Amblyopia

Introduction
Amblyopia is a condition where vision fails to develop fully in one eye. Mostly seen among children, it is also called as the ‘lazy eye’. If not treated timely the vision fails to develop correctly in that eye. Vision dysfunction becomes long lasting as the developing brain of the child may ignore images from poorly developed eye. Hence, regular diagnosis of the child with amblyopia is extremely essential.

Causes
Amblyopia develops when one eye has a much clearer focus compared to the other eye. For instance, one eye might be farsighted or have astigmatism, while the other does not manifest this disorder. When a child’s brain is confronted with both a blurry image and a clear one, it begins to ignore the blurry image. When this occurs for months or years in a young child, the capacity to perceive the blurry image gets deteriorated.

Another cause of amblyopia is strabismus, an ocular misalignment, which turns one eye inward or outward. This prevents the eyes from focusing together on an image and may lead to double vision. To fight this condition, the child’s brain generally chooses to ignore the image from the deviated eye, causing the vision in that eye to deteriorate. In other cases, a child is not able to see correctly with one eye because something blocks light from getting through, such as a cataract or a small amount of blood or other material in the back of the eye.

Symptoms
Symptoms usually include vision that favors one eye. Hence, a tendency to bump into objects on one side is noticed. Symptoms are not always apparently manifested.

Diagnosis
It is mandatory to screen at school-going age. The eye specialist checks for three aspects of child’s eye health. The eyes should allow light to pass through them. Both eyes should show equal vision and move normally.

Eye care experts recommend an exam by an eye doctor at 6 months, 3 years, and consecutively every two years during school phase. Family history of amblyopia is a risk factor for the condition. It is rather difficult for parents to detect amblyopia in children. Timely diagnosis and treatment is the solution to obtain best visual outcome.

Treatment
Most commonly used treatment for amblyopia is to compel the brain to start using the visually challenged eye. This is initially done by correcting underlying problems in the eye and then by concealing the eye with proper vision. Initially, the child can face problem while perceiving vision with the weaker eye. Hence, it is very important for the child to wear the patch to improve his/her vision. It usually takes weeks or months for an eye patch to have improved vision. It is important to follow doctor’s instructions and schedule diligently during the treatment.

Once the condition improves and vision normalizes, it is not essential to wear the patch. In some situations, children are likely to lose partial vision and hence, are required to wear a patch again. In mild amblyopia cases, the doctor recommends an eye drop called atropine to be inserted in the proper eye instead of a patch. The action of atropine dilates the pupil and blurs the vision, forcing the less functional eye to carry out visual perception when the child is involved in activities such as playing, eating, drawing, or reading.

Most children with amblyopia need glasses to focus. If cataract is the reason behind the blocking of light, an eye surgery may be recommended to remove the blockage. If strabismus is obstructing the eyes from synchronized movement, doctor may suggest surgery for the muscles of the eye.

Alternative Medicine
Naturopaths recommend intake of citrus fruits and carotene rich vegetables for delaing with this eye condition. Citrus fruits contain bioflavonoids such as eriocitrin, hesperidin, flavonols, flavones, flavonoids, naringenin, and quercetin. These along with Vitamin C (Ascorbic acid) are hugely vital for eyes. Vitamin A is important for strong healthy eyes. Carotenes get readily converted to vitamin A in the body. Mixed carotenoids (astaxanthin, beta carotene,cryptoxanthin, lutein, Lycopene, Zeaxanthin)
can be obtained from carrots and other brightly colored vegetables. Extracts derived from plants of Bilberry  (Vaccinium myrtillus); Jujube extract (Zizyphus jujube); Suma extract (Pfaffia paniculata); Sarsaparila; active components found in Mucuna pruriens and Lycium berry are also known to heal eye conditions. Magnesium and Zinc are known to improve vision. Most of all, DHA, a primary structural fatty acid present in the brain and retina of the eye is important for signal transmission in the brain, eye and nervous system.

Homeopathy Remedies
Euphrasia, Natrum Mur, Nux Vomica, Phophorous, Pulsatilla are some of the homeopathic remedies used for treating this ailment.

References
1. Kushner, BJ. Amblyopia. In: Nelson LB, ed.Harley’s Pediatric Ophthalmology. 1998:125-39.

2. American Academy of Ophthalmology. Amblyopia. In: Basic and Clinical Science Course: Pediatric Ophthalmology and Strabismus. 1997: 259-65.

3. Bruce A, Pacey IE, Bradbury JA, Scally AJ, Barrett BT. Bilateral Changes in Foveal Structure in Individuals with Amblyopia.Ophthalmology. Sep 29 2012;[Medline].

4. von Noorden GK. Binocular Vision and Ocular Motility: Theory and Management. 1996;216-54.

5. Daw NW. Critical periods and amblyopia.Arch Ophthalmol. Apr 1998;116(4):502-5. [Medline].

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