Amblyopia is a condition in which one eye sees better than the other due to the visual center not developing sufficiently during infancy and childhood. Its name in the medical literature is amblyopia.

The prevalence of amblyopia in the population is 1.5% to 3.5%. In the early stages, it causes symptoms such as frequent blinking movements or shifting of the weak eye to the right or left in children. Lazy eye often occurs in one eye. However, in some cases, it can occur on both sides.

Amblyopia occurs when the brain focuses on the signals coming from the better seeing eye and the visual acuity decreases in the other eye. The main reason for its formation is the anomaly experienced during childhood. These are usually problems such as cataracts, strabismus or neglect of a refractive error that requires the use of glasses, and droopy eyelids. The disease may also occur due to genetic transmission.

Amblyopia treatment is carried out by stimulating the visual center in various ways and restoring its functionality. Since the development of the visual center in the brain is completed by the age of 8-10, early diagnosis is critical in the treatment of amblyopia. Families have the main responsibility in detecting the problem early for early diagnosis.

What is Lazy Eye?

Amblyopia is a problem in which one eye becomes idle and sees less than the other due to the insufficient development of the visual center due to an anomaly in the eye during childhood. Amblyopia can occur even if there is no structural defect in the eye.

The brain develops continuously from birth, which means that the person’s vision capacity also develops throughout the development process. For this reason, the person begins to see better over time.

During this development process, the image coming from outside does not fall on the retina properly due to an anomaly in any eye. At this point, the brain prefers to perceive images coming from the better seeing eye. As a result of this situation, the poorly seeing eye becomes inactive and lazy eye develops. In other words, the disease is a problem with the development of the visual center in the brain.

What Causes Lazy Eye?

There are multiple reasons for the formation of amblyopia. Common causes of the disease are as follows:

Strabismus: Strabismus is known as strabismus in the medical literature. It is the most common cause of the disease. There are six external muscles in each eye, and weakness in one of these muscles causes strabismus. If strabismus occurs in newborns and does not disappear after 6 months, this condition is considered a disease. To prevent the child from seeing double due to misaligned eyes, the brain deactivates the side with misalignment and perceives the image coming from only one side. Thus, lazy eye occurs.
Glasses Number Differences Between Two Eyes: Refractive errors can be corrected with the use of glasses. The fact that myopia, astigmatism and hyperopia problems are more common in one eye than the other causes blurred vision on one side compared to the other, which causes the brain to not perceive the image coming from one eye to create an optimized image perception. As a result, laziness may occur if the refractive error with a high degree of refractive error is not treated with glasses or contact lenses.
Droopy Eyelid: Congenital or acquired droopy eyelid blocks the field of vision by at least 1 millimeter, preventing healthy vision. This situation may lead to the formation of the disease.
Blurring in Eye Tissues That Should Be Transparent: Cataract problem or clouding of the cornea causes the image that falls on the retina and is transmitted to the visual center of the brain to be unclear. As a result of this situation, the brain will only accept the image coming from the healthy side. This results in lazy eye.

Symptoms of Lazy Eye

Symptoms of amblyopia may manifest themselves as a rapid decrease in visual acuity, loss of vision in both eyes, and difficulty in perceiving depth of field when the disease is left untreated. Since the disease begins after birth and occurs in childhood, it is difficult for the person to realize it himself. Symptoms of amblyopia usually appear in childhood, between the ages of 6 and 9.

The first symptoms do not appear until the disease progresses. Therefore, it is difficult to diagnose at an early age. The sensitivity of the family in recognizing the symptoms is important. Additionally, regular check-ups are critical for early diagnosis.

Symptoms of the disease include vision loss that does not improve despite the use of glasses. In addition, strabismus, eye misalignment, and eye tremors are also among the symptoms of the disease. Children with these symptoms should be taken to an ophthalmologist without delay.

Because as time passes, the possibility of early diagnosis is delayed and the probability of success of the treatment decreases accordingly. The most common symptoms of amblyopia are as follows:

-Difficulty identifying distant or close distances of objects (depth perception problem)
-Blink frequently and to see objects clearly
-Frequent rubbing of eyes
-Having difficulty performing tasks that require coordination of hands and eyes
-Turning the head to one side or tilting forward while looking at the focused object
-Don’t be afraid to look closer.
-Having problems with attention deficit
-Double vision

Lazy Eye Diagnosis

Diagnosing amblyopia is difficult in children when there is no visually evident disorder such as strabismus and eye misalignment. That’s why parents often don’t realize if there is a problem. Additionally, poor vision in one eye cannot be directly associated with amlyopia. Doctors can easily diagnose how each eye tracks objects during an examination.

After diagnosis of the disease, it is necessary to start treatment without delay. As the disease progresses, the success rate of treatment decreases.

Lazy Eye Treatment

Lazy eye is a problem seen in an average of 3% of the total human population around the world. Especially in children, the period up to 8-9 years of age is critical for treating the disease. In this period, success can be achieved with early treatment.

For the treatment of amblyopia, the disease that causes this problem is primarily treated. If laziness is caused by cataracts, strabismus and eyelids, these problems can be resolved with surgical intervention. Apart from these options, surgical intervention is not possible in the treatment of amblyopia.

If there is a need for treatment with glasses, this treatment is started. After this treatment, the eye closing treatment phase is started. The aim of this treatment is to improve vision by forcing the weak side to be used.

In this treatment, the good seeing eye is covered with an adhesive pad and the lazy eye is enabled to function. At the end of the period planned at the beginning of the treatment, an increase in visual acuity is detected. If necessary, this period can be extended to increase visual acuity.

Orthoptic treatment is a type of physical therapy method. Its basis lies in the aim of activating the non-working muscles. It is an effective method for increasing depth perception, and is also known as eye exercises throughout the society.

Glass treatment is a form of treatment applied together with closure treatment in a hospital environment. A card consisting of black and white colors with different patterns is turned with the help of a machine at the bottom of a maze. Meanwhile, the child is asked to find the exit of the maze using a pencil. The aim of this treatment is to strengthen the eye muscles and also increase the ability to focus.

Neurovision Treatment

If the critical age threshold has been exceeded or for the problem of amblyopia in adults, it is possible to get positive results with neurovision treatment. This treatment is applied to teach the brain how to see by improving contrast sensitivity.

In neurovision treatment, the person is shown images with different contrasts and is given visual tasks. There are results showing that visual acuity in adults increases with this individually planned and computer-based treatment. The main purpose of the treatment is to increase the depth of vision for the side with amblyopia and to improve the coordination of the eyes with each other and with the brain.

Neurovision treatment begins in the office under the supervision of a doctor in the first session, and then the treatment continues in front of the computer at the patient’s own home.

It sends signals to the computer by clicking on various images and visual tasks shown to the patient with amblyopia problem. If the progress is correct, a positive signal is received from the computer; if there is a negative progress, a warning is sent to the person. This process continues until these visual tasks are progressed correctly.

The treatment is continued for an average of 2-3 days and 30-40 minutes on different days of the week. At the end of the period planned at the beginning of the treatment, the physician checks the change in the patient’s visual acuity.


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