home Auditorium 7 Treatment of lazy eye syndrome in children and adults. Amblyopia in adults: treatment, diagnosis, symptoms What happens if amblyopia is not treated

Treatment of lazy eye syndrome in children and adults. Amblyopia in adults: treatment, diagnosis, symptoms What happens if amblyopia is not treated

Amblyopia (lazy eye syndrome) is an ophthalmological disease associated with impaired binocular vision function.

With this disease, one of the two organs is practically not involved in the visual process.

It turns out that different images appear before the eyes, but the brain is not able to combine them into a single whole. That's why the work of one eye is suppressed. In each individual case, the ophthalmologist prescribes individual treatment for the patient.

Symptoms of amblyopia in an adult

It is almost impossible to determine the presence of pathology in the initial stages on your own. But you should not ignore these symptoms:

Persistent double vision. People with strabismus are susceptible to this as a result of the inability of the optic nerve to connect two different pictures at once.
Visual impairment, which cannot be corrected with lenses or glasses.
Constant a veil before the eyes.
Blurry outlines of objects. The type of deviation in which this syndrome is diagnosed in adults is uncommon and is called “refractive amblyopia.”
Sudden loss of vision literally in a few months, days, and sometimes hours.
Problems with orientation in free space, feeling distracted and clumsy.
Inability to withstand any visual load. As a rule, the affected organ looks away and reflexively closes.
Rapid eye fatigue after visual stress.
Reaction to stress and other emotional stress, as a result of which bilateral damage to peripheral or central vision develops, lasting from several hours to several days.

Important! Having discovered at least one of the listed signs of amblyopia, you should visit an ophthalmologist, since the disease can occur in a latent form, but at the same time progress rapidly, thereby worsening the general condition of the patient.

Causes and main forms of the disease

Depending on the reasons that provoked the development of the disease, Amblyopia can be of the following types:

Dysbinocular. The cause of this pathology is strabismus. In cases where the first eye is severely affected, the brain can exclude it from work, transferring the entire load to the second organ. The reverse process is sometimes possible, when strabismus is a consequence of this type of pathology.

Photo 1. Dysbinocular amblyopia in an adult. One eye is strongly slanted towards the bridge of the nose.

Refractive. The disease occurs due to refractive errors. In cases where nearsightedness, farsightedness or astigmatism were not diagnosed in time and the patient did not use corrective lenses or glasses, this can lead to the development of “lazy eye” syndrome.
Deprivation(other name "obscuration"). Characterized by the presence of an obstruction in one eye that prevents the passage of light. The provocateurs of the disease are cataracts, cataracts, disruption of the eye muscles, causing a narrowing of the pupil size and a descent of the upper eyelid.
Anisimetropic. The main factor in the occurrence of this form of the disease is the refractive power of the eyes, which makes up more than 3 diopters.
Psychogenic. The main signs are mental disorders such as hysteria or neuroses. This is the only form in which, after appropriate treatment, the patient's vision can be restored. But usually it is accompanied by other diseases, for example, increased sensitivity to light, narrowing of picture fields and distortion of color perception.

Reference. Amblyopia occurs in both humans with a genetic predisposition, and in patients never faced such a problem.

Medical diagnosis

To make a correct diagnosis, it is necessary to undergo full examination by an ophthalmologist.

On primary During the examination, the doctor determines the relative position of the eyeballs, analyzes light sensitivity, and assesses the general condition of the eyelids and palpebral fissure.

visometry, visual acuity testing;
testing color fields;
perimetry;
refractive analysis.

In cases of diagnosing amblyopia at extreme stages resort to the following procedures:

Fundus examination.
I will examine the eye in transmitted light to determine the level of transparency of the lens and vitreous body. If opacity is detected, an ultrasound examination is prescribed.

To determine the risk of developing strabismus, Hirschberg angle analysis.

The essence of the method is simple: the patient is asked to focus on the opening of the ophthalmoscope. The doctor looks at how light rays are reflected from a special mirror surface on the eyeball. Depending on the angle of deflection of the rays, the specialist diagnoses the stage of the disease.

At the diagnostic stage it can be used synaptophore. This device determines the objective and subjective angles of strabismus.

Fits not only for diagnosis, but also for treatment. Can improve eye mobility, remove functional scotoma and stabilize binocular vision.

The full examination includes tonometry, electroretinography. For a comprehensive analysis, the patient is also examined by a neurologist.

How to treat with conservative methods

In advanced stages, vision loss usually cannot be avoided. If the disease is detected at the initial stage, then treatment can stop the development of the pathology.

Attention! Extreme amblyopia in adults incurable.

Optical correction

For patients with amblyopia that accompanies ametropia, a mandatory point of treatment is regular spectacle or contact correction.

When selecting glasses for the prevention of significant ametropia, the specialist will personally recommend most suitable for the patient lenses (they can be high-index, aspherical design or with anti-reflective coating).

