The lazy eye syndrome in adults and children

Among a large number of various functional problems with vision, the lazy eye syndrome (or amblyopia) is most common.

This pathology is characterized by a visual defect, which arises from the coordination failure of the function of visual centers in the brain.

Epidemiology

According to the latest statistical data of polls conducted by specialists in the preservation and restoration of vision, in the world at least 2% of adults suffer from lazy eye syndrome. Among children this percentage is:

• about 1% without clinical symptoms of vision impairment;
• about 4-5% with diagnosed pathology of the visual organs.

At the same time, about half of the per- cent of preschool children fall ill with lazy eye syndrome every year.

In 91% of diagnosed cases, the syndrome is represented by a disbinocular and refractive variant of the course of the disease.

[1], [2], [3], [4]

Causes of the lazy eye syndrome

The lazy eye syndrome can form in the child even before the moment of his birth. In addition, some changes in the organs of vision may interfere with the rays on the retina - this may cause the development of amblyopia.

Other reasons may be:

• Hereditary predisposition.
• Omission of the upper eyelid.
• Refraction imbalance is anisometry.
• Congenital visual disturbances.
• Astigmatism.
• The opacity of the cornea of the eye.

[5], [6]

Risk factors

According to WHO, at the moment such factors are defined that contribute to the appearance of the lazy eye syndrome:

• premature birth of a baby;
• prematurity (lack of weight);
• retinopathy;
• Cerebral palsy;
• violations of intellectual and (or) physical development;
• family-related cases of such a syndrome, as well as strabismus, hereditary cataracts, etc.

In addition to these factors, the risk of developing a lazy eye syndrome increases:

• reception of alcoholic beverages by a pregnant woman;
• smoking during pregnancy;
• use of drugs prohibited during pregnancy.

[7]

Pathogenesis

For normal visual function, it is required that before the left and right eye there is a good visual field. Any obstacle that prevents the transfer of an accurate picture to the retina, during the first ten years of life of the baby can provoke the development of the lazy eye syndrome.

Most often, the syndrome occurs when there is an asymmetry in the visual perception. In this case, unilateral amblyopia develops.

Bilateral lazy eye syndrome may occur if there are serious bilateral visual disorders - for example, bilateral cataracts or amethropia.

In the lazy eye syndrome, vision can go down imperceptibly or quickly, leading to an absolute loss of visual function, but with the preservation of lateral vision.

[8], [9]

Symptoms of the lazy eye syndrome

Among the main signs of the lazy eye syndrome, the following should be emphasized:

• visible difference when looking in one direction;
• one-sided clarity of vision;
• decreased degree of visual perception of depth;
• decreased vision of the affected eye;
• the appearance of a dark spot (or spots) that interferes with vision;
• limitation of the visual field of one eye;
• decreased visual concentration of one eye.

The first signs of the disease may differ depending on the type of syndrome.

• Anisometropic lazy eye syndrome is manifested by myopia, hypermetropia and astigmatism, almost never occurs against the background of strabismus and is found in children under 7 years of age.
• Refractive lazy eye syndrome, in fact, proceeds secretly, without any obvious symptoms.
• Obscuration syndrome of the lazy eye is manifested by cataracts, clouding of the lens and cornea, small hemorrhages in the eye. According to the sensations, the patient sees surrounding objects, as if through a veil.

All types of lazy eye syndrome occur with increasing visual impairment.

Stages

By the degree of impairment of visual function, the lazy eye syndrome can be:

• weak (from 0.4 to 0.8 diopters);
• average (from 0.2 to 0.3 diopters);
• high (from 0.05 to 0.1 diopters);
• very high (less than 0.04 diopters).

The syndrome of mild and moderate degree is very difficult to diagnose, in contrast to other stages of the disease.

Forms

Depending on the initial cause, the specialists identified such types of secondary lazy eye syndrome:

• Refractive syndrome - characterized by a refractive disorder, fuzzy focusing of the picture with the eye (or eyes). Violation of refraction can occur with improper or inadequate treatment of myopia, hypermetropia or astigmatism.
• Obstetrical syndrome is a disorder associated with opacity of the cornea, ovulation of the eyelid and congenital cataract. This violation leads to a significant decrease in vision without hope of recovery.
• Anisometropic syndrome develops with a refractive imbalance of the organs of vision, which leads to a wrong formation in the visual center of a clear visual image. As a result of this discrepancy, the brain center "turns off" one eye.
• Disbinocular syndrome occurs against a background of monolateral friendly strabismus. In the absence of qualitative focusing, a person's ability to see is reduced to zero (due to the development of the lazy eye syndrome as the result of aninopsy).
• The hysterical syndrome appears after a strong psychoemotional traumatic situation, when the visual perception is blocked by the brain. Especially often this variant of the syndrome develops in very impressionable and easily excitable people.

