Amblyopia, the most common cause of visual acuity decrease in children

Amblyopia, lazy or lazy eye is the most common cause of preventable visual acuity decrease in children, without there being any organic lesion in the eye that justifies it, it is generally of a single eye, although it can rarely be bilateral.

The incidence according to statistics varies from 1.3 to 5% of children, hence the importance of checking ALL children.

Amblyogenic factors can be strabismus (deviated eyes), anisometropia (different elevated refraction in each eye), high refractive errors of myopia, hyperopia and/or astigmatism, as well as cataract (clouding of the lens). Any of these diseases interfere with the development of visual pathways during the critical period of maturation, which is in the first years of life. The result is functional and structural damage to the visual cortex with damage to vision that can be irreversible.

With a population of 625 million children under 5 years of age in the world, more than 15 million may have amblyopia and more than half of them will not be identified until the school stage, that is why it is currently authorized by the Ministry of Health to carry out a visual screening of all newborns, in order to diagnose in time any disease that may cause a decrease in visual acuity. 

Many children who are not screened may suffer permanent vision loss that may have been preventable. The consequences of not identifying and treating these children early, in addition to causing them poor visual acuity, causes adverse effects on their school development, decreased fine motor skills, impairment in their social development, self-esteem and as an adult in their working life, being able to deprive him of doing the work he wants.

Treatment

Amblyopia occurs when there is a different image in each eye, if the difference in visual capacity between both eyes is significant, the child uses only the eye with the greatest visual capacity, while the opposite eye ends up being functionally nullified (suppresses). Although its physical structure remains intact and is an apparently healthy eye, it is simply an eye that could not manage to develop its maturity.

Treatment is based on 3 fundamental pillars:

  1. Determine the cause of the problem.
  2. Correct the problem with the necessary means, for example, the prescription of glasses if there is any refractive anomaly, surgery in case of congenital cataract, etc.
  3. Occlusion (patch), application of atropine drops, or use filters on the eye that has good vision to stimulate the neuronal pathways of the affected eye, that is, to put the lazy eye to work.

Conclusion

Children should be monitored periodically with the necessary frequency, which can vary from 1 to 6 months, depending on the depth of amblyopia and the age of the child up to 12 years.

The collaboration of parents is essential, they must understand the importance of early treatment, since a large part of the success of the treatment depends on their dedication practically 100%, because at that early age children don’t know how valuable treatment is for their future life.

Early diagnosis is a priority and must be carried out by the specialist.

Thanks to Dr. Patricia Díaz Bringas, a medical surgeon specializes in ophthalmology, who shared with us the information. She acquired a Sub-Specialty of Strabismus at the Hospital of the Association to Avoid Blindness in Mexico, where she completed her specialty in Ophthalmology. She has 34 years of experience and has focused on strabismus, examination for children, refractive surgery, among others.



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