Their optical zone is particularly effective, which is necessary for the treatment of refractive errors.

Another type of therapy is contact correction. Its advantage is that it can be used in any situation, since with this method of correction the patient receives a more accurate, realistic picture. For severe anisometropia, in most cases, spectacle therapy is unacceptable, so contact therapy is necessary. The main goal of spectacle correction is correct and accurate treatment of dioptric defect.

Occlusion

This is the second prerequisite for successful treatment of amblyopia. Healthy eye cover with a bandage or sticker to unlock the potential of the affected eye. It is recommended to use a bandage daily for at least two hours for several months.

Reference. When prescribing this therapeutic method, the ophthalmologist takes into account difference in monocular visual acuity patient, as it is important that the occlusion does not interfere with the perfect fit of the glasses on the face.

Sometimes applicable optical penalization, it consists of creating artificial anisometropia (difference in refraction) in the patient by using special temporary glasses. Penalization glasses are selected strictly individually.

Photo 2. Special overlay for glasses used for amblyopia. It is placed on one of the lenses and covers the field of view of the eye.

Hardware treatment

Photostimulation of the affected eye- this is the activation of the retina of a weak organ with light beams. The essence of the process is stimulation with different color signals. The selected rhythm of beam delivery and their sequence help the visual organs to work in an enhanced but safe mode. Photostimulation promotes correct perception of the distance between objects.
Hardware treatment is a method of physiotherapy that involves exercises on specialized devices using magnetic stimulation, laser exposure, electrical stimulation, photostimulation, massage and focusing (accommodation) training.

Average course of hardware therapy for adults lasts for 10 days. Based on the degree and nature of the disease, the period can be doubled. One lesson includes procedures on at least five devices, and the average session time is about an hour.

The main methods of hardware treatment:

Laser therapy (infrared)- activates massage of the muscle associated with focusing the organs of vision. This type of treatment nourishes the eye tissues and also reduces spasm. Prescribed for myopia, strabismus or eye strain.
Ultrasound- affects the organs of vision in different modes. Treatment is prescribed for eye pathologies associated with inflammation, injury, etc.
Vacuum glasses Sidorenko- a modern device that resembles safety swimming goggles. However, traditional glasses have been replaced by mini pressure chambers that fit tightly to the eyes after putting them on. They exert low-intensity vacuum pressure on eye tissue and muscles. The device has built-in emitters for color pulse treatment.

Additional techniques

Pleoptic exercises- This is physical training on an ongoing basis, in which the affected eye has to work as hard as possible at close distances. They develop visual function eyes.

Within their framework, they widely use light-type stimuli. Pleoptic gymnastics develops color vision and significantly improves spatial orientation.

Treatment by a psychiatrist or neurologist- if the deviation is caused by psychotic disorders, it is important to contact the appropriate doctors to draw up an individual course for restoring the nervous system. It would be useful to establish a work and rest schedule, and sometimes do yoga. The essence of treatment is to relieve stress. The doctor will prescribe sedatives (sedatives) and recommend courses of psychotherapy.

How and where to treat with surgery, reviews

It is carried out in situations where specific causes of amblyopia need to be removed. These include cataracts, strabismus or myopia.

Possible laser correction. The procedure involves partial destruction of the layers of the cornea using a laser. All this is necessary so that the simulated shape of the cornea does not prevent the rays from concentrating on the retina.

Postoperative rehabilitation is progressing about three hours. In cases of strabismus, the muscle attachment site moves away from the cornea. After a week of recovery eyes, due to the absence of other diseases, the ophthalmologist can prescribe amblyopia therapy.

The most popular center where operations to treat amblyopia are performed is MNTK "Eye Microsurgery". In addition to surgical intervention, the center also provides hardware treatment.

The institution provides free amblyopia therapy for compulsory health insurance policy (CHI).

Amblyopia. The disease code according to ICD-10 is H53 (amblyopia due to anopsia).

Amblyopia due to anopsia is considered one of the ophthalmological diseases in which visual function is impaired in one eye without any visible abnormality in the eye. This disease in adults is almost impossible to treat with optical devices. But if the disease is diagnosed in a timely manner, there is little chance of correcting the situation and completely returning visual function. Amblyopia in adults is much more complicated and can lead to complete loss of vision.

Amblyopia is considered a childhood disease, but every year you can increasingly meet an adult suffering from this disease.

There are many factors that can lead to such a pathology. But the main reasons are hidden in functional and structural changes in the visual organ. It can be caused by strabismus, which can be congenital or acquired.

The following are considered possible causes of the disease.

A dystrophic process that is provoked by a lack of vitamins and minerals.
Congenital cataracts, clouding of the cornea, abnormalities in the development of the vitreous body.
Regular exposure to ultraviolet rays on the eyes.
Diseases of the inflammatory type of tissue structures around the visual organ.
Astigmatism and farsightedness.

Types of Amblyopia

Amblyopia in adults is divided into five main types. This includes the following forms.

