is poor vision in an eye that, for various reasons did not develop normal
vision during early childhood. When one eye develops good vision and the other
does not, the eye with poor vision is called amblyopic. Amblyopia occurs in
about 2-3% of the population and can only be treated in childhood, preferably
before 7 years of age. It is because of this possibility of developing amblyopia
(for which there are no outward signs) that Dr. Kronwith believes all children
should be examined by a pediatric ophthalmologist by 4 years of age. At this
age there can still be enough time to reverse the amblyopia before the child
is too old.
causes of amblyopia are strabismus and unequal focusing
of the eyes.
can cause amblyopia since when one eye is not aligned, the brain, which does
not want to experience double vision, will shut off the image in the deviating
eye. This prevents the development of the cells and nerves which enable that
eye to see.
focusing of the eye is the other major cause of amblyopia. If each eye has
to focus a different amount to see clearly, the brain, which cannot focus
each eye a different amount, will chose one eye to focus and the other will
remain out of focus. The unfocused eye does not develop normally and amblyopia
occurs. It is this form of amblyopia that is most difficult to diagnose since
the eyes may be perfectly straight and there are no complaints from the child
since there is excellent sight in one eye. Diagnosing this condition requires
dilation of the pupils and examination of the inside of the eye with special
instruments. Parents are often shocked to learn that their child has amblyopia
in this situation, especially when the child is too young to read the eyechart.
However, the doctor can, by examining the inside of the eye, diagnose amblyopia
even without the child reading an eyechart! This is again why all children
should be seen by 4 years of age, earlier if there is a family history of
of amblyopia almost always requires the patching of the good eye combined,
often, with glasses. The glasses will correct the error in focusing but this
is often not enough and the better eye must be patched in order for the brain
to be forced to use the amblyopic eye and develop the cells and nerve connections
necessary for excellent sight in that eye. Amblyopia is usually treated first
before correcting any associated strabismus.
is not treated, the child will permanently have a poor seeing eye. This will
cause many problems in the future including lack of depth perception and the
fear, that if anything should ever happen to the good eye, the child will
be left with poor or no vision in both eyes. We understand that most children
hate to have their eyes patched, especially when they depend upon that good
eye to see. As the parent, it is incumbent upon you to make sure the
child does what is best for him or her and the success or failure of the treatment
mostly depends upon your interest and involvement, as well as your ability
to gain your child's cooperation. Dr. Kronwith will go over various
methods to aid you.
detection and treatment, amblyopia is usually reversible and excellent vision