye.

Symptomatics

The most common symptoms of this disease include:

1. Reducing visual acuity in one or both eyes.
2. Frequent dizziness associated with poor perception of voluminous objects.
3. Difficulties during training.
4. The deviation of the eye in the opposite direction from the direction of sight.

Diagnostics

As mentioned above, the answer to the question of whether amblyopia - what it is, and this article will be devoted to. Therefore, we turn to the story of the diagnosis of this disease. So, children do this by different methods.

Vision

As a rule, at each age the child has a kind of bar of visual acuity. But the task of an optometrist should be to determine the greatest visual acuity without correction and with correction. The features of the conductivity of visionimetry in children include:

1. Clarification before the examination, whether the child knows the pictures that are shown on the table.
2. Conduct a survey with constant praises of the child, if it answers correctly.
3. If a low visual acuity is detected, it is recommended to repeat the examination in a few days, and it is necessary to start with the eyes that showed the worst result.

An important point of the survey is careful monitoring of the child in order to keep him from possible squinting.

Refractometry

She is able to show if there is amblyopia in children or not. There is such a survey using a refractometer or keratofractometer. An important role in the diagnosis is the correct placement of the child behind the device. It should be borne in mind that the primary indicators of the device may be slightly different from the following, therefore it is recommended to conduct repeated diagnostics several times to confirm the diagnosis of "amblyopia of the eye".

Degrees

To date, doctors have distinguished the following degrees of amblyopia:

1. Very low degree - visual acuity 0.8-0.9.
2. Low - 0.5-0.7.
3. Amblyopia of medium degree - 0,3-0,4.
4. High - 0.05-0.2.
5. Very high - visual acuity below 0.05.

Amblyopia of high degree is usually accompanied by impaired binocular vision.

Amblyopia in children: treatment

With the diagnosis of amblyopia, treatment can be both conservative and operational.

Important! The index of visual acuity after surgery is affected by the degree of amblyopia.

So, what if the amblyopia is diagnosed in children? Treatment, as a rule, begins with occlusion, optical correction, penalization and visual therapy.

Optical correction

When diagnosing a child for amblyopia, which is accompanied by ametropia, one of the conditions for successful treatment is the appointment of a constant wearing glasses or lenses. Particular attention in the presence of high degrees of ametropia should be given to the choice of high quality lenses, preferably with aspheric design, as these lenses have an extremely effective zone of optics, which is important in the treatment of amblyopia.

Application of occlusion

The use of occlusion is by far the standard in the world of medicine. Occlusion happens:

1. Straight (when the normally seated eye closes).
2. Reverse (when the eye closes, whose visual acuity is less).
3. Alternating (alternating eye closure).

By periodicity it happens:

1. Constant.
2. Partial.
3. The minimum.

The principle of this method is to enhance the functionality of a poorly seeing eye with the exception of the healthy eye. As practice shows, the effectiveness of this method in children under 6 years is much lower than that of the older ones. This is due to some difficulties, related more to the psychological factor.

An important element for successful treatment is the correction of eccentric fixation.

But it will be correct to mention and about some negative aspects, which can entail the method of occlusion. They include:

1. Lowering the level of vision on a healthy eye. This happens, as a rule, because of negligent attitude from both parents and doctors.
2. Development or intensification of strabismus.
3. Diplopia (doubling of objects).
4. Problems with the skin.
5. Various allergic reactions.

It is especially worth noting that one of the main reasons for the failure in treatment by occlusion is the disinterest of the children themselves in the prolonged wearing of the bandage.

Penalization

Penalization is the method of treating this disease, which creates artificial anisometropia using various combinations of optical correction and joint (according to the doctor's prescription) application of atropine for the eye, at which the percentage of vision is higher. The principle of atropine is to create fuzziness in a healthy eye after instillation, which causes the eye to become more active. This method, unlike occlusion, is more suitable for children and is much more effective.

But do not forget that he also has negative points. They include:

1. The appearance of redness on the skin.
2. Irritation in the eye.
3. Frequent headaches.
4. Intensive therapy of vision.

This technique is used for intolerance of occlusion. It combines methods aimed at restoring or improving the fixation and movement of the eyeball, perception in space, accommodation of vision. To this end, special adaptations can be used, for example synoptophor. One of the advantages of this method is a significant reduction in the treatment period with sufficiently high rates of visual acuity.

