Amblyopia (patient information): Difference between revisions

	Amblyopia;
	A child wearing an adhesive eyepatch to correct amblyopia
ICD-10	H53.0
ICD-9	368.0
DiseasesDB	503
MedlinePlus	001014
MeSH	D000550

	Amblyopia
Overview
What are the symptoms?
What are the causes?
Who is at highest risk?
When to seek urgent medical care?
Diagnosis
Treatment options
Where to find medical care for Amblyopia?
What to expect (Outlook/Prognosis)?
Prevention
Amblyopia On the Web
Ongoing Trials at Clinical Trials.gov
Images of Amblyopia
Videos on Amblyopia
FDA on Amblyopia
CDC on Amblyopia
Amblyopia in the news
Blogs on Amblyopia
Directions to Hospitals Treating Amblyopia
Risk calculators and risk factors for Amblyopia

VisualWikitext

Latest revision as of 18:53, 9 December 2011

For the WikiDoc page for this topic, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor(s)-In-Chief: Erin E. Lord

Overview

Amblyopia (commonly referred to as "lazy eye") is the failure of one eye to develop normal vision and see details properly, although the eye itself is otherwise physically normal. It is the most common cause of vision problems in children.

What are the symptoms of Amblyopia?

Amblyopia can often go undetected to the untrained observer. In fact, many people with amblyopia, especially those who are only mildly so, are not even aware they have the condition until tested at older ages since the vision in their stronger eye is normal. However, people with more severe amblyopia may experience associated visual disorders, most notably poor depth perception. Other symptoms include:

Eyes that turn in or out
Eyes that do not appear to work together
Poor spatial acuity
Low sensitivity to contrast
Problems of binocular vision:
- Limited depth perception
- Difficulty seeing the three-dimensional images in hidden stereoscopic displays such as autostereograms.^[1]
Some "higher-level" vision problems, such as reduced sensitivity to motion ^[2]

What are the causes of Amblyopia?

The brain and the eye work together to produce vision. Light enters the eye and is changed into nerve signals that travel along the optic nerve to the brain. Amblyopia is the medical term used when the vision in one of the eyes is reduced because the eye and the brain are not working together properly. The eye itself looks normal, but it is not being used normally because the brain is favoring the other eye. As a result, the affected eye fails to develop normal vision, and therefore has trouble seeing details. It has been estimated to affect 1–5% of the population.^[3]

Amblyopia is caused primarily by one of two factors: improper alignment of the eyes (known as strabismus), or unequal refractive power. If the child's eyes are not properly aligned, the brain will receive two different images from the eyes. Perceiving double vision, the brain will not use the image from the weaker eye. This eye, through lack of use, gradually loses its ability to function.

The second primary cause of amblyopia is significantly unequal refractive power in the two eyes. For example, one eye may be very farsighted or nearsighted while the other eye may have normal vision. Again the brain receives different images from the two eyes and suppresses the image from the weaker eye.

Other causes of amblyopia include:

Family history of amblyopia
Astigmatism in both eyes
Childhood cataracts

Ambylopia can also occur physiologically after tobacco or alcohol consumption.

Who is at highest risk?

Those with a family history of amblyopia have an increased risk of the disorder. Additionally, young children with an astigmatism in both eyes, childhood cataracts, strabismus, and unequal refractive power are at increased risk of amblyopia. Ambylopia can also occur physiologically after tobacco or alcohol consumption.

Diagnosis

Amblyopia often goes undetected to the untrained observer, but is usually easily diagnosed with a complete examination of the eyes. Special tests are not typically required.

When to seek urgent medical care?

Although not considered a medical emergency, amblyopia should be treated as early as possible. An ophthalmologist or optometrist should be seen if a vision problem is suspected in a young child so that proper treatment may begin before permanent vision loss occurs.

Treatment options

There are several methods currently used to treat amblyopia:

Patching: Patching is the main method used to treat amblyopia. An opaque, adhesive patch is worn over the stronger eye for weeks to months. This therapy forces the child to use the eye with amblyopia. Patching stimulates vision in the weaker eye and helps the part of the brain that manages vision to develop more completely.

Atropine: A drop of a drug called atropine is placed in the stronger eye once a day to temporarily blur the vision so that the child will prefer to use the eye with amblyopia. Similar to patching, treatment with atropine stimulates vision in the weaker eye and helps the part of the brain that manages vision to develop more completely.

Surgery is sometimes necessary if severe strabismus is present. The surgery is usually an outpatient procedure, and will properly align the eye muscle attachments.

