Lazy eye syndrome

Lazy eye syndrome or amblyopia is a functional (reversible) decrease in vision, in which one eye is partially or not involved in the visual process at all. Since the eyes in this case see different images, the brain is unable to compare them into a single three-dimensional image. As a result, the work of one eye is suppressed, and binocular vision is absent.

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Epidemiology

This disorder is estimated to affect 1-5% of the world's population. The pathology most often develops in early childhood.

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Causes lazy eye syndrome

The most common causes of amblyopia are the following diseases:

• strabismus,
• cataract,
• ptosis,
• refractive errors,
• astigmatism,
• nystagmus

This happens because both eyes do not work the same way and cannot equally send the same images to the brain.

Strabismus is when one eye is unable to focus on the object the sufferer is trying to see. In this situation, the brain begins to ignore the out-of-focus image. This causes the eye to become weaker. Over time, that eye may remain displaced, resulting in lazy eye syndrome.

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Symptoms lazy eye syndrome

Usually, lazy eye syndrome occurs in early childhood up to 6 years. Symptoms of amblyopia can be seen with the naked eye. Timely diagnosis and timely initiation of treatment are the key to success in the fight against this pathology. It is for this reason that children aged 6 months are recommended to undergo a full ophthalmological examination, the next one – at the age of 3 years.

Symptoms of lazy eye syndrome in children:

• Different directions of gaze of the eyes.
• Greater dominance of one eye.
• Poor depth perception.
• The vision of one eye is significantly worse than the other.

Clinical symptoms of lazy eye syndrome in adults differ from those in children:

• Split image.
• A feeling of a veil or fog before the eyes.
• Fuzzy outlines of objects.
• Drooping of the upper eyelid.
• Significant decrease in visual acuity.

Lazy eye syndrome is characterized by several functional abnormalities in spatial vision, including decreased visual acuity (VA), contrast sensitivity (CSF), as well as spatial distortion, abnormal spatial interactions, and impaired edge detection. In addition, individuals with this syndrome suffer from binocular vision impairments, such as stereopsis and abnormal binocular summation.

Forms

Depending on the cause that causes the disease, the following types of amblyopia are distinguished:

1. Deprivation - appears as a result of organic damage to one of the eyes. Most often, this is a congenital form, or acquired as a result of corneal opacity, cataracts. Such amblyopia is difficult to correct.
2. Anisometropic – appears when there is a large difference in the refractive abilities of the eyes. Characteristic when there is a significant decrease in vision in one eye. This type of pathology cannot be corrected with glasses or lenses, which complicates treatment.
3. Disbinocular – occurs with strabismus. Most often characteristic of children under 6 years of age. Treatment is not particularly difficult if the disease is detected in time and the correct diagnosis is made.
4. Hysterical - reversible deterioration of visual acuity in mental disorders, in particular hysteria. Often associated with photophobia and neurological symptoms. Treatment consists of bringing the patient out of this condition.
5. Refractive – occurs when there is a refractive disorder in one or both eyes.

Diagnostics lazy eye syndrome

In order to prescribe the correct treatment, it is necessary to conduct diagnostics and establish the correct diagnosis. Lazy eye syndrome in adults is determined by a complete ophthalmological examination. It is very important for the correct diagnosis to collect anamnesis, as well as the patient's complaints. The ophthalmologist must first visually assess the patient's condition and conduct an external examination, paying special attention to the eyeballs and eye slits, as well as the condition of the eyelids themselves. It is also important to assess the condition of the pupils and how they react to light stimuli.

Diagnosis of amblyopia involves conducting various tests. First of all, it is necessary to assess visual acuity, which is determined using a special board with letters of different sizes. It is also necessary to determine the patient's color perception and conduct perimetry. Additional methods for diagnosing lazy eye syndrome are biomicroscopy and ophthalmoscopy. These methods will help the doctor conduct an examination of the fundus.

To assess the refractive power, a study of the permeability of the vitreous body of the eye and the lens is carried out. In case of strabismus, it is necessary to determine the angle of strabismus.

Treatment lazy eye syndrome

Occlusion is the main method of treating amblyopia. It involves wearing an eye patch to force the lazy eye to work. This procedure should last 3-4 hours a day, not constantly. The result of this treatment method depends on the age of the child, the severity of the disease and strict adherence to the doctor's instructions.

If your child refuses to wear an eye patch, you may want to consider using specially designed contact lenses that block light from entering the eyes. These lenses will not affect your child's appearance.

If for some reason it is not possible to wear an eye patch, it is possible to use Atropine drops. One drop of the drug is dripped into the healthy eye, which promotes constant dilation of the pupil and blurring of the image. This leads to the fact that the brain makes the lazy eye "work". The advantage of this method is the absence of wearing any patches, and among the side effects is photosensitivity. Constant dilation of the pupil can lead to paralysis of the ciliary muscle, which entails a violation of the eye's accommodation and ability to focus.

If the development of amblyopia is caused by a refractive error, treatment of the pathology consists of wearing glasses, lenses, laser vision correction, and for children, vitamins for vision are recommended [Blueberry Forte, Vitrum Vision (Vision), Doppel Herz Lecithin and Active].

If the cause of lazy eye syndrome is nearsightedness or farsightedness, ophthalmologists recommend the use of corrective contact lenses or glasses.

In case of strabismus, drooping of the upper eyelid, cataracts, surgical intervention is used to eliminate lazy eye syndrome, because it is necessary to initially eliminate the causes, and only then begin to correct amblyopia.

Frequently used methods of treating lazy eye syndrome in ophthalmology are laser stimulation, electrical stimulation, photopulses. These methods help stimulate the lazy eye.

In the complex treatment of lazy eye syndrome, special exercises are also prescribed that will help train the lazy eye.

New treatment methods

Transcranial magnetic stimulation of the brain can temporarily improve contrast sensitivity and spatial resolution in the affected eye of adults with amblyopia. This treatment is under development. In addition, various types of brain stimulation have been proposed for the treatment of lazy eye syndrome using anodal transcranial direct current stimulation.

Older children and even adults suffering from this disease can use special computer programs that improve visual acuity and contrast sensitivity.

One such program is RevitalVision. The treatment typically consists of 40 sessions of 40 minutes each, conducted over several weeks.

Currently, RevitalVision is the only FDA-approved computerized treatment for lazy eye syndrome.

Prevention

To prevent the development of lazy eye syndrome, the American Optometric Association recommends an initial eye exam at 6 months of age, a second exam at age 3, and a third exam before entering school.

For children under one year of age, as a preventative measure, toys can be placed further away, and bright objects should not be placed close to the child’s face.

For effective prevention of amblyopia, it is essential to have good, healthy sleep and systematic relief of eye strain, which is ensured by special exercises.

Lazy eye syndrome is a disease that requires a visit to an ophthalmologist at the first signs; it can be treated, and diagnosis is not particularly difficult.

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