A Review on Management of Amblyopia

Amblyopia is a visual cortex neurodevelopmental condition cause am vision abnormalities during childhood. It is one of the most typical causes of vision loss at an early age. It occurs due to abnormal development of the visual cortex. The part receiving signals from the diseased eye does not receive it correctly and thus develops abnormally. This abnormal development during the critical period of growth of child results in brain damage. Depending on its aetiology the types of amblyopia are Strabismic amblyopia, Visual deprivation amblyopia, Anisometric, Ametropic, Meridional, Toxic amblyopia. Clinical features are visual acuity is reduced, the effect of neutral density filter, the Crowding phenomenon is present. Complications of amblyopia include a Lazy eye becoming weak permanently, the eye may move out from the visual axis (squints). When treating amblyopia, our goal is that the eyes will work together in unison at an equal level; this will create a clear vision in the lazy eye. Amblyopia is treated in various ways depending on the seriousness of the disease and the patient's age. Patching of the non-amblyopic eye, as well as treatment with drugs like atropine, are common treatments. Vision therapy and some modifications to spectacles and contact lenses have been discovered to be effective in treating amblyopia in recent years. Modern Treatment- Falling Blocks, Occlu-pad. With current breakthroughs in amblyopia therapy, the success rate of a multimodal strategy is also improving. The purpose of this review article is to present information on the management of amblyopia. Literature on AMBLYOPIA MANAGEMENT has been taken from PubMed, Scopus, Science Direct, and other internet resources.

Rehabilitation of visual functions in adult amblyopic patients with a virtual reality videogame: a case series

Amblyopia or lazy eye is a dysfunction of the visual system that appears during childhood and traditionally has been considered untreatable in adults. Its main consequences are the loss of visual acuity and contrast sensitivity of the amblyopic eye and binocular vision impairments. During the last years videogames have been used as a therapeutic tool for amblyopia with the inconclusive results. The present work has assessed the effectiveness of a virtual reality videogame (AmbliOK®) in the neurorehabilitation of four adult clinical cases with anisometropic amblyopia. Visual acuity, contrast sensitivity, stereopsis and interocular suppression were assessed before, during, immediately after, one month and one year (in one patient) after the training. The intervention was conducted along four weeks (10 h) and yielded the variable results. In general, all patients showed an improvement in visual functions although not all ameliorated in the same way. Visual acuity measures improved in all patients, falling outside the amblyopia criterion at the end of the treatment. However, the improvement was not maintained one month later in two patients. Contrast sensitivity progressively improved for the amblyopic and the fellow eyes with all patients showing better results one month after the treatment. The patient assessed one year after still showed better results than in the baseline. Patients showing bad stereopsis in the baseline reached a performance considered normal one month and even one year after the treatment. The effectiveness of the treatment seems to be related to the characteristics of patients.

Factors Predisposing to Amblyopia After Exotropia Surgery

Amblyopia (lazy eye) is one of the significant complications of strabismus surgery. It is the most important cause of unilateral visual impairment in both children and adults. The current investigation was achieved to determine the postoperative amblyopia rate and to identify factors predisposing to amblyopia following exotropia surgery among patients who had been referred to Imam Khomeini Hospital in Urmia, Iran. The present investigation is a retrospective study that was conducted over three years (2008-2010). The study consisted of sixty patients who underwent their first strabismus surgery for treatment of horizontal deviation. Patients were followed up for at least 24 months, and the rate of postoperative amblyopia was measured. The preoperative deviation, strabismus type (exotropia vs. esotropia), visual acuity, age at surgery , and the number of operated muscles were analyzed as determining factors of postoperative development of amblyopia. Amblyopia was observed in 50% of cases during the follow-up period. No statistically significant differences were observed between amblyopic and non-amblyopic eyes in terms of sex, age at surgery, strabismus type, and visual acuity. But amblyopic eyes showed higher deviation angles compared to nonamblyopic eyes (<0.001). The Cox hazard model analysis revealed a significant contribution of deviation angle to postoperative development of amblyopia. A larger deviation angle has been identified as a positive predictor of postoperative development of amblyopia in our investigated population. Due to such a high rate of postoperative amblyopia, it seems better to initiate and complete amblyopia therapy before strabismus surgery.

AMBLYOPIA WITH RESPECT TO PARENTS AWARENESS AND PERCEPTIONS IN AL-JOUF REGION OF SAUDI ARABIA

Background/Objective: Amblyopia also known as lazy eye is an abnormal condition which is associated with decrease in an eye vision. Parents can play an important role in the management of amblyopia in their children, if they have correct information regarding the disease. The present study was conducted to check parents awareness and perception regarding the treatment, diagnosis, causes and consequences of amblyopia in Al-Jouf region of Saudi Arabia. Methodology: A questionnairebased study was conducted in Al-Jouf region of Saudi Arabia to fulfill the objectives of the study. A total of 429 parents aged between 19-45 years were included in the study. Out of 429 parents, 110 were males and 312 were females. Data obtained was analyzed both qualitatively and in percentages. Results: Majority of participants were of the opinion that there is no treatment for amblyopia 280 [66.4%], early treatment leads to better outcomes 369 [87.4%], can be best treated at young age 326 [77.3%] and condition worsens if left untreated 324 [76.8%]. It was observedthat parents occupation and source of knowledge regarding amblyopia is statistically significant with the amblyopia (p-value less than 0.05). Conclusion: In this study we reported that most of the parents are having mild to moderate level of knowledge regarding amblyopia. Furthermore, there is need for parents to increase their awareness level regarding the treatment options and causes of amblyopia.Social media has emerged as an important resource of information regarding amblyopia.

Adherence to home-based videogame treatment for amblyopia in children and adults

ObjectiveHome-based videogame treatments are increasingly being used for various sensory conditions, including amblyopia (“lazy eye”), but adherence continues to limit success. To examine detailed behavioral patterns associated with home-based videogame treatment, we analyzed in detail the videogame adherence data from the Binocular treatment of amblyopia with videogames (BRAVO) clinical trial (ACTRN12613001004752).MethodsChildren (7-12 years), Teenagers (13-17 years) and Adults (≥18 years) with unilateral amblyopia were loaned iPod Touch devices with either an active treatment or placebo videogame and instructed to play for 1-2 hours/day for six weeks at home. Objectively-recorded adherence data from device software were used to analyze adherence patterns such as session length, daily distribution of gameplay, use of the pause function, and differences between age groups. Objectively-recorded adherence was also compared to subjectively-reported adherence from paper-based diaries.Results105 of the 115 randomized participants completed six weeks of videogame training. Average adherence was 65% (SD 37%) of the minimum hours prescribed. Game training was generally performed in short sessions (mean 21.5, SD 11.2 minutes), mostly in the evening, with frequent pauses (median every 4.1 minutes, IQR 6.1). Children played in significantly shorter sessions and paused more frequently than older age groups (p<0.0001). Participants tended to over-report adherence in subjective diaries compared to objectively-recorded gameplay time.ConclusionAdherence to home-based videogame treatment was characterized by short sessions interspersed with frequent pauses, suggesting regular disengagement. This complicates dose-response calculations and may interfere with the effectiveness of treatments like binocular treatments for amblyopia, which require sustained visual stimulation.Clinical trial IDACTRN12613001004752