Amblyopia: Warattaporn Chanlalit MD

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Amblyopia

Warattaporn Chanlalit MD

Definition
Decrease central vision without detectable anatomical damage in eye or visual pathway

Definition
Result from abnormal visual experience during critical period of visual development ~ 8-9 yr visual loss and brain damage

Classification
Strabismic amblyopia
most common form develop in consistently deviating eye

Classification
Refractive amblyopia
Anisometropic amblyopia
significant difference in refractive error between two eyes common in hyperopia, astigmatism > 1.00-2.00 D myopia > 3.00 D detection and tx often delay until school age

Classification
Isoametropic amblyopia
bilateral equally high refractive error common in myopia > - 10.00 D hyperopia > + 5.00 D astigmatism > 2.00 D

Classification
Deprivation amblyopia
least common but most damaging and difficult to treat cause
cong cataract ptosis media opacities

unilateral deprivation produced more severe effects

Diagnostic test
Preverbal & preliterate child
binocular fixation pattern

Literate child
decrease VA > 2 Snellen lines Crowding phenomenon

other : grating acuity, neutral density filter effect

Treatment
Eliminate any obstacle to vision Correcting refractive error

Force using poorer eye


occlusion therapy penalization (medical, optical)

Neurotransmitter : levodopa, carbidopa

Complications of therapy
Iatrogenic amblyopia
regular F/U is required

End point
Alternate fixation VA differs < 1 Snellen line

THE END

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