Glasses: If the lazy eye is due to a vision problem (nearsightedness or farsightedness), glasses or contact lenses will be prescribed. However, glasses alone will not correct amblyopia.

Orthoptics are a controversial practice of using eye exercises to teach new vision habits. As with glasses, eye exercises alone will not correct amblyopia.

Previously, eye care professionals often thought that treating amblyopia in older children would be of little benefit. However, surprising results from a nationwide clinical trial, An Evaluation Of Treatment Of Amblyopia In Children 7 To < 18 Years Old (ATS3), show that many children age 7 through 17 with amblyopia may benefit from treatments that are more commonly used on younger children.^[4] This study shows that age alone should not be used as a factor to decide whether or not to treat a child for amblyopia.

For treatment of crossed eyes, see: Strabismus

Where to find medical care for Amblyopia?

Directions to Hospitals Treating amblyopia

Prevention of Amblyopia

Amblyopia cannot be prevented from initially occurring, but early recognition and treatment of the problem in children can help to prevent permanent vision loss. All children should have a complete eye examination at least once between ages 3 and 5.

What to expect (Outlook/Prognosis)?

Vision screening by age 4 can successfully detect reduced vision in one or both eyes resulting from amblyopia. Children who receive treatment before age 5 usually have a near complete recovery of normal vision.

Children will not outgrow either amblyopia or strabismus, so early examinations are essential. Delaying treatment can result in permanent vision problems. After age 10, only a partial recovery of vision can be expected. A child whose amblyopia or strabismus is left untreated will grow into an adult who has poor or little vision.

Additional links

http://www.nei.nih.gov/health/amblyopia/amblyopia_guide.asp
http://www.nlm.nih.gov/medlineplus/ency/article/001014.htm

Sources

↑ Tyler, C.W. (2004). "Binocular Vision In, Duane's Foundations of Clinical Ophthalmology. Vol. 2, Tasman W., Jaeger E.A. (Eds.), J.B. Lippincott Co.: Philadelphia".
↑ Hess, R.F., Mansouri, B., Dakin, S.C., & Allen, H.A. (2006). "Integration of local motion is normal in amblyopia". J Opt Soc Am a Opt Image Sci Vis. 23 (5): 986–992. doi:10.1364/JOSAA.23.000986. PMID 16642175.
↑ Weber, JL; Wood, Joanne (2005). "Amblyopia: Prevalence, Natural History, Functional Effects and Treatment" (^{[dead link]} – ^{Scholar search}). Clinical and Experimental Optometry. 88 (6): 365–375. doi:10.1111/j.1444-0938.2005.tb05102.x. PMID 16329744.
↑ http://www.nei.nih.gov/news/pressreleases/041105.asp

Template:WH Template:WS

[Tyler-1] Tyler, C.W. (2004). "Binocular Vision In, Duane's Foundations of Clinical Ophthalmology. Vol. 2, Tasman W., Jaeger E.A. (Eds.), J.B. Lippincott Co.: Philadelphia".

[Hess-2] Hess, R.F., Mansouri, B., Dakin, S.C., & Allen, H.A. (2006). "Integration of local motion is normal in amblyopia". J Opt Soc Am a Opt Image Sci Vis. 23 (5): 986–992. doi:10.1364/JOSAA.23.000986. PMID 16642175.

[asn-3] Weber, JL; Wood, Joanne (2005). "Amblyopia: Prevalence, Natural History, Functional Effects and Treatment" (^{[dead link]} – ^{Scholar search}). Clinical and Experimental Optometry. 88 (6): 365–375. doi:10.1111/j.1444-0938.2005.tb05102.x. PMID 16329744.

[4] ttp://www.nei.nih.gov/news/pressreleases/041105.asp

[1]

[2]

[3]

[4]