Complications and consequences

The lazy eye syndrome can lead to various adverse effects, the most severe of which is the absolute loss of vision. At the same time, the eyesight of not only the affected eye, but also the healthy one, may suffer, as it suffers from visual overload for many years.

The risk of loss of vision in the lazy eye syndrome is very high.

A number of consequences can be identified in the following list:

1. Absolute or partial loss of visual function, with the preservation of the possibility of side vision.
2. Professional inadequacy in many areas of activity.
3. Some social isolation.
4. Inability to manage vehicles and other mechanisms that require visual coordination.

[10], [11]

Diagnostics of the lazy eye syndrome

Early diagnosis is very important in order to influence in time the further development of the lazy eye syndrome and prevent the loss of vision.

Deprivational syndrome can be diagnosed already in a newborn, therefore it is recommended that the child be inspected no later than 4-6 weeks after his birth. When the child is 1 year old, a repeated control of the refractive power should be carried out. In case the child has a high risk of developing a lazy eye syndrome (for example, with an anamnesis), the ophthalmologist is examined every year.

Laboratory tests can not point to specific problems with the visual organs. With the help of blood tests, you can find out about the presence of inflammatory diseases, hematopoiesis, hormonal disorders, etc.

Instrumental diagnostics may involve the use of the following procedures:

• visometry (checking the degree of visual acuity with the use of special schemes Orlova or Sivtseva);
• perimetry (studies of the boundaries of the fields of vision, with a projection onto a spherical surface);
• automatic refractometry and keratometry - methods of refractive examination;
• control of motor function of the eyes;
• control of eye fixation;
• electrophysiological diagnostic procedures, which include electroculography, electroretinography, electrical sensitivity testing of the optic nerve and electroencephalography with further registration of potentials that are caused in the visual cortex of the brain.

Differential diagnosis

Often, the diagnosis of lazy eye syndrome is established using the elimination method. Thus, differential diagnosis is carried out taking into account the following diseases:

• Astigmatism, hyperopia, myopia.
• Congenital variant of optic nerve hypoplasia.
• Atrophy of the optic nerve.
• Compression, intoxication or hereditary factor with the development of optic nerve neuropathy.
• Retinopathy.
• The defeat of the nuchal lobes of the brain is cortical blindness.
• Glaucoma.
• Visual impairment associated with psychogenic pathologies.

Treatment of the lazy eye syndrome

Several techniques are known that are used by practicing ophthalmologists for the treatment of lazy eye syndrome.

The lazy eye syndrome in adults is most often cured after using occlusion, an artificial covering of a healthy eye with good eyesight. For this purpose, use a special device that is sold in pharmacies and optics. Due to the fact that the unaffected eye is covered, stimulation of the cerebral cortex of the diseased eye occurs, which eventually leads to restoration of the visual function.

Occlusion can be used to treat lazy eye syndrome, both in adult patients and in older children. The standard periodicity of carrying the device is 1 hour per day, with an increasing duration increase.

The lazy eye syndrome in children can be treated with computer correction - this method is used in most ophthalmological centers.

The total duration of therapy is determined by the doctor individually, which can depend not only on the age of the patient, but also on the degree of eye damage.

During the entire treatment period, the patient is under the control of a treating ophthalmologist, who evaluates the dynamics of the process.

In addition to these methods, it is possible to use hardware procedures, such as laser correction, electro and magnetic stimulation.

Medications are prescribed as a supplement to the hardware procedures. In the vast majority of cases, we are talking about multivitamin preparations, whose action is aimed at improving visual function, strengthening the optic nerves and improving metabolic processes.

To accelerate the restoration of vision and in the presence of indications, the patient can be recommended to wear contact lenses. Lenses will be especially relevant if one eye suffers from myopia, and the other - hyperopia.

Less commonly used is a therapeutic method, such as penalisation - this is a purposeful temporary decrease in the quality of vision of a healthy eye. This method leads to activation of the visual function of the affected side. Penalization is carried out with the use of atropine and is practiced for the treatment of lazy eye syndrome in children under 4 years of age.

