What is amblyopia?
Amblyopia is a condition wherein your child’s visual pathways fail to develop normally despite not having any pathological anatomical abnormalities. This is often referred to as a lazy eye.
What are the risk factors for developing amblyopia?
The most common cause of amblyopia is the lack of spectacle corrective lenses for those needing a large and significant prescription in both eyes or a large difference in prescription between the two eyes.
The next most common cause if from a misalignment between the two eyes that causes crossing or straying of the fellow eye. A child’s brain has the capacity to suppress vision out of the deviating eye in order to avoid double vision. Due to the suppression, the visual pathway is underutilized and does not develop concurrently with the dominant eye.
A rarer cause of amblyopia is due to deprivation of sight from a congenital cataract, drooping eyelid or eyelid mass.
How do we diagnose amblyopia?
A comprehensive thorough pediatric eye examination can detect issues with the visual system that would be suggestive of amblyopia. It may uncover unknown refractive errors or a need for glasses. We will also assess for stereo vision which is the ability of the patient to fuse images from both eyes to obtain complete depth perception. It may also detect subtle ocular misalignments in addition to ocular pathology that had previously gone unnoticed.
How do we treat amblyopia?
When early intervention is implemented, favorable outcomes can often be achieved and we can ultimately obtain functional vision in the amblyopic eye for your child.
The treatments can begin with obtaining a prescription for full time wear of eyeglasses to correct for the refractive error. If this does not correct for the amblyopia, physical patching therapy or chemical patching with eye drops may be needed. Patching therapy helps encourage the child to utilize the weaker eye to further develop the underdeveloped visual pathway. Your child may need multiple follow up visits to monitor for resolution of the amblyoipa and the efficacy of the treatment. Although other interventions are undergoing FDA studies, they have not been approved at this point in time.
When is surgery indicated and is it covered by insurance?
Surgery is indicated if the eyes are significantly misaligned and the patient is suppressing the deviating eye or experiencing double vision. This is a functional surgery and it is covered by insurance.
Are there alternatives to surgery?
There are times when the placement of prisms inside corrective lenses may help alleviate the symptoms of suppression or double vision.