Refractive amblyopia. It manifests itself as a result of the development of diseases such as astigmatism, myopia and farsightedness. If correction of visual function is not started in a timely manner, the structure of the eye completely changes and adapts to new conditions. Anisometropic amblyopia is a type of refractive amblyopia. In this case, the difference between the eyes is significant.
Obscurational amblyopia. It is characterized by clouding of the cornea and degenerative processes in the eye, resulting in impaired visual function. Optic nerve damage and corneal injury may also occur.
Dysbinocular amblyopia. Characterized by impaired binocular vision due to strabismus. In such a situation, the brain reacts to the violation in such a way that it completely turns off the affected eye.
Anisometric amblyopia. Occurs when the difference between the refractive power of the eyes differs by more than three diopters.
Hysterical amblyopia. Occurs when there is a disorder of the nervous system. When treating this type of disease in adults, vision in the affected eye can completely return. Symptoms such as sensitivity to light, narrowing of the visual field and distortion of color perception are also noted.

Symptoms of amblyopia eyes

Amblyopia in adults has several main symptoms. These include the following problems.

Weakness of the visual organs, as a result of which the patient begins to see poorly.
Double vision.
The appearance of a veil.
Blurry of visible objects.
Absent-mindedness.
Deterioration of orientation in space.
Increased eye fatigue.

Degrees of amblyopia eyes

In some situations, amblyopia is asymptomatic. Visual acuity decreases gradually and color perception is impaired. As a result, the disease has several degrees.

Amblyopia is very high. Visual acuity ranges from 0.04 and below.
High degree of amblyopia. The range of visual acuity ranges from 0.05 to 0.1.
Moderate amblyopia. Visual acuity ranges from 0.2 to 0.3.
Low degree amblyopia. The range is from 0.4 to 0.8.

Diagnosing eye amblyopia

To make a diagnosis, you need to undergo an examination. First, an examination is carried out to assess the condition of the eyeballs, their response to light and the condition of the eyelids. After this, procedures such as:

viziometry;
definition of color fields;
perimetry;
determination of refractive power.

If high-degree amblyopia is observed, then you need to undergo a fundus examination, microscopy and examine the lens and vitreous body for transparency. If there is clouding, then in this situation an ultrasound examination is prescribed.

If the main cause of the disease is strabismus, then the Hirschberg angle is determined. In addition to all this, the patient may be prescribed tonometry and consultation with a neurologist.

Treatment of amblyopia in adults

Amblyopia due to anopsia is a pathology that was caused by a disorder not in the visual apparatus, but in the psychological aspect. Therefore, the patient undergoes treatment for amblyopia under the supervision of a psychologist. He is advised to keep complete rest and is prescribed the use of sedatives.

For a refractive disease, treatment for amblyopia consists of restoring vision using optical correction or surgery with a laser device.

If clouding of the cornea, strabismus or drooping eyelid is detected, then surgical intervention is first performed, and then a course of treatment is prescribed.

For mild to moderate disease, treatment of amblyopia involves the use of several methods. These include the following.

Occoludes. The healthy eye is bandaged with a bandage. This is necessary so that the weak visual organ gains strength. The bandage should be worn for at least two hours a day. Treatment of amblyopia with this method lasts from two to four months.
Drug therapy. In such a situation, treatment consists of using Atropine eye drops. Their action is aimed at relaxing the muscles in the healthy eye. In this case, the weak eye is forced to work independently.
Computer programs. This method in the form of a game stimulates the weak eye. This treatment for amblyopia is used in children.
Photostimulation is prescribed as an additional treatment. It involves the use of a light beam that is directed to the retina of the eye. At the same time, various exercises are performed that are aimed at developing the muscle structure of the lazy eye.
Hardware method. Used for severe forms of amblyopia. For treatment, special-purpose light sensors are used that irritate the weak eye. To all this, impulsive lamps, an electrical stimulator and structured stimuli are used.

Complex therapy, which includes medication, computer and physiotherapeutic methods, has a beneficial effect on the functioning of a weak eye.

If the disease was caused by cataracts or other serious pathologies, then amblyopia cannot be completely cured. Often, a severe form of the disease in adults leads to complete blindness.

Treatment of amblyopia at home

If you consult a doctor in a timely manner, you can stop the development of amblyopia. If the disease is in the initial stages, then home treatment methods can be used. These include gymnastic exercises, reflex massage and providing the body with proper nutrition.

Performing eye exercises is quite simple. It is important to devote at least twenty minutes a day to this process. Exercises can be performed by both children and adults. Such exercises include the following.

