17Mar

The causes and treatment of amblyopia in children

Amblyopia in children is persistent, taking place without any visible changes in the fundus, and unchangeable correction, a decrease in central vision.

In this case, changes occur in the visual cortex of the brain. At the same time, the development of the parts of the nervous system responsible for the vision is slowed down. Therefore, the therapy of this disease is very difficult, and sometimes fruitless.

Normally, light rays entering the eye focus on the symmetrical areas of the retina, which contributes to an adequate perception of the images.

If, as a result, the rays do not reach the retina or are focused on asymmetric areas, the perception of information is disturbed and amblyopia develops. The second name is "lazy eye syndrome" , becausewith this pathology, one eye usually does not work, and all the load falls on the other.

Obstructive amblyopia in children

The causes of amblyopia in children may be different. This or another pathology in the eye somehow prevents the rays from getting on the retina, which eventually ends with a lazy eye. This is the so-called secondary amblyopia, in addition to which there is also a primary variant of the disease developing in one or both eyes without any apparent reason. There is also such a thing as congenital amblyopia.

Depending on the specific reason that led to the development of this disease, several of its types are distinguished.

Obstetrical amblyopia , as a rule, develops in the presence of a thorn( ie, opacity of the cornea).Also, its occurrence can be expected in such a state as congenital opacification of the lens. Perhaps the appearance of this variant of the disease and with ptosis( omission of the century).

In this case, it is characteristic that as a result of untimely elimination of these causes, the patient retains a reduced vision that is difficult to restore. And sometimes it does not seem possible to restore it.

Peripheral amblyopia in children as a result of astigmatism

Strictly speaking, children often have amblyopia and astigmatism combined. Moreover, astigmatism with respect to the refractive form of the lazy eye syndrome is perhaps the main reason.

Refractive amblyopia in children is characterized by the fact that because of the blurred image of the retina of one eye, the perception of the image by the symmetrical retinal segment of the other eye is disturbed. As a result, one of the retinas, as it were, "turns off" from work, the other eye assumes the role of presenter.

Amblyopia and strabismus in children

Anisometropic amblyopia occurs with high degree of anisometropia, a condition in which each eye has a different refraction( ie refractive force).

The development of the disease in this case occurs on the eye where anisometropia is more pronounced and can not be corrected.

Disbinocular amblyopia develops on the mowing eye, which is "turned off" by the brain, so as not to interfere with normal vision.

It should be noted that strabismus and amblyopia in children seem to flow from each other: strabismus leads to amblyopia, and it in turn, as it progresses, aggravates strabismus.

Do not forget that there is a type of described disease, such as hysterical amblyopia. It is not difficult to guess that he is developing under hysteria.

Amblyopia in children with high degree and amblyopia of both eyes

Speaking about the manifestations of this disease, it can be noted that it stands on three whales: in any form of the disease, visual acuity deteriorates, binocular vision disorder develops, and improper fixation( and in some casesit is generally absent).

It must be said that, depending on how much vision is reduced, a weak degree of the disease( vision 0.4-0.8), an average degree of disease( at which the vision is at a level of 0.2-0.3), as well as high( sharpness 0.05-0.1) and very high( vision below 0.04) degree.

Amblyopia of high degree in children is accompanied by strabismus and visual fixation.

Visual fixation is a fixed installation of the eye when looking at an object. Fixation is considered correct when the image is fixed in the area of ​​the retina yellow spot. For this factor, the "lazy eye" is divided into three types: with correct or incorrect fixation, as well as with its absence.

In addition, it is worth mentioning that amblyopia is one-sided or two-sided. The first, as a rule, does not affect negatively the life, development and level of health of the child. Amblyopia of both eyes is the worst option.

Is it possible to cure amblyopia and who cured amblyopia in a child?

Those who cured amblyopia in a child will confirm that they did it at an early age. But after 7 years, when the formation of the eye has been completed to a greater degree, the effect of treatment may not be.

Treatment of amblyopia in children, as a rule, echoes with strabismus therapy, because these two diseases are closely related: strabismus is complicated by amblyopia, and in case of high amblyopia, strabismus appears in turn.

In each case, the treatment plan is individual. In this case, it is not superfluous to say that the basis of all is the elimination of the cause.

How to treat amblyopia in children

When obscurating the disease, surgery comes to the fore: it is necessary to remove cataracts, get rid of ptosis, etc.

It is better to operate the first six months of a child's life to avoid serious visual impairment. However, in the case of small cataracts, it is better to wait until 4-6 years.

In the case of the disbinocular form of the disease, it is necessary to restore the correct position of the eyeballs. This is also done by surgical methods.

When deciding how to treat amblyopia of refractive or anisometropic type, preference is given to conservative methods.

At the same time they begin with the appointment of glasses, and after 3 weeks they go to the so-called pleiotics necessary to activate the amblyopic eye, against the background of eliminating the competition of the eye that sees better.

In children under 4 years of age, this treatment starts with a penalization, the essence of which is that the eyesight of a healthier eye is purposefully worsening, with the passive involvement of the worst eye in the work.

From the age of 4, you can apply occlusion. It is also used in the absence of a positive effect of penalization. This method consists in gluing the eye, which is carried out with a plaster or a piece of clean tissue. Also, you can close the eye with a special occluder, which is sold in the pharmacy. In this case, with a direct occlusion, the eye closes, which is better seen, and when the occlusion closes, the amblyopic organ of vision is sealed.

The method of local dazzling light applies to apparatus treatment of amblyopia in children. Its essence in local stimulation by special apparatus or lasers of the foveolar zone of the retina.

In the treatment of this disease in older children, usually use a variety of computer programs.

Additional methods include reflexotherapy and percutaneous electrostimulation.

Following the pleoptotic treatment, the stage of amblyopia therapy is the orthoptic method. His goal is to restore binocular vision. It is used when it reaches the age of four. In this case, the visual acuity of both eyes should be at least 0.4.

To restore binocular vision, synoptophore exercises help. In this case, for each eye with the help of special eyepieces are shown those or other parts of the image. The patient must unite these parts together.

As soon as the ability to merge appeared, begin training to fix it. To develop binocular vision is possible and with the help of specialized computer programs.