Among the most frequent visual disturbances in children is amblyopia, also known by the term “lazy eye syndrome“. This has been affecting about 2% of the entire population and 4-5% of children. It is considered one of the leading causes of visual impairment and blindness in people under 20 years of age.
Amblyopia cannot be called a real disease but more or less a marked loss of visual acuity of an eye with respect to which the child is instinctively brought to compensate with his good eye, thus adapting to the disturbance of vision.
Patients with amblyopia are often asymptomatic. Occasionally, patients will complain that one eye is blurry, or younger children may report discomfort in the affected eye.
Amblyopia is an anomaly rather devious as there are no particular symptoms or disorders and it is very difficult for a parent to see that your child is not equally using both eyes.
The diagnosis requires two components. First, the patient must have a condition that can cause the disorder. Examples would include strabismus or a deprivation cause (ptosis, cataract, etc.). Second, the patient must have residual asymmetric acuity beyond the level expected from the underlying condition. For example, a child with hyperopia receives proper spectacle correction. Acuity in the more hyperopic eye improves but is still below that of the less hyperopic eye.
Since amblyopia stabilizes permanently at around 8-10 years of age, it is absolutely necessary to undergo an early diagnosis to begin an optical correction and appropriate rehabilitative therapy treatments that have good success rates before 5 years of age.
Otherwise, amblyopia may result in the permanent visual impairment and interfere with the proper mental and physical development of the individual.
The key to optimal treatment of amblyopia is early detection and intervention. Treatment consists of addressing the etiology of the diminished vision. Often, there is residual amblyopia which may improve over time. Active treatment with patching can often improve the residual visual deficit.
Gradually, it will lead to a proper balance of visual acuity in both eyes.
Treatment is always carefully tailored to the patient’s needs. The eye specialist, depending on the severity of the condition and the patient’s age, determines the number of hours per day of the need for patching. Normally, it only takes about 6-8 hours daily for a period ranging from several weeks to a few months, preferably accompanied by activities that stimulate vision such as reading and drawing.
Pharmacologic penalization of the sound eye is another commonly used modality to treat amblyopia. Dosing can be a drop in the sound eye daily, or on weekends only. A recent study showed results with weekend-only dosing to be similar to daily dosing for moderate amblyopes.