Relaxation of visual muscles. To do this, you need to fold your hands in the form of a bucket so that the fingers of one hand lie crosswise on top of the other fingers. Then bring them to your eyes so that your nose is located between your palms. It is not recommended to put pressure on the eyes and the skin around them. Then close your eyes and relax. You need to be in this position until the patient sees blackness without white gaps.
The next exercise is to use a piece of paper with a simple image on it. The patient must carefully draw the image he sees with his weak eye. After this, the exercise can be a little more complicated. To do this, place the image shown in a circle or square and repeat the exercise again.
Using a light bulb. For this exercise you need to take a simple light bulb with a power of sixty watts. Glue a black circle on it, the diameter of which is no more than one centimeter. Cover the healthy eye with a bandage, and the weak eye should look at the light bulb for several seconds. After this, turn your gaze to a white sheet.

To prevent yourself from the appearance of amblyopia, it is necessary to provide the body with those products that contain the following elements.

Vitamin A. It is one of the components of the retina of the eye. It is found in liver, cheese, butter, carrots and greens.
Vitamin B. Responsible for the functioning of the optic nerves. To avoid their deficiency, you need to eat vegetables, beans, milk and fish.
Vitamin C. Responsible for the permeability of capillaries in the retina. Ascorbic acid is found in citrus fruits, tomatoes, cabbage and potatoes.

Amblyopia can also be cured with the help of reflexive foot massage. Using this method, active points are affected. You can do it at home yourself.

The points are located on the thumb, second and third fingers. They are responsible for the functioning of the visual organ. Massage must be carried out at least twice a day. The feet must first be thoroughly warmed up.

Preventive measures to prevent amblyopia in adults

Unfortunately, the disease can only be completely cured in childhood. It is best to begin treatment for amblyopia at the age of under six years, until the formation of the visual organ is completed. If amblyopia makes itself felt only in adulthood, then the pathology can be cured with surgery. After this, an additional treatment method is prescribed.

But every patient can prevent himself from developing an eye disease. It is enough to follow a few simple recommendations.

Provide the body with the necessary vitamins. To do this, you need to consume foods that contain many microelements, and during the season of vitamin deficiency, add vitamin complexes.
Do not strain the visual organ and allow it to relax more often. To do this, you can do simple exercises every day.
If an eye disease was discovered in childhood, then you should not delay treatment. The sooner it is started, the less consequences there will be.
Do not strain children's eyes. During the day, the child should watch TV or play on the computer for no more than thirty minutes a day.
If there is nearsightedness or farsightedness, then it is necessary to correct vision by wearing lenses and glasses.
Don't forget about preventive examinations. For children under two years of age, they are performed as often as possible, after which the patient must visit doctors at least once a year. When the first symptoms appear, you should immediately seek help from a doctor.

For amblyopia in adults, treatment is quite lengthy and complex, and does not always end successfully. In most cases, we are talking about a congenital disorder that was not treated in childhood. An exception is hysterical amblyopia, which occurs as a result of exposure to psychogenic factors and severe stress.

In this case, spontaneous healing of the disease often occurs. For congenital disorders, it is important to maintain eye health through exercise and other methods.

Amblyopia or "lazy eye" (from the Greek: "amblys" = dim and "ops" = eye) is clinically defined as decreased visual acuity without the presence of an uncorrected refractive error or ocular pathology.

Treatment methods for amblyopia

Amblyopia not only limits a person’s choice of profession, but also significantly increases the risk of serious medical and social consequences if a healthy eye is lost. The prevalence of the disorder in the population is estimated at 3%.

This eye defect can be cured, but if treatment is not started on time, it can lead to permanent damage as the affected eye gradually loses its visual ability. Treatment of amblyopia in adults is based on eliminating the causes that cause the disorder.

Therefore, in case of dioptric defect, the doctor prescribes glasses, prescribes cataract surgery, etc. Sometimes surgical treatment of strabismus is even necessary.

Additionally, it is important that the person begins to use the affected eye. For this purpose, an occluder is used that temporarily covers the healthy eye, as a result of which the brain is unable to use the vision of the healthy eye, forcing the affected eye to function.

This helps restore vision. A healthy eye can be covered in various ways - by gluing a special patch on the eye, using contact lenses or an occluder on glasses. An important part of the treatment are the so-called pleoptic exercises aimed at developing the visual function of the affected eye.

Within their framework, the perception of light stimuli, the development of color vision, improvement of orientation in space, training of visual motor orientation, etc. are used.

Exercises can be done not only in the doctor's office, but also at home. In this case, a person can carry out the actions recommended by a specialist, which is forced to use the eye affected by amblyopia. Treatment for the disorder is long-term and requires close collaboration between the person and the doctor.

In adults, similarly to in children, it involves conservative treatment (non-surgical). The therapeutic approach is always individual and should be carried out under the professional and regular supervision of an ophthalmologist and orthoptist.

Amblyopia in adults is usually treated with a combination of the following:

spectacle correction - a person is prescribed glasses, the purpose of which is the correct and accurate correction of a dioptric defect;
occlusion or occluder - a person’s healthy eye is covered for several hours a day so that the affected eye is forced to work;
pleoptic exercises are regular physical exercises in which the affected eye is forced to work as closely as possible at close distances.