@@ Line 1: / Line 1: @@
+{{Template:Amblyopia (patient information)}}
 '''For the WikiDoc page for this topic, click [[Amblyopia|here]]'''
+{{Infobox_Disease |
+  Name           = Amblyopia |
+  Image          = Child eyepatch.jpg|
+  Caption        = A child wearing an adhesive eyepatch to correct amblyopia|
+  DiseasesDB     = 503 |
+  ICD10          = {{ICD10|H|53|0|h|53}} |
+  ICD9           = {{ICD9|368.0}} |
+  ICDO           = |
+  OMIM           = |
+  MedlinePlus    = 001014 |
+  eMedicineSubj  =  |
+  eMedicineTopic =  |
+  MeshID         = D000550 |
+}}
-{{SI}}
+{{CMG}}; '''Assistant Editor(s)-In-Chief:''' Erin E. Lord
-{{EEL}}
-{{EJ}}
-==What is amblyopia?==
+==Overview==
+Amblyopia (commonly referred to as "lazy eye") is the failure of one eye to develop normal vision and see details properly, although the eye itself is otherwise physically normal.  It is the most common cause of vision problems in children.
-Amblyopia (commonly referred to as lazy eye) is the failure of one eye, although otherwise physically normal, to develop normal vision and see details.
+==What are the symptoms of Amblyopia?==
+Amblyopia can often go undetected to the untrained observer. In fact, many people with amblyopia, especially those who are only mildly so, are not even aware they have the condition until tested at older ages since the [[vision]] in their stronger eye is normal.  However, people with more severe amblyopia may experience associated visual disorders, most notably poor [[depth perception]].  Other symptoms include:
-The [[brain]] and the [[eye]] work together to produce [[vision]].  Light enters the eye and is changed into [[nerve signals]] that travel along the [[optic nerve]] to the [[brain]]. Amblyopia is the medical term used when the [[vision]] in one of the eyes is reduced because the [[eye]] and the [[brain]] are not working together properly. The eye itself looks normal, but it is not being used normally because the [[brain]] is favoring the other [[eye]]. As a result, the affected [[eye]] fails to develop normal [[vision]] and see details. It has been estimated to affect 1&ndash;5% of the population.<ref name="asn">
-{{cite journal
-| url=http://www.optometrists.asn.au/gui/files/ceo886365.pdf
-| format={{Dead link|date=June 2008}} &ndash; <sup>[http://scholar.google.co.uk/scholar?hl=en&lr=&q=intitle%3AAmblyopia%3A+Prevalence%2C+Natural+History%2C+Functional+Effects+and+Treatment&as_publication=Clinical+and+Experimental+Optometry&as_ylo=2005&as_yhi=2005&btnG=Search Scholar search]</sup>| author=Weber, JL; Wood, Joanne
-| year=2005
-| title=Amblyopia: Prevalence, Natural History, Functional Effects and Treatment
-| journal=Clinical and Experimental Optometry
-| volume=88
-| issue=6
-| pages=365–375
-| doi=10.1111/j.1444-0938.2005.tb05102.x
-| pmid=16329744}} </ref>
-==What are the symptoms of amblyopia?==
-Amblyopia often gives no clues to the untrained observer. In fact, many people with amblyopia, especially those who are only mildly so, are not even aware they have the condition until tested at older ages, since the [[vision]] in their stronger eye is normal.  However, people with more severe amblyopia may experience associated visual disorders, most notably poor [[depth perception]].  Other symptoms include:
 * Eyes that turn in or out
@@ Line 33: / Line 30: @@
 * Low sensitivity to [[contrast]]
 * Problems of [[binocular vision]]:
-** Limited stereoscopic [[depth perception]]
+** Limited [[depth perception]]
-** Difficulty seeing the three-dimensional images in hidden stereoscopic displays such as [[autostereogram]]s.<ref name="Tyler">
+** Difficulty seeing the three-dimensional images in hidden [[Stereopsis|stereoscopic]] displays such as [[autostereogram]]s.<ref name="Tyler">
    {{cite journal
 | author=Tyler, C.W.
@@ Line 41: / Line 38: @@
   </ref>
-* Some "higher-level" deficits to [[vision]], such as reduced sensitivity to motion <ref name="Hess">
+* Some "higher-level" [[vision]] problems, such as reduced sensitivity to motion <ref name="Hess">
   {{cite journal
@@ Line 55: / Line 52: @@
 }} </ref>
-==What are the causes of amblyopia?==
+==What are the causes of Amblyopia?==
+The [[brain]] and the [[eye]] work together to produce [[vision]].  Light enters the eye and is changed into [[nerve signals]] that travel along the [[optic nerve]] to the [[brain]]. Amblyopia is the medical term used when the [[vision]] in one of the eyes is reduced because the [[eye]] and the [[brain]] are not working together properly. The eye itself looks normal, but it is not being used normally because the [[brain]] is favoring the other [[eye]]. As a result, the affected [[eye]] fails to develop normal [[vision]], and therefore has trouble seeing details. It has been estimated to affect 1&ndash;5% of the population.<ref name="asn">
