Amblyopia, commonly known as lazy eye, results from inadequate stimulation of the retina and abnormal binocular interaction during visual development. It can be caused by strabismus, significant refractive error differences between the eyes, stimulus deprivation, high symmetrical refractive errors, or uncorrected astigmatism. Diagnosis involves assessing visual acuity differences between eyes and other vision tests. Treatment aims to eliminate obstacles to vision by correcting refractive errors, forcing use of the weaker eye through occlusion or penalization of the stronger eye, with earlier treatment yielding better results. The required treatment time depends on the degree of amblyopia and patient compliance with the prescribed regimen.

1. AAMMBBLLYYOOPPIIAA
Dr. Christina Samuel

2. It implies a partial loss of sight in one or
both eyes For which no cause can be
detected by physical examination of the
eye

3. PPAATTHHOOPPHHYYSSIIOOLLOOGGYY
Amblyopia is believed to result from
inadequate foveal or peripheral retinal
stimulation and/or abnormal binocular
interaction that causes different visual
input from the foveae.

4. CCllaassssiiffiiccaattiioonn
Strabismic
Anisometropic
Stimulus deprivation
Bilateral ametropic
Meridional

5. Strabismic :
results from prolonged uniocular
suppression in children with uniocular
squint who fixate with the normal eye.

6. Anisometropic:
Caused by difference in refractive error
between eyes….one eye having a higher
refractive error than the other eye.

7. Stimulus deprivation:
Results from vision deprivation.
When one eye is totally excluded from
seeing early in life as in congenital
cataract or corneal opacities or ptosis
covering the pupil.

8. Bilateral ametropic:
Results from high symmetrical refractive
errors, usually hypermetropia.

9. Meridional:
Results from image blur in one meridian.
It can be unilateral or bilateral and is
caused by uncorrected astigmatism
usually >1D persisting beyond the
period of emmetropization in infancy.

10. DDiiaaggnnoossiiss
Clinical features
VA:
1. Difference of 2 lines between 2 eyes
2. Crowding phenomenon: Single letter
acuity better than linear acuity
• Color vision: Abnormal
• Contrast sensitivity: Decreased
• Stereoacuity: Decreased
• ? RAPD

11. TTrreeaattmmeenntt
Treatment of amblyopia involves the
following steps:
Eliminating (if possible) any obstacle to
vision such as a cataract
Correcting refractive error
Forcing use of the poorer eye by limiting
use of the better eye.

12. CCaattaarraacctt rreemmoovvaall
Cataracts capable of producing amblyopia
require surgery without delay.
Removal of significant congenital lens
opacities during the first 2-3 months of life
is necessary for optimal recovery of vision.
In symmetrical bilateral cases, the interval
between operations on the first and second
eyes should be no more than 1-2 weeks.
Acutely developing severe traumatic
cataracts in children younger than 6 years
should be removed within a few weeks of
injury, if possible.

13. RReeffrraaccttiivvee ccoorrrreeccttiioonn
In generally, optical prescription for
amblyopic eyes should correct the full
refractive error as determined with
cycloplegic.

14. OOcccclluussiioonn
It is the most powerful means of treating
of amblyopia by enforced use of the
defective eye.
Occlusion therapy
 Age to initiate treatment:
– The earlier the better
– After 6-7yrs of age, slow improvement
– Full time vs part time

15. Methods of occlusion:
1. Direct patch over skin: Best
(completely blocks stimulus from sound
eye)
2. Patch over back surface of glasses
3. Occlusive contact lens for very
uncooperative children

17. PPeennaalliizzaattiioonn::
A cycloplegic agent (usually atropine 1%
or homatropine 5% ) once daily to the
better eye
This form of treatment has recently been
demonstrated to be as effective as
patching for mild to moderate amblyopia.

18.  The time required for completion of
treatment depends on the following:
1. Degree of amblyopia
2. Choice of therapeutic approach
3. Compliance with the prescribed
regimen
4. Age of the patient

19. TTHHAANNKK YYOOUU