Innovative treatment methods

Currently, the most widely used methods are penalization of the dominant eye, which forces the visual cortex of the brain to process sensations coming from the amblyopic eye. But this is an approach that does not guarantee complete and lasting recovery in all cases and does not take into account the binocular nature of the visual impairment.

The biggest disadvantage of occlusive therapy is the fact that it is ineffective after the so-called critical period (after 9-12 years of life). The reason for this is a decrease in the ability of the adult brain to adapt to external influences; there is a lack of plasticity.

However, lack does not mean absence! Therefore, occlusion therapy is sometimes used for amblyopia in adults. At the same time, there are many cases where such a therapeutic approach helps alleviate the manifestations of the disorder. This is evidenced, for example, by a sociological study conducted in 1994 with an amblyopic patient who seriously damaged the dominant (healthy) eye.

During the first 6 weeks after injury, the treating ophthalmologist observed an increase in visual acuity in the amblyopic eye from 6/60 to 6/24, and visual acuity in the injured eye deteriorated in light perception.

After enucleation of the injured eye, which was performed approximately 1 year after injury, visual acuity of the amblyopic eye improved to 6/9. Given the absolute lack of plasticity in the adult visual cortex, such an improvement would hardly be possible.

Further results confirming the possibility of improving vision in amblyopia in adults were recently presented by a team led by Professor Hess, a recognized expert in this field of ophthalmology.

His team used antisuppressive therapy on adult amblyopic patients, which involves very intense binocular perception exercises using virtual reality glasses or a regular iPod equipped with prismatic film. The result of this therapeutic approach was the achievement of a significant improvement in visual acuity in amblyopic eyes.

In some cases, previously non-existent binocular vision even appeared. From the above information, it is clear that the visual cortex of an adult with amblyopia has the ability to enhance visual representation, although to a much lesser extent than in the case of children. That is why in adulthood there is a need for more intensive training of the visual system.

The only problem that ophthalmologists may encounter is the reluctance of adults to sacrifice so much time and energy for perceptual exercises. The question is whether it is possible to help the adult brain in other ways, for example, by increasing its plasticity.

Pleoptic therapy through exercises aims to train the activity of the amblyopic eye, while the healthy eye is covered with an occluder. In practice, simple pleoptic exercises are carried out aimed at improving spatial orientation, developing the perception of color, light stimuli, professional development of visual motor orientation, etc.

Passive and active methods are used in treatment:

Passive exercises. They are carried out in a specialized clinic using special devices, under the supervision of an orthoptist. The amblyopic eye is trained, due to which vision is leveled, and the brain perceives signals from both eyes. The duration of pleoptic exercises is about 1 hour.
Active training. They are carried out in a specialized clinic under the supervision of an orthoptist and involve the use of various activities that require precision, develop fine motor skills, spatial orientation and, in particular, require the participation of the affected eye.
Home workouts. Activities suitable for doing at home include simulations, various board games, memory games, puzzles, throwing and others. For home workouts, you can use gaming applications for mobile phones, tablets and computers.

It is advisable to complement occlusion therapy with the following exercises for amblyopia, which are technically called “pleoptic training”. They are carried out in specialized orthoptic clinics using the necessary devices.

It is also important to do additional exercises at home. It is not enough to simply cover the healthy eye; it is important to try to make the amblyopic eye work.

Exercises for children and adults are practically no different. The main difference is that adults must devote more time to exercise. Suitable activities for training a healthy eye:

assembling mosaics, puzzles;
modeling from plasticine or clay, wood carving;
coloring books - you should start with larger and simpler pictures, gradually moving towards smaller and more complex images;
outlining - through transparent paper with a colored pencil along a pre-drawn line with a brush or watercolor;
pinning image templates;
exercises on the line - on a pre-drawn line, a person traces circles, squares or other more complex shapes, trying to trace exactly along the line, in addition, you can stick to pre-cut shapes from colored paper;
stringing beads;
cutting and folding models - various patterns and details are cut out (from thick paper, fabric, felt, etc.) and attached or glued to each other, you can make houses, flowers, cars, etc., you can also cut a picture into several parts, and then assemble it into the original image;
fixation on dots - draw several dots on paper, which you will later connect into drawings, such as flowers in a vase;
embroidery - you can embroider on paper or fabric with colored threads, this exercise is very effective because it forces you to concentrate;
games - checkers, cards, chess, dominoes, etc.;
movement - ball games, table tennis, line walking;
reading - you should start with text in large font, moving to smaller ones;
computer games, watching TV (for a limited time).

The more the acuity of the amblyopic eye increases, the more subtle the activities and games that are included in the training should be. The more visually intense activities a person engages in, the faster their amblyopia will improve.

