AMBLYOPIA

Amblyopia is poor vision in an eye that, for various reasons did not develop normal vision during early childhood. When one eye develops good vision and the other does not, the eye with poor vision is called amblyopic. Amblyopia occurs in about 2-3% of the population and can only be treated in childhood, preferably before 7 years of age. It is because of this possibility of developing amblyopia (for which there are no outward signs) that Dr. Kronwith believes all children should be examined by a pediatric ophthalmologist by 4 years of age. At this age there can still be enough time to reverse the amblyopia before the child is too old.

The major causes of amblyopia are strabismus and unequal focusing of the eyes.

Strabismus can cause amblyopia since when one eye is not aligned, the brain, which does not want to experience double vision, will shut off the image in the deviating eye. This prevents the development of the cells and nerves which enable that eye to see.

Unequal focusing of the eye is the other major cause of amblyopia. If each eye has to focus a different amount to see clearly, the brain, which cannot focus each eye a different amount, will chose one eye to focus and the other will remain out of focus. The unfocused eye does not develop normally and amblyopia occurs. It is this form of amblyopia that is most difficult to diagnose since the eyes may be perfectly straight and there are no complaints from the child since there is excellent sight in one eye. Diagnosing this condition requires dilation of the pupils and examination of the inside of the eye with special instruments. Parents are often shocked to learn that their child has amblyopia in this situation, especially when the child is too young to read the eyechart. However, the doctor can, by examining the inside of the eye, diagnose amblyopia even without the child reading an eyechart! This is again why all children should be seen by 4 years of age, earlier if there is a family history of amblyopia.

The treatment of amblyopia almost always requires the patching of the good eye combined, often, with glasses. The glasses will correct the error in focusing but this is often not enough and the better eye must be patched in order for the brain to be forced to use the amblyopic eye and develop the cells and nerve connections necessary for excellent sight in that eye. Amblyopia is usually treated first before correcting any associated strabismus.

If amblyopia is not treated, the child will permanently have a poor seeing eye. This will cause many problems in the future including lack of depth perception and the fear, that if anything should ever happen to the good eye, the child will be left with poor or no vision in both eyes. We understand that most children hate to have their eyes patched, especially when they depend upon that good eye to see. As the parent, it is incumbent upon you to make sure the child does what is best for him or her and the success or failure of the treatment mostly depends upon your interest and involvement, as well as your ability to gain your child's cooperation. Dr. Kronwith will go over various methods to aid you.

With early detection and treatment, amblyopia is usually reversible and excellent vision is obtained.