Amblyopia  

AMBLYOPIA DIAGNOSIS

Ophthalmologist diagnose amblyopia by checking to see if vision differs between the two eyes. To check a baby’s or young child’s vision, the ophthalmologist may cover one of the child’s eyes and watch how well they can follow a moving object. The doctor may also watch how the child reacts when one eye is covered. If one eye has amblyopia and the other good eye is covered, the child may try to look above or below the patch, pull it off or cry.

The ophthalmologist will do a complete medical eye exam, looking for other eye problems that could be affecting vision leading to amblyopia.

WHEN SHOULD A CHILD’S VISION BE TESTED?

All children who are born with normal weight and apparently healthy otherwise should have their vision checked by their paediatrician, family physician, or ophthalmologist at or before entering pre-K or kindergarten.

Some children need earlier eye checkup if there is a family history of misaligned eyes, childhood cataracts or serious eye diseases in the family. Ideally an ophthalmologist should check their eyes when they are an infant. Premature babies with low birth weight need eye checkup immediately after birth.

Most doctors test vision as part of a child’s medical exam. If they see any sign of eye problems, they may send a child to an ophthalmologist for further tests.

AMBLYOPIA TREATMENT

AMBLYOPIA IS USUALLY CORRECTED BY MAKING THE CHILD USE THEIR WEAKER EYE. This is often done by putting a patch over the child’s stronger eye. In some cases, eye drops can be used to blur vision in the stronger eye. Or the child may wear eyeglasses with a lens that blurs vision in that eye.

It generally takes several weeks to several months for vision to get stronger in a weaker eye. Once the child has better vision in that eye, then we need to wear an eye patch part-time for a few years. This helps keep their vision strong. Remember to keep all appointments with the child’s Ophthalmologist who will carefully monitor your child’s vision.

HOW TO CHOOSE AND USE AN EYE PATCH?

An eye patch should be comfortable, yet remain firmly in place. It should not allow the child to peak around its edges. Most drug stores have a variety of sizes and types of eye patches. Decorated fun patches are available online. Do not use the black eye patches with elastic bands or ties (such as a pirate-type patches). These are too easy for a child to remove or peak around. To wear the patch, simply attach it to the skin around your child’s eye.

If your child wears glasses, there are patches designed to attach to the lens. These may be good for children who are used to wearing a patch, but they are not as good for a child’s new to treatment. This is because the patch can slip or the child may learn to peek around it. If your child wears glasses and is not used to patching, it is best to attach the patch directly around the stronger eye underneath the glasses.

KEEP YOUR CHILD FROM TAKING OFF THE EYE PATCH

• Children do not like to have their stronger eye patched or blurred. However, you need to help your child do what is best for them. Otherwise, treatment will not work.
• Try distracting the child or having them do something that keeps their attention like playing with colourful toys or drawing or painting. Or reward the child with a treat for wearing the patch.
• It can take a while for your child to get used to wearing a patch. Over time, this should get easier for them and parents. Strengthening the weaker eye is the only way to develop healthy, normal vision in the weak eye.
• If your child still takes off the patch, as a last resort, cover his or her hands with gloves, mittens, or socks.

TEACH YOUR CHILD ABOUT THE EYE PATCH

• Pre-school or school-age children might not want to wear an eye patch or use blurring eye drops. To help, parents should explain how important these treatments are to be able to see well. And reassure them that lots of children wear eye patches for the same reason.
• Consider having a very young child practice putting an eye patch on a doll. Or let the child decorate his or her patch with crayons or markers.
• Explain the amblyopia treatment to child’s teacher. Ask teacher to compliment the child on being so good about wearing the patch. Children thrive one positive feedback from their teachers.

THINGS TO CONSIDER WITH PATCHING TREATMENT

• In very rare instances it is possible to overuse the patch or blurring eye drops. This can affect vision in the stronger eye.
• Be sure to keep the child’s appointments with the ophthalmologist so that vision in both eyes can be closely monitored.
• The skin near your child’s eye patch can get irritated. To help, try different size or type of patch, and angle the patch differently each day.
• Your child may initially be clumsy when wearing a patch. Try to keep an eye on your child when they are climbing stairs or being active.

SURGERY

• In some cases, the ophthalmologist will recommend surgery to correct certain eye problems causing amblyopia. After surgery, the child may need to keep wearing a patch or otherwise cover the stronger eye until their vision improves.

TREATING AMBLYOPIA USING NEW TECHNOLOGY

A new treatment for amblyopia uses a virtual reality (VR) headset to help improve vision in children aged 4 to 7. A child watches videos wearing the headset, which helps them use their weaker eye. To learn more, ask your child’s ophthalmologist.

TREATING AMBLYOPIA FOR BETTER LIFELONG VISION

When a child has amblyopia, it is important to make vision stronger in the weak eye. It is possible to prevent vision loss from amblyopia. For best results, amblyopia should be treated before a child reaches 7 or 8 years old. Many children do not like to have their stronger eye patched or blurred. However, you need to help your child do what is best for them – Correct causes of amblyopia. Even if eye problems causing amblyopia are corrected with glasses or surgery, the amblyopia itself must be treated. If not, the child may have lifelong vision problems.