Medicines and vitamins, which can be prescribed by a doctor with lazy eye syndrome:

• Biofit-blueberry is a biologically active additive to food, the purpose of which is to improve eyesight and save the patient from visual problems. The drug is taken, depending on the symptoms, from 1 to 3 tablets per day. Do not take the product if there is an individual intolerance of the constituent components.
• Duovit is a complex multivitamin preparation that is successfully used to support the body and replenish essential vitamins and microelements. Duovitis with lazy eye syndrome takes 2 pills a day. Rarely the drug can cause allergies.
• Lutein complex is a widely used biologically active additive, which contains carotenoids, flavonoids, vitamins and microelements, necessary for restoring the efficiency of the visual organs. Lutein complex is used for 1-3 tablets a day with food. The only contraindication to taking the drug is the individual intolerance of the constituent vitamins and other components.
• Vitrum is a supportive and restorative complex drug, which is recommended to take 1 tablet daily, both as a treatment for the lazy eye syndrome, and for its prevention. Vitrum is approved for use from the age of 12 years.
• Strix is a herbal preparation that has been approved for use since the age of 7 years. Strix improves the function of the retina and has long and successfully been used in ophthalmic practice, including with the lazy eye syndrome. The drug is recommended to take 1-2 tablets per day. Allergic reactions during treatment are relatively rare, but the possibility of their development should not be excluded.

An integrated approach often includes physiotherapy. Appointed procedures for drug electrophoresis, acupuncture (reflexology), as well as sessions of vibrating massage.

Alternative treatment

To slow down the development of the lazy eye syndrome and accelerate the restoration of vision can such recipes of alternative medicine:

• daily include in the diet young leaves of nettle, both fresh and dried - from them you can prepare the first dishes, salads, and add to garnishes and casseroles;
• every morning to drink a glass of currant or carrot juice (preferably freshly squeezed);
• prepare and periodically use wine from red or black currant (about 50 g of dry wine daily);
• to drink on an empty stomach blueberry juice, compote or mors.

Alternative treatment also implies the treatment with medicinal herbs.

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Herbal Treatment

• Take a handful of leaves or rosemary stems, pour 1 liter of dry white wine, insist two days and filter. Take 1 tbsp. L. Daily before meals.
• Take 3 tbsp. L. Plants of the hernia and 1 tbsp. L. Eyes, pour 600 ml of boiling water and insist under the lid for 2 hours. Take 1 glass before eating.
• Take 1 tbsp. L. Finely chopped parsley, pour a glass of water and boil for 2-3 minutes. Take 1-2 glasses a day daily, for a long time.
• Grind in a coffee grinder dried plants: rhizome ginseng (4 g), horsetail grass (5 g) and inoculum carrots (10 g). Take a little received powder on the tip of the knife three times a day before eating.

Homeopathy

The question of the use of homeopathic remedies in the lazy eye syndrome should be highlighted separately - especially if the pathology is caused by a violation of accommodation. Homeopathy can help to eliminate accommodation spasm, relax visual musculature. For this purpose, the following drugs may be suitable:

• Yaborandi, Physostigma - are used in case of pain in the eyes, with an accommodation disorder in patients with nearsightedness;
• Kokkulyus, Gelsemium, Pulsatilla - will help with farsightedness;
• Selenium, Likopidum - are applied at weak mobility of visual musculature.

Before applying homeopathic remedies, it is necessary to remember that their effectiveness is possible only against the background of the traditional treatment of the lazy eye syndrome. The dosage of drugs is set individually, after receiving a qualified homeopathic doctor.

Whether operative treatment is applied at a syndrome of the lazy eye?

Operative treatment is possible if the lazy eye syndrome is associated with the presence of strabismus or cataracts - in such situations it is really possible to help the patient. In all other cases, the operation does not allow to achieve complete elimination of the disease, so the only optimal option is considered a comprehensive therapeutic approach without performing a surgical intervention.

Prevention

In order to prevent the development of the lazy eye syndrome, it is necessary to observe some simple conditions:

• sleep well, rest;
• Do not overexert vision, avoid nerve shocks and injuries;
• periodically visit a doctor-ophthalmologist or oculist for preventive examination.

In some cases, when the risk of developing a lazy eye syndrome is particularly high, the doctor may recommend wearing special glasses that have the ability to relieve eye strain and alleviate the function of the optic nerves.

For children, even special computer programs are developed in the form of games that improve the quality of visual focusing.

[14], [15]

Forecast

The prognosis of the lazy eye syndrome may depend on many factors:

• from properly prescribed treatment;
• from the type of syndrome;
• from the quality of eye fixation;
• from the initial quality of sight;
• from the prescription of the lazy eye syndrome at the time of the beginning of treatment;
• from the age of the patient at the time of treatment;
• from the completeness of the therapeutic effect.

Unfortunately, there is no guarantee that lazy eye syndrome does not appear again after the end of therapy. Given this, patients should undergo a regular examination at an ophthalmologist two and four months later, and then six months and a year after treatment.

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