Treatment of amblyopia and strabismus

As mentioned earlier, the treatment of amblyopia can begin only after the elimination of its causes. And if amblyopia develops against the background of strabismus, then first of all we eliminate it. For today, there are several options for treating this pathology. These are operational and therapeutic methods:

1. Pleoptika. Treatment consists in strengthening the load on the eye, which mows. To achieve this effect, use both a special laser and programs for the PC.
2. Orthoptics. In this case, synoptic devices and PC programs are used to restore vision and eliminate strabismus.
3. Diplomacy. Restoration of vision at home.
4. Special exercises are used to improve the muscles of the eye.

It is important to realize the fact that strabismus will not pass with age, as some people mistakenly believe. In addition, if it can not be cured in time, it can lead to very sad consequences. Remember that the maximum age when treatment of strabismus gives the best effect is 25 years.

Home Treatment

The insidiousness of this disease lies in the fact that with insufficient zeal during his treatment, relapses are possible. Therefore, it is especially important to show perseverance to parents, since often a child who has amblyopia is diagnosed does not understand what it means to see well, because his level of vision seems to him the norm. Therefore, it is necessary to combine procedures in medical institutions and treatment of amblyopia at home. After all, only the joint work of the whole family can bring such a desired and long-awaited result, like good eyesight. A help in this special program for the treatment of amblyopia at home. Although each program is selected by the doctor individually, but there are several exercises that are suitable for everyone.

Exercise with an electric lamp

To do this, take a thick black sheet of paper and a bulb with a power of up to 80 V. Next, cut out a circle of paper with a diameter of 8 mm and glue it on a light bulb. After that, the child should close the eye, which sees better, and for 30 seconds look at the light bulb, and then on a clean white sheet of paper, pre-glued to the wall. Watch it until the image of the light bulb on paper appears. Exercise should be repeated for 1-2 months several times a day.

Exercise with text

We close the child with a well-seeing eye patch. We take in hand a pre-prepared text with a small font and bring it to the second eye to the maximum permissible distance at which the child can read it. After this, we begin very slowly to move the text down until it becomes difficult to read. We repeat this exercise several times.

Exercise with a larger lamp

We choose a lamp with a larger capacity and a dense black sheet of paper. Cut out the cap with a hole (diameter 6 mm) in the middle and put it on the lamp. After that, close the hole with a red film. We put the lamp at a distance of at least 40 cm from the child and turn it on. The task of the child is to look at the lamp for 3 minutes without distraction, and parents should turn the lamp on and off every 3 seconds.

Using the flash

To do this, you need a camera with a flash and a piece of paper on which you can draw images or letters. The procedure is as follows: a flare (at a distance of at least 50 cm) is brought to the eye level of the child and a series of flashes (up to 10) is performed. After each of them, the child should look at a sheet of paper and try to make out what is written there (a sheet of paper placed within a meter or two). The recommended number of lessons per day is up to 3 times, the total duration is up to 2 months.

Not bad is a small manual work or games, where accuracy is required.

A few tips

In order not to have to find an answer to the question of whether amblyopia - what it is, it is necessary to adhere to the following rules:

1. Perform periodic preventive examinations with an ophthalmologist.
2. If a child has even the slightest hint of strabismus, at least confirm or deny this diagnosis by performing the necessary studies in an ophthalmic clinic or a specialized medical institution.
3. Do not provoke the development of strabismus by placing toys or bright objects near it.
4. Provide the child with adequate nutrition and avoid stressful situations.
5. Constantly engage in its self-development.
6. At the first appearance of problems with eyesight, immediately consult a specialist.

As practice shows, the prognosis with amblyopia is favorable with timely started treatment, but the following is important here:

1. The strictest observance and implementation of all the recommendations of the attending physician.
2. Type of amblyopia.
3. The location of the eye.
4. Initial visual acuity.
5. Age category of the patient.
6. Method of treatment.

The main thing is to remember that if you set a goal and go to it, then nothing is impossible in the world. But it should be noted that an untreated patient may face a complete loss of vision in the future. Therefore, it is recommended to prevent the development of this disease, to know in advance the answer to the question: "Amblyopia - what is it?"