+{{cite journal
+| url=http://www.optometrists.asn.au/gui/files/ceo886365.pdf
+| format={{Dead link|date=June 2008}} &ndash; <sup>[http://scholar.google.co.uk/scholar?hl=en&lr=&q=intitle%3AAmblyopia%3A+Prevalence%2C+Natural+History%2C+Functional+Effects+and+Treatment&as_publication=Clinical+and+Experimental+Optometry&as_ylo=2005&as_yhi=2005&btnG=Search Scholar search]</sup>| author=Weber, JL; Wood, Joanne
+| year=2005
+| title=Amblyopia: Prevalence, Natural History, Functional Effects and Treatment
+| journal=Clinical and Experimental Optometry
+| volume=88
+| issue=6
+| pages=365–375
+| doi=10.1111/j.1444-0938.2005.tb05102.x
+| pmid=16329744}} </ref>
-Amblyopia is caused primarily by one of two factors: improper alignment (known as [[strabismus]]) and unequal [[refractive power]]. If the child's eyes are not properly aligned, the brain will receive two different images from the eyes. Perceiving [[double vision]], the brain will not use the image from the weaker eye. This eye, through lack of use, gradually loses its ability to function. The second primary cause of amblyopia is significantly unequal [[refractive power]] in the two eyes. For example, one eye may be very [[farsighted]] or [[nearsighted]] while the other eye may have normal [[vision]]. Again the [[brain]] receives different images from the two eyes and suppresses the image from the weaker eye.
+Amblyopia is caused primarily by one of two factors: improper alignment of the eyes (known as [[strabismus]]), or unequal [[refractive power]]. If the child's eyes are not properly aligned, the brain will receive two different images from the eyes. Perceiving [[double vision]], the brain will not use the image from the weaker eye. This eye, through lack of use, gradually loses its ability to function.
+The second primary cause of amblyopia is significantly unequal [[refractive power]] in the two eyes. For example, one eye may be very [[farsighted]] or [[nearsighted]] while the other eye may have normal [[vision]]. Again the [[brain]] receives different images from the two eyes and suppresses the image from the weaker eye.
 Other causes of amblyopia include:
@@ Line 67: / Line 78: @@
 Ambylopia can also occur [[Physiology|physiologically]] after [[tobacco]] or [[alcohol]] consumption.
-==Who is at risk for amblyopia?==
+==Who is at highest risk?==
 Those with a [[Heredity|family history]] of amblyopia have an increased risk of the disorder.  Additionally, young children with an [[astigmatism]] in both eyes, childhood [[cataracts]], [[strabismus]], and unequal [[refractive power]] are at increased risk of amblyopia.  Ambylopia can also occur physiologically after tobacco or alcohol consumption.
-==How to know you have amblyopia?==
+==Diagnosis==
+Amblyopia often goes undetected to the untrained observer, but is usually easily diagnosed with a complete [[Eye examination|examination of the eyes]]. Special tests are not typically required.
-Amblyopia often gives no clues to the untrained observer, but is usually easily diagnosed with a complete [[Eye examination|examination of the eyes]]. Special tests are usually not required.
-==When to seek urgent medical care==
+==When to seek urgent medical care?==
 Although not considered a medical emergency, amblyopia should be treated as early as possible.  An ophthalmologist or optometrist should be seen if a vision problem is suspected in a young child so that proper treatment may begin before permanent vision loss occurs.
 ==Treatment options==
 There are several methods currently used to treat amblyopia:
-* '''[[Patching]]:'''  Patching is the main method used to treat amblyopia.  An opaque, adhesive patch is worn over the stronger eye for weeks to months. This therapy forces the child to use the eye with amblyopia. Patching stimulates [[vision]] in the weaker eye and helps the part of the [[brain]] that manages [[vision]] develop more completely.
+* '''[[Patching]]:'''  Patching is the main method used to treat amblyopia.  An opaque, adhesive patch is worn over the stronger eye for weeks to months. This therapy forces the child to use the eye with amblyopia. Patching stimulates [[vision]] in the weaker eye and helps the part of the [[brain]] that manages [[vision]] to develop more completely.
-* '''[[Atropine]]:'''  A drop of a drug called [[atropine]] is placed in the stronger eye once a day to temporarily blur the [[vision]] so that the child will prefer to use the eye with amblyopia. Treatment with [[atropine]] also stimulates [[vision]] in the weaker eye and helps the part of the [[brain]] that manages vision develop more completely.
