In the Amblyopia is a functional reduction of visual acuity of an eye, which is due to a failure to operate during the visual development. Severe vision loss threatens if amblyopia is not detected and treated before age 8. The diagnosis is based on corrected visual acuity on a difference between the two eyes that can not be explained by a different pathology. Treatment depends on the cause.
Amblyopia affects about 2-3% of children and usually develops before the age of two years, but each child under about 8 years may develop amblyopia.
In the Amblyopia is a functional reduction of visual acuity of an eye, which is due to a failure to operate during the visual development. Severe vision loss threatens if amblyopia is not detected and treated before age 8. The diagnosis is based on corrected visual acuity on a difference between the two eyes that can not be explained by a different pathology. Treatment depends on the cause. Amblyopia affects about 2-3% of children and usually develops before the age of two years, but each child under about 8 years may develop amblyopia. The brain has to receive a simultaneous, clear and focused, properly aligned image from each eye, so that the visual system can develop properly. This development takes place mainly in the first 3 years of life, but was completed only at the age of 8 years. Amblyopia occurs when there is a permanent interference of the images from one eye but not the other eye. The visual cortex suppressed the image of the affected eye. If the oppression continues long enough, the vision loss may be permanent. Etiology There are three reasons: Strabismus anisometropia obstruction of the visual axis strabismus can cause amblyopia by a misalignment of the eyes that causes different retinal images are relayed to the visual cortex. If this misalignment occurs, a child’s brain can only focus his attention on a single eye – the information from the other eye will meanwhile suppressed. Since the visual pathways are already fully developed in adults, a finding with two different visual images can only be a diplopia, not suppression of an eye. The anisometropia (unequal refraction in both eyes, usually by astigmatism, myopia or hyperopia) can also cause amblyopia, because in her a different focus of the retinal images is present, the image of the eye with the larger refractive error is less well focused. A transfer of the optical axis at a point between the surface of the eye and the retina (for. Example, by a congenital cataract) interferes with a retinal image on the affected eye formation or stops it completely. This obstruction can result in amblyopia. Symptoms and complaints Amblyopia is often asymptomatic and is often only discovered during a routine examination. Children rarely complain of a unilateral vision loss, although they squint or cover one eye. Remember very young children either do or do not realize that vision in one eye compared to the other is different. Some older children complain sometimes a decreased vision in the affected eye or develop a poor depth of field. If strabismus is the cause, look for other deviation can be recognizable. A cataract, causes a transfer of the visual axis can proceed unnoticed. Early diagnosis screening Photo screening Additional tests (eg. As cover test, covering Turndown Test, refraction, ophthalmoscopy, slit lamp) A amblyopia and strabismus screening is for all children before starting school, preferably with three years recommended. The Photo screening is an approach for screening of very young children who are to undergo no subjective tests because they have either learning or developmental disabilities. At the Photo Screening using a camera that receives images of the pupillary reflex during fixation on a visual target and red reflex in response to light. The images are then compared for symmetry. When testing older children, the accuracy is tested when descendants of figures or with the Snellen Eye cards (eg. As e descendants with a cotton swab, Allen cards or HOTV figures). If an underlying cause identified, further tests are necessary. Strabismus can be confirmed with the alternating cover test or the covering Turndown test. (Strabismus: Diagnosis). Ophthalmologists can confirm anisometropia, by proceeding to refraction of each eye. A transfer of the optical axis can be confirmed by examination with an ophthalmoscope or slit lamp. Forecast Amblyopia can be irreversible if not diagnosed and treated before age 8 because the visual system is mature at this time. Most children identified before age 5 and treated, have better eyesight. A very early treatment increases the probability of complete visual recovery. Under certain circumstances, older children can still benefit with amblyopia from treatment. has matured to the visual system, recurrences are possible in some cases. In some patients, a slight decrease in visual acuity has occurred even after the visual maturity. Treatment glasses or contact lenses cataract removal taping atropine drops Treatment of strabismus, when this is. Treatment of amblyopia should be initiated by an ophthalmologist who has with eye diseases in children experience. Each underlying cause must be treated (for. Example, glasses or contact lenses to correct a refractive error, removal of a cataract, the treatment of strabismus). The use of the amblyopic eye should be encouraged by taping the better eye or by administering atropinhaltigen eye drops in the better eye, which provide a visual advantage the amblyopic eye. A better therapy compliance is achieved with drops. The maintenance therapy to prevent recurrence can be recommended if recovery has stabilized and the child is about 8-10 years old. Summary Amblyopia is a loss of vision in one eye due to the lack of clearly focused, properly aligned image information from each eye to the visual cortex in early childhood before the maturation of the visual pathways. The diagnosis is made primarily by screening tests that should be done around the age of 3 years. Treatment depends on the cause (z. B. refractive surgery, cataract removal, treatment of strabismus), followed by covering or Atropintropfen for the better eye.