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Home » Vision Therapy » Amblyopia (Lazy Eye)

Amblyopia (Lazy Eye)

Young Mother Reading to Baby 1280×853Amblyopia, which is also called “lazy eye”, is a disorder that affects the visual development in children. Amblyopia is difficult to correct just with the use of eyeglasses or contact lenses alone. Studies have shown that with the proper eyeglass prescription in conjunction with undergoing vision therapy will provide optimal visual improvement. Amblyopia can cause vision loss if it is not treated early and properly. This vision disorder affects 2-3% of the population.

What are the symptoms of Amblyopia?

Usually children that are born with amblyopia, the symptoms start in early childhood. Some signs of amblyopia in children are squinting, closing one eye in order to see better, poor general vision, headaches, and eyestrain. Usually caretakers such as parents, caregivers, doctors, or nurses notice these symptoms and recommend the child for treatment.

What are the causes of Amblyopia?

Strabismus is usually the cause of amblyopia. Strabismus is the eyes aligning incorrectly. Amblyopia can also be caused when there is a large difference between the eyes in refractive errors (prescription much higher in one eye than the other). For example, one eye is nearsighted, while the other is farsighted. If amblyopia is not treated, the brain will learn to disregard the vision in the eye with amblyopia. The eye that is disregarded does not grow with clear image and vision loss can be permanent.  This is why it is very important to get early treatment and take your child to see your eye doctor if any signs are apparent.

How is Amblyopia treated?

There are several treatments for amblyopia, depending on the cause. According to new research studies, the most common and up-to-date treatment is with the correct prescription eyeglasses and vision therapy. For more information visit www.amblyopiaproject.com.

Previous treatments of amblyopia include patching, atropine eye drops and/or surgery. Studies are showing these previous treatment methods are not as effective in treating amblyopia due to the following reasons:

eye patching stats1) Visual
- possible regression in visual acuity once patching is discontinued
- Still reduced depth perception and 3D vision
- negative Side effects from Atropine eye drops

2) Psychological/Emotional
- frustration, anger, unhappiness, bullied, teased
*these are common effect on children required to patch or use atropine eye drops (can you italicize this sentence?)

3) Surgery
-95% cases of strabismus are not a muscular problem and lies at the level of the brain control
- “Most strabismus is the result of an abnormality of the poorly understood neuromuscular (and brain) control of the eye movement. Less commonly, a problem with the actual eye muscle causes strabismus” (American Association for Pediatric Ophthalmology and Strabismus)

In a scientific study by Dr. Fitzgerald and Krumholtz, they found value in including vision therapy in the treatment of Amblyopia.

“Eye patching alone is no longer the standard of care” - Dr. Fortenbacher, OD

To read more about the article by Dr. Fortenbacher click here.

According to the Pediatric Eye Disease Investigator Group (PEDIG), Binocular Vision Therapy...
▪ Corrects binocularity
▪ Improves depth perception
▪ Reduces suppression
▪ Improves VA
▪ Faster results

Therefore, standard patching and atropine penalization may not be indicated.

Read the article on Ophthalmology Times discussing the benefits of binocular vision therapy activities to improve amblyopia (lazy eye) here https://www.ophthalmologytimes.com/view/pedig-focusing-binocular-activities-amblyopia

Vision Therapy

Vision therapy consists of eye exercises, which aim to teach the eyes to work together. In cases of amblyopia, the exercises require the brain to recognize the affected eye, which restores vision in that eye. Some doctors place a patch over the more functional eye, which forces the less functional eye to work harder and become stronger. The patch is generally worn for a few hours a day. Depending on the severity of the condition, treatment can last for weeks or months. Some children refuse to wear a patch, in those cases, a prosthetic contact lens is available. These contact lenses look like the regular eye, and are designed to block vision in that eye.

Prescription eyeglasses

If your child has developed amblyopia because of uncorrected vision, the first treatment is an appropriate eyeglass prescription and then vision therapy. When there is a strong uncorrected prescription, or when there is a large difference in prescription between the two eyes, sometimes amblyopia can result. The eyeglass prescription will aim to improve clarity of vision in both eyes while vision therapy will aim to train the brain to use both eyes equally. With vision therapy, the patient will perform exercises to allow the brain to use both eyes and not shut off information to one eye. This will minimize suppression of the brain to the weaker eye. Therefore, with vision therapy, patients will have improved eye teaming skills (binocularity) and depth perception (3D Vision). This will reduce clumsy behaviors such as bumping into walls or tripping. Patients also show improvement in sport’s performance by allowing them to easily now judge how far the ball is located, resulting in better game performance and confidence.

Amblyopia must be treated as early as possible as there is no chance that it will resolve by itself. Untreated amblyopia can lead to permanent vision loss in that eye and reduced depth perception. Amblyopia needs to be treated promptly so that your child can have the best vision possible in childhood and later in life. If you or anyone sees any signs of amblyopia, go to your eye doctor to find the best treatment for your child.

Vision Therapy is effective at ALL ages from child to adulthood

New recent studies show that vision therapy is effective not only in early childhood but also in adults as well. Why? Because of NEUROPLASTICITY.

“We are in a new era of neuroscience and everyday more applications are being investigated for brain rehabilitation. Neuroplasticity is a reality that nobody now denies.” – Dr. Ramachandran, Ph.D.

What is Neuroplasticity?

– Neuroplasticity is a process by which neurons can increase their connections with other neurons through sensory stimulation, learning and experience.

– New neurons in our brain can be created everyday.

– Scientific evidence shows that this can occur at any age. Neuroplasticity exists throughout life.

-The brain is so plastic that dendrogenesis can occur in less than 30 sec = New neural pathways are created!

For more information on how vision therapy is shown to be effective in adults see below:

Susan Barry (“Stereo Sue”) publishes a book called “Fixing my Gaze”

Newswise - For the better part of five decades, Mount Holyoke professor of biological sciences Susan R. Barry saw life as a flat landscape. Cross-eyed since infancy, she was able to see in only two dimensions, despite having several surgeries to correct the misalignment of her eyes.

After she realized in college that she wasn't seeing in three dimensions like others, Barry was advised by medical specialists that she had long passed the critical developmental window during which the visual center of the brain could rewire itself to correct the problem. When her sight worsened in her late 40s, she turned to optometric vision therapy - and she soon demonstrated that the previously neglected neurons of an older brain could be nudged back into action, enabling her to see in 3D for the first time at the age of 48.

Now Barry, a neurobiologist, recounts her struggle for her recovery in a new book, Fixing My Gaze: A Scientist's Journey into Seeing in Three Dimensions (Basic Books, 2009).

"I assumed that if I could see in 3D, I would be better at threading a needle, parking a car, and hitting a tennis ball," she said. "Of course, all of this is true, but I had no idea just how different and how magnificent the world would appear in all its glorious dimensions."

The book includes a foreword by renowned neurologist and author Oliver Sacks, who wrote about Barry in his award-winning 2006 New Yorker article, "Stereo Sue."

"Fixing My Gaze will offer inspiration for anyone in this situation, but it is equally a very remarkable exploration of the brain's ability to change and adapt, as well as an ode to the fascination and wonder of the visual world," Sacks wrote in the foreword.

Publishers Weekly praises the "poignant story" and recommends the book "for all readers who cheer stories with a triumph over seemingly insuperable odds." Fixing My Gaze has been featured in the Hot Science section of Discover magazine, as well as in New Scientist magazine and Princeton Alumni Weekly, in Scientific American Book Club, and as a SEED Magazine "pick" for the month of June.

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