+* '''[[Atropine]]:'''  A drop of a drug called [[atropine]] is placed in the stronger eye once a day to temporarily blur the [[vision]] so that the child will prefer to use the eye with amblyopia. Similar to patching, treatment with [[atropine]] stimulates [[vision]] in the weaker eye and helps the part of the [[brain]] that manages vision to develop more completely.
-* '''[[Surgery]]''' is sometimes necessary if severe [[strabismus]] is present. Usually an outpatient procedure, surgery will properly align the eye muscle attachments.
+* '''[[Surgery]]''' is sometimes necessary if severe [[strabismus]] is present. The surgery is usually an outpatient procedure, and will properly align the eye muscle attachments.
-*  '''[[Glasses]]:''' If the lazy eye is due to a vision problem ([[nearsightedness]] or [[farsightedness]]), [[glasses]] or [[contact lenses]] will be prescribed.  Glasses alone will not correct amblyopia.
+*  '''[[Glasses]]:''' If the lazy eye is due to a vision problem ([[nearsightedness]] or [[farsightedness]]), [[glasses]] or [[contact lenses]] will be prescribed.  However, glasses alone will not correct amblyopia.
-* '''[[Orthoptics]]''' are a controversial practice of using eye exercises to teach new vision habits. Again, as with glasses, eye exercises alone will not correct amblyopia.
+* '''[[Orthoptics]]''' are a controversial practice of using eye exercises to teach new vision habits. As with glasses, eye exercises alone will not correct amblyopia.
 Previously, [[Eye care professional|eye care professionals]] often thought that treating amblyopia in older children would be of little benefit. However, surprising results from a nationwide [[clinical trial]], An Evaluation Of Treatment Of Amblyopia In Children 7 To < 18 Years Old (ATS3), show that many children age 7 through 17 with amblyopia may benefit from treatments that are more commonly used on younger children.<ref>http://www.nei.nih.gov/news/pressreleases/041105.asp</ref> This study shows that age alone should not be used as a factor to decide whether or not to treat a child for amblyopia.
@@ Line 97: / Line 104: @@
 For treatment of crossed eyes, see: [[Strabismus]]
-==Where to find medical care for amblyopia==
+==Where to find medical care for Amblyopia?==
 [http://maps.google.com/maps?f=q&amp;hl=en&amp;geocode=&amp;q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|amblyopia}}}}&amp;sll=37.0625,-95.677068&amp;sspn=65.008093,112.148438&amp;ie=UTF8&amp;ll=37.0625,-95.677068&amp;spn=91.690419,149.414063&amp;z=2&amp;source=embed Directions to Hospitals Treating amblyopia]
-==Prevention of amblyopia==
+==Prevention of Amblyopia==
 Amblyopia cannot be prevented from initially occurring, but early recognition and treatment of the problem in children can help to prevent permanent [[vision loss]]. All children should have a complete eye examination at least once between ages 3 and 5.
-==What to expect (Outlook/Prognosis)==
+==What to expect (Outlook/Prognosis)?==
 [[Vision screening]] by age 4 can successfully detect reduced vision in one or both eyes resulting from amblyopia.  Children who receive treatment before age 5 usually have a near complete recovery of normal [[vision]].
-Children will not outgrow either amblyopia or [[strabismus]], so early examinations are essential. Delaying treatment can result in permanent vision problems. After age 10, only a partial recovery of [[vision]] can be expected.
+Children will not outgrow either amblyopia or [[strabismus]], so early examinations are essential. Delaying treatment can result in permanent vision problems. After age 10, only a partial recovery of [[vision]] can be expected.  A child whose amblyopia or [[strabismus]] is left untreated will grow into an adult who has poor or little [[vision]].
-The child whose amblyopia or [[strabismus]] is left untreated will grow into an adult who has poor or little [[vision]].
-==Sources==
+==Additional links==
 http://www.nei.nih.gov/health/amblyopia/amblyopia_guide.asp <br>
 http://www.nlm.nih.gov/medlineplus/ency/article/001014.htm <br>
-http://www.sightandhearing.org/sightcenter/ambly.asp <br>
-{{reflist}}
+==Sources==
+{{reflist|2}}
-{{SIB}}
 {{WH}}
 {{WS}}
-[[Category:Patient Information]]
-[[Category:Opthalmology]]
+[[Category:Patient information]]
+[[Category:Ophthalmology]]
+[[Category:Ophthalmology patient information]]
 [[Category:Optometry]]
+[[Category:Pediatrics]]
+[[Category:Pediatrics patient information]]
+[[Category:Genetic disorders]]
+[[Category:Genetic disorders patient information]]
+[[Category:Disease]]
+[[Category:Mature chapter]]
+[[Category:Overview complete]]
+[[Category:Template complete]]