Miscellaneous

Amblyopia: What is it? Causes and Treatment in Adults

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Amblyopia - a visual impairment, due to the nature of the visual analyzer functional disorders, which can not be corrected with the use of contact lenses and glasses.

According to another disease called "lazy eye" or the syndrome of "blunt eyes." ICD has 10 H53.0 code. In ophthalmology amblipiya considered one of the main causes of unilateral visual loss.

The causes of amblyopia

What it is? If the image is blurry, double vision, blurry or difficult to see, the eye as the visual analyzer, off from work - this is the basis of amblyopia.

There are two types of amblyopia:

  • Primary, which is formed in the womb as a result of violations of the right formation and growth of the eyeball.
  • secondary occurring during the lifetime due to the formation of various ocular pathologies.

The reasons for amblyopia secondary options that depend on the disease, which results in getting off of. The reasons for this are many:

  • amblyopia due to the difference in vision in their eyes, when adequately performed, and the correction of the image with different eyes do not match.
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  • prolonged clouding of the lens, so called amblyopia of obscure.
  • amblyopia due tsvetoslepoty due cones anomalies, it is always two-way.
  • amblyopia in children often occurs as a result of strabismus. Cockeye transmits incorrect information to the brain, because of what the images do not match, vision double vision and an imbalance occurs. The brain turns off the visual work of the affected eye.

Risk factors for the development of amblyopia include the presence of the age of 6-8 years of strabismus, a high degree of refractive error, conditions conducive deprivation (in this case meaning a loss of body deprivation of visual incentives). In addition, risk factors include:

  • prematurity;
  • shortage of newborn weight;
  • retinopathy of prematurity;
  • cerebral paralysis;
  • mental retardation;
  • family history with regard to anisometropia, izoametropii, strabismus, amblyopiainherent cataract.

Maternal smoking during pregnancy, use of drugs and alcohol may increase the risk of developing amblyopia and strabismus.

degrees

Total known 5 degrees of the disease. It should be noted that the blurred vision occurs incrementally.

  • At decrease of less than 0.05 indicates a very high (5-th) degree lazy eye syndrome. Amblyopia 1st class takes place in the case where the visual acuity of 0.8-0.9. This degree is called very weak.
  • About amblyopia 2nd degree (weak degree) when it comes to visual acuity of 0.5-0.7.
  • Amblyopia third degree, which is called secondary, corresponds to visual acuity of 0.3-0.4. If the visual acuity is set at 0.05-0.2, then it is the fourth degree of the disease or amblyopia high degree.

Classification

The following types of amblyopia:

refractive When nekorrigiruemom violation of refraction, causing fuzzy focus the subject's eyes (one or both).
anisometropic It develops when a significant difference of refractive eye abilities.
strabismic When strabismus, when the brain uses only information from one eye to suppress ghosting.
Deprivation, of obscure It develops due to visual deprivation one eye provoked by congenital anomalies, such as cataracts, corneal clouding. After the elimination of blurred vision can not be restored.
Hysterical (psychogenic blindness, amaurosis hysterical) It observed in hysteria, in most cases combined with a number of other functional disorders of the visual analyzer, such as photophobia, visual field loss, impaired color perception, and others.

For each type of amblyopia is characterized by its pathological and clinical features, but there is a common clinical attribute for all kinds of diseases - functional reduction of central vision varying degrees - from mild to very severe.

symptoms of amblyopia

If amblyopia typical symptoms are worsening of one or both eyes, difficulty perception bulk objects, distances to them evaluation, learning difficulties.

In the presence of strabismus may complain of eye deviation to one side of the direction of gaze, double vision when viewed with two eyes and his disappearance at the close of the squinting eye. 27% of patients with amblyopia have izogipermetropicheskoy collateral deficit of visual perception skills, which may lead to difficulties in learning. He was approximately 3-fold greater in children who used the optical correction with 4 years old than children who started to do it before.

Is unilateral amblyopia usually does not cause significantly impede vision symptoms as good visual acuity provided good eye.

amblyopia treatment

If amblyopia treatment results directly depend on the patient's treatment time to see a doctor and the adequacy of the designated course. Up to 7 years of age amblyopia correction is quite successful, while after 10-12 years, the disease is very difficult to remedy.

The success of the ophthalmic correction of amblyopia is directly connected with the elimination of its causes. Thus, in need of obscure amblyopia cataract surgical correction of ptosis holding resorbable therapy or vitrectomy with hemophthalmia. In the case of strabismic amblyopia performed surgical correction of strabismus.

Treatment Refractive amblyopia or anisometropic carried conservative methods. In the first phase is assigned the optimal vision correction: made selection of glasses, contact lenses or night, with anisometropia made laser correction.

After about three weeks pleoptic begin treatment with a view to eliminating the dominant role of the better seeing and activation of amblyopic eye function. For the treatment of amblyopia used active and passive pleoptika.

Passive pleoptika - is sealing the functional eye, or occlusion. In parallel, stimulating the retina of the eye of the patient by means of electrical pulses, light rays of different computer simulators.

Good effect in amblyopia provide techniques such as laser, vibration and magnetic stimulation, acupuncture. Treatment should be repeated up to 4 times a year.

In preschool children amblyopia treatment is performed using a special method - penalization. He is in a special deterioration in visual function active eye through overcorrection, or topical application of atropine.

When the vision in the dominant body falls view, the amblyopic eye is, on the contrary, improved. Good results are obtained and physiotherapy amblyopia, including electrophoresis with drugs.

After pleoptic stage of treatment of amblyopia are moving to restore binocular vision - orthoptic treatment. Carrying out of this stage is possible at achieving visual acuity in both eyes at least 0.4 and not the age of the child under the age of 4 years. Usually used for this purpose machine-sinoptofor looking through the eyepieces which the patient sees the individual parts of the whole image to be visually combined into one image.

amblyopia treatment is carried out to achieve approximately the same visual acuity of both eyes. When hysterical amblyopia appointed sedatives, conducted psychotherapy.

training methods

A good result gives special exercises for the eyes, as well as playing with the exact hitting the target and fine manual motility. Effective stimulation of damaged eyes with flashes of light, ie photic stimulation.

Modern way of training is to use the amblyopic eye device "Ambliokor". Operation is based on the method of computer training videos.

The patient looks at a movie or any video. At this time the sensor is removed about the eyes. In parallel fixed encephalogram brain. The image on the monitor is stored, provided the "correct" view. But when it becomes blurred, the picture disappears.

This way the appliance inadvertently causes the cord to reduce non-contrast periods impaired. As a result, optimized operation of neurons in the visual cortex and vision is greatly improved.

Forecast

If untreated, amblyopia is constantly progressing, causing, in the end, persistent irreversible visual impairment. In this case, it may cause blindness and impossibility of gaze fixation.

When time begun treatment can achieve 100% recovery of functions, but sometimes from the time of diagnosis until complete healing takes place more than a year. At the same time, the younger the patient, the higher the chances of a cure, since more and more difficult to make the retina to function normally over time. Nevertheless, the results of numerous studies suggest that a good faith performing a clinician improved vision in patients with amblyopia may even the elderly. The final forecast in each case depends on many factors:

  • type of amblyopia;
  • the accuracy of compliance with the recommendations;
  • age of the patient, wherein treatment was initiated;
  • initial visual acuity;
  • treatment.

Of great importance is the early diagnosis of the disease and the start of treatment. Worsens the prognosis of the presence of strabismus and lack of positive dynamics in his therapy, which make it difficult to fight with concomitant amblyopia.

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