Amblyopia refers to a condition in which vision is reduced in one or both eyes. Patients with amblyopia lack binocular vision - the brain's ability to correctly combine two images (of both eyes) into a single whole. This ability is necessary for the ability to assess depth, the order of objects in the field of view, the volume of the picture, and the integrity of perception. Why does amblyopia appear and what is it? Let’s consider further?

What is amblyopia?

Amblyopia is a decrease in visual acuity in one or both eyes that is not amenable to optical correction, occurring for no apparent reason (primary) or due to the lack of normal conditions for the functioning of the retina (secondary).

As we noted above, people with amblyopeia completely lack binocular vision. It is this that makes it possible to fully perceive the surrounding reality, stereoscopic vision, that is, the ability to determine the distances between objects.

This in turn is accompanied by an increase in visual acuity. Only if you have good binocular vision is it possible to work in several specialties, in particular, as a driver, surgeon, pilot, etc.

To form binocular vision, the following conditions are necessary:

equal visual acuity in both eyes (not lower than 0.4 in each eye);
the same refraction (degree of farsightedness or myopia) in both eyes;
symmetrical position of the eyeballs; .
equal sizes of images in the left and right eyes - iseikonia.
Normal functional ability of the retina, pathways and higher visual centers.
The location of the two eyes in the same frontal and horizontal plane

"Lazy eye" is a common, non-medical term used to describe amblyopia because an eye with poor vision does not seem to do the necessary work to provide normal vision.

Causes

The causes of amblyopia can be different. The most common is strabismus. Amblyopia with strabismus is its consequence. At the same time, it can also be a cause of strabismus.

It has been proven that strabismus and amblyopia, like refractive errors, are purely functional problems. From the fact that they always decrease with the release of the tension that they accompany, it follows that any methods that help achieve relaxation and central fixation can be used to eliminate them.

As with refractive errors, strabismus disappears and amblyopia is corrected as soon as the person achieves sufficient mental control to remember the black spot.

The prevalence of the disease is difficult to estimate. According to preliminary estimates, it is present in 1-3.5 percent of healthy children and in 4-5.3 percent of children with other vision problems. Among all forms, 2 variants are common - dysbinocular, refractive. These forms account for about 90% of cases.

Taking into account the reasons, several forms of secondary amblyopia are distinguished:

strabismic (dysbinocular),
obscuration (deprivation): usually develops with clouding of the cornea (cataract), with congenital clouding of the lens (congenital cataract), with ptosis.
refractive,
anisometropic: develops against the background of high degree anisometropia. It develops in the eye with more pronounced anisometropia, which cannot be corrected;
hysterical: formed during a mental state disorder: hysteria, neuroses. Only with treatment of this type of amblyopia can normal vision be fully restored in adults.
mixed.

Provoking factors for the development of amblyopia:

Retinopathy of prematurity;
Compounded family history of anisometropia, isoametropia, strabismus, congenital.
Prematurity;
Mental development disorder;
Cerebral paralysis;
Congenital cataract;
Anisometropia.

Establishing the cause is extremely important, since treatment tactics depend on it.

Amblyopia symptoms

amblyopia of the right and left eye

Amblyopia is also sometimes called the “lazy eye”, since during the development of the disease, one eye is almost completely excluded from the vision process, while the second eye becomes the “leading” one and takes on the entire visual load.

Manifestations of amblyopia vary, and may be asymptomatic:

Visual acuity decreases (no improvement with correction),
color perception and dark adaptation are impaired,
strabismus occurs (convergent, divergent, etc.).

Typical symptoms of amblyopia are:

deterioration of vision in one (right or left), or maybe both eyes at once,
difficulty perceiving three-dimensional objects, assessing the distance to them,
double vision,
increased eye fatigue during activities that require visual attention,
learning difficulties.

Visual impairment with amblyopia can vary from a slight decrease in visual acuity to almost complete loss of vision (light perception) and the impossibility of visual fixation.

Monolateral amblyopia usually does not cause symptoms that significantly impede vision, since good visual acuity is provided by the healthy eye.

Amblyopia may be temporary and resolves after a few days or months. In general, vision loss with any type of amblyopia can be slight or very pronounced, leading to blindness.

Degrees of amblyopia eyes

There are functional, organic and hysterical amblyopia. Potentially functional amblyopia is treatable, while organic amblyopia is irreversible in most cases.

According to the loss of visual acuity, the following degrees are distinguished:

Amblyopia of the 1st degree occurs when visual acuity is 0.8-0.9. This degree is called very weak.;
At the second degree, visual acuity decreases to a level of 0.5-0.7;
Amblyopia of the 3rd degree, which is called moderate, corresponds to visual acuity of 0.3-0.4.
At stage 4, visual acuity ranges from 0.05 to 0.2;
The latest stage is 5. The maximum degree of the disease, in this case vision is reduced to 0.05 or lower. Almost impossible to correct.

Amblyopia in adults

Amblyopia of the eye is a predominantly childhood disease; it is quite rare in adults. In the unilateral form of the disease, the disease is diagnosed in one eye. With bilateral amblyopia, the disease affects both eyes.

