After the pandemic’s disruption to spring school sessions, we are hopeful that classes will resume in safe environments this fall. Now is the time to turn attention to children’s vision and a serious vision condition. Affecting about 3 of every 100 children, amblyopia is their most common cause of vision loss and can be difficult to detect in the very young. Also known as “lazy eye,” amblyopia is the condition in which the brain doesn’t recognize visual input from one and sometimes both eyes. The brain then relies on the stronger eye for vision, and the amblyopic eye becomes progressively worse.
Causes are not always known but there are three identifiable types of amblyopia: 1. Strabismus amblyopia is the result of an eye muscle imbalance that causes eye misalignment. 2. Refractive amblyopia, in which there is a significant refractive difference between the eyes, and 3. Deprivation amblyopia, which can be the most severe type, caused by an eye structure anomaly in infancy such as cataract or ptosis that impedes clear vision. Risks include premature birth, small birth size, developmental disability and a family history of childhood eye conditions. Symptoms include a misaligned eye after a few weeks of age, poor depth perception, squinting, closing one eye and head tilt. There are techniques for assessing vision in infants who are at risk or exhibit symptoms, and eye exams are recommended for all children between ages 3 and 5 years.
The sooner treatment begins, the better because amblyopia becomes more difficult to treat with age and can be nearly impossible to treat in adulthood. Surgery is sometimes needed for muscle imbalance, but the most common treatment is to occlude the better eye to stimulate the brain to accept input from the weaker eye. Methods of occlusion include patching, atropine to blur the better eye, Bangerter foil to frost an eyeglass lens and an opaque contact lens. The American Association for Pediatric Ophthalmology and Strabismus notes that eyeglasses and contact lenses can be successfully used on infants as young as one week. An opaque contact lens, when parents have been trained in care and handling, may have advantages over patches and spectacles on children. A contact lens won’t be pulled off, the child can’t peek around it, and it is cosmetically less obvious for school age children.
As we prepare so carefully for the coming school year, let’s remember one very special tool our children need—their vision. Learn more about the development of the visual system and common refractive errors in children with our CE, “Check Your Eye Development IQ” at 2020mag.com.
• Linda Conlin
Pro to Pro Managing Editor