Refractive Amblyopia

Refractive Amblyopia

Amblyopia is a disorder characterized by loss of visual acuity in the absence of any structural eye defect and in spite of best vision correction. It affects only children. Amblyopia or ‘lazy eye’ may affect one or both the eyes. In amblyopia, the brain receives blurry images from either or both the eyes and gets used to those blurry images. So in spite of using corrective spectacles, the vision still remains blurry. Amblyopia is of 3 types – deprivation amblyopia, refractive amblyopia, and strabismic amblyopia. Refractive amblyopia occurs as a result of a large refractive error (myopia, hypermetropia, astigmatism) in one or both the eyes. The brain learns to ignore the eye with the refractive error and recognizes only the good eye. Refractive amblyopia frequently coexists with strabismus and anisometropia.

Causes and risk factors

An unequal refractive error in both the eyes (anisometropia) gives rise to refractive amblyopia. Since the brain ignores the blurred images from the bad eye, only half the visual system develops normally whereas the other half remains undeveloped.

Clinical presentation

The visual acuity of the child is reduced to a variable extent. The perception of depth is hampered and hence three-dimensional vision is difficult. Their spatial acuity (ability to detect shapes) and contrast sensitivity (detection of contrast between an object and its background) is poor. Their vision is less sensitive to motion and they frequently experience crowding phenomenon. Their stereoscopic ability (3-dimensional vision) is impaired and they are unable to carry out binocular summation (combining the information received from both the eyes).

Investigations

A vision test can easily diagnose refractive amblyopia.

Treatment

If detected early, refractive amblyopia has good scope for improvement. Corrective contact lenses are the preferred mode of treatment; however, corrective glasses may also be used. Refractive surgery can also be considered.

Patching of the good eye helps to improve the vision in the affected eye. A procedure known as penalisation is also recommended, wherein atropine drops are put in the good eye in order to blur its vision. This helps to develop the visual acuity of the other eye.

Complications

Deprivation amblyopia can result in loss of visual acuity up to the extent of blindness.

When to contact a doctor

Contact a doctor if you suspect that you kid is having any visual trouble.

Systems involved

Ophthalmology

Organs involved

Eyes

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