When describing the symptoms, it should be noted that quite often a person does not realize that he has developed this disease. The detection of pathology occurs by chance. The patient's one eye becomes dominant, and the brain can only perceive images coming through it.

One of the signs in adults is double vision. It is noted in patients with severe strabismus as a consequence of the brain’s inability to combine two too different images into a single one.

A sharp decrease in vision that lasts from several hours to months can also be a sign of lazy eye syndrome.

With hysterical amblyopia, adults complain of a sharp decrease in vision, which occurs a short period of time after hysteria or a nervous breakdown.

Amblyopia in adults is diagnosed when there are complaints of blurred vision, as well as during a medical examination.

Treatment in adults is much more difficult than in children. If measures to eliminate the causes of amblyopia are not taken in a timely manner, it will not be possible to restore vision.

How does amblyopia manifest in children?

In children, amblyopia is manifested by the following symptoms:

the upper eyelid droops;
asynchrony of movements of the eyeballs, involuntary movements of one eye;
the child tilts his head or squints when trying to look at an object;
complaints of rapid fatigue, headaches when reading, doing painstaking work that requires increased visual strain (knitting, embroidery, etc.).

Treatment of amblyopia in children must begin with its differentiation and identification of organic disorders, which can also accompany strabismus, astigmatism, and farsightedness. This can only be done using an objective method for determining the nature of visual perception at the level of the visual cortex of the brain - the study of visual evoked potentials (VEP). Like an electrocardiogram, VEPs objectively reflect the work of neurons in the visual cortex of the brain.

Treatment is especially effective before the age of 7 years, while the eye is still developing. After 7 years, the eye, as a rule, is already formed and the effect of treatment will already be insignificant, and the prognosis of treatment will worsen more and more every year and can subsequently lead to irreversible loss of vision.

Diagnostics

Diagnosis and correction of amblyopia is carried out by an ophthalmologist. Shown:

determination of visual acuity using tables,
performing perimetry,
study of color perception,
biomicroscopy of the eye,
intraocular pressure measurement
tonometry and determination of dark adaptation.

The eyes are examined in transient light to determine the degree of transparency of the lens and cornea. If their opacity is detected, an ultrasound of the eye will be required.

If strabismus is suspected, the strabismus angle is determined according to Hirschberg or using synaptophore.

Treatment of amblyopia

Treatment is impossible without an ophthalmologist, and untimely treatment of amblyopia leads to permanent loss of visual function. Standard methods are to combat all possible diseases that could lead to the formation of a lazy eye.

Restoring visual acuity and improving visual functions depends on the following factors:

strict compliance with all recommendations by the patient;
type of amblyopia;
correct fixation of the eye;
age of manifestation of amblyopia;
initial visual acuity;
the age of the patient at which treatment was started;
treatment methods.

If a patient is diagnosed with refractive or anisometropic amblyopia, then therapy includes mainly non-surgical methods. Visual acuity must be corrected using contact lenses, glasses, and special night lenses.

Treatment of childhood amblyopia is directly related to eliminating the cause that caused its development. With obscuration, this is surgical treatment: removal of cataracts, elimination of ptosis, etc.

In children, contact or night lenses are often used for therapeutic purposes. Laser correction can be performed.

A child with amblyopia should receive 3-4 courses of pleoptic treatment per year. If treatment is not carried out in a timely manner or the child does not wear glasses and does not perform occlusion consistently, then the achieved visual acuity may decrease significantly.

Treatment is carried out until approximately the same visual acuity is achieved in both eyes. For hysterical amblyopia, sedatives are prescribed and psychotherapy is performed. The choice of the optimal method of therapy should be entrusted to a qualified ophthalmologist. Only a specialist will be able to select the optimal regimen, conduct dynamic monitoring and, if necessary, adjust treatment.

Operation

Surgery on the eye muscles to treat strabismus is possible and can straighten uneven eyes. Surgery alone usually does not provide a complete cure for amblyopia. Surgery to make the eyes straight can only help make the eyes work together as a team. Children with strabismus amblyopia require careful monitoring and treatment.

Forecast

The prognosis depends on the causes and time of detection of the disease. The sooner correction of amblyopia is started, the more successful the result will be. The greatest effect is achieved when treatment is carried out before the child reaches 7 years of age, until the formation of the eye is completed.

Prevention

As with the prevention of any other disease, a rational daily routine, good rest, healthy nutrition, vitamin supplements, walks in the fresh air, normal conditions for classes and work, as well as strict control over the time spent in front of the TV or computer are important.

Remember to visit your ophthalmologist for preventive examinations up to twice a year.
Constant medical examination of children aged 1 month and older is necessary. If pathology is detected, treatment should be carried out immediately
If a child under 5 years of age has even slight strabismus, he should be regularly observed by an ophthalmologist.

840 10/08/2019 4 min.

Among ophthalmological diseases, there are those in which one eye completely refuses to transmit the image, entrusting this function to its fellow eye. This disease is called amblyopia, which occurs in adults and children. In childhood, the disease is easily treatable, while in adults, in order to eliminate it, some difficulties must be overcome.

Description

With amblyopia, both eyes perceive the same image differently, because of this the brain cannot compare these two signals into a single whole and perceives a partial picture.

At the beginning of the disease, one eye begins to dominate and participates more in the visual process, while the second eye gives up and takes on the role of a slave, and over time completely atrophies. Such improper redistribution of visual load leads to deterioration of vision and in most cases results in strabismus. But what exercises for strabismus should be done first will help you understand this

The video shows a description of the disease:

Symptoms

Early stages of the disease can occur without visible or tangible abnormalities; their detection occurs by chance. If amblyopia appears as a result of strabismus or nystagmus (you can find out how surgical treatment of nystagmus is carried out), then signs of these diseases will be present. It is impossible to determine the disease on your own; it is diagnosed only by an ophthalmologist after a series of examinations.

Among the obvious symptoms that accompany the various stages of this disease are:

This is typical for people with strabismus, who cannot combine the picture into a single whole, since the brain perceives only partial readings from each eye.
Dizziness. It occurs even when a person stands still and examines a three-dimensional object.
Deterioration of visual acuity in one eye, which cannot be corrected even after wearing glasses for a long time.
Frequent feeling of pain in the eyes.
Veil. It appears when examining objects whose contours appear blurry. Here are the reasons for the veil, indicated:
Spatial confusion in new places, a person cannot find his way for a long time where he is.
Sudden deterioration of vision.
When examining objects, a person automatically begins to squint.
While watching TV or video on a computer, the patient spontaneously closes one eye as he begins to look to the side. This link to this article will help you understand why.

These signs of the disease are accompanied by a person’s absent-mindedness, severe fatigue when working, which requires increased visual attention, and over time, anger and fatigue appear.

Causes

The most common of them is strabismus, which must be treated in childhood so that other eye diseases do not develop against its background, but sometimes amblyopia itself becomes the cause of strabismus. But how strabismus is treated in children will help you understand this

Among the obvious causes of the disease are:

Changes in the cornea of the eye and its fundus. But you can see what pachymetry of the cornea looks like
Genetic predisposition also influences the occurrence of this disease.
Cataract.
One of the eyes has an obstruction that prevents its retina from clearly perceiving light.
Severe farsightedness.
Different sizes of eyeballs.
If vision does not improve after replacing the lens.

It is advisable to identify the disease as early as possible in order to fully restore visual functions.

Treatment

Its effectiveness depends on correctly selected methods of therapy; during the course of treatment, the doctor will make adjustments that are necessary to more fully cover the process. There are several ways to restore vision; the most popular ones are described below.

Occlusion

It involves excluding the healthy eye from the working moment. To perform this technique, plastic occluders are used, which are attached to the frame of glasses if the person wears them. Some progressive-minded patients prefer to wear a leather patch over one eye. After the healthy visual organ is disabled, the “lazy eye” begins to try to work for two. This treatment is possible at home.

Video of eye occlusion:

At first, a person sees practically nothing; it is up to him to guess the outlines, but then the eye gradually begins to get involved in the work. The process of restoring vision is long and requires patience.

Hardware

It uses structured or light stimuli that activate the eyes.

These methods include:

The general direction of such treatment is as follows:

stimulating energetic changes in the retina. But what retinoschisis of the retina of the eye looks like, and how such treatment occurs, is indicated
improvement of blood flow in local places;
facilitating the transmission of impulses to the cornea of the eye. It will also be interesting to know more about what it looks like

The duration of hardware treatment is 10 days, standard therapy can cost from 24 thousand rubles.

Surgical

Surgery is used in cases of detection of tumors or to eliminate the “overhanging” upper eyelid.

Surgery to eliminate strabismus in adults is performed on an outpatient basis. Anesthetic drops are injected into the patient's eyes, surgery is performed, and after seven days he is discharged. But after such treatment, vision may not be restored immediately; it will take a long time for the person to get used to seeing equally with both eyes. The cost of such operations depends on their complexity and can vary from 80 to 150 thousand rubles.

Operations must be combined with conservative and new treatment methods in order to achieve a 100% result, and not just eliminate a cosmetic defect.

3D technologies

An innovative program based on virtual 3D occlusion improves visual acuity and speeds up treatment. This treatment does not require wearing special adhesives or bandages, which are accompanied by some inconvenience.

With this method, the eyes are gradually involved in work and normal vision is returned to them. During therapy, a person wears glasses with special lenses, his healthy eye works as usual, and the “lazy” eye gradually develops and takes part in the visual process through game programs that resemble putting together a jigsaw puzzle.

There are several types of amblyopia, some of them may disappear on their own, but in most cases immediate treatment is required, and it is better to use an integrated approach.