Get to know about lazy eye therapy or Amblyopia

Amblyopia or “lazy eyes” is the reduction of vision in one or both the eyes. In amblyopia, the patient may need glasses to improve the vision. Refractive amblyopia causes reduced visual acuity in childhood. Most of the times, one may need glasses in only one eye as the brain receives weaker image from the lazy eye. However, amblyopia in both the eyes is also common; hence there may be a need for glasses for both the eyes. Lazy eye therapy also includes use of patch or occlusion. Children with amblyopia who need glasses for only one of the eyes are advised to wear a patch in the non-affected eye. As part of Lazy eye therapy, in some cases recommendation is to wear glasses only for small periods to restore normal vision. However, in children where glasses alone do not work, wearing a patch has shown vision improvement to a greater extent.  With time, it is acknowledged that managing the lazy eye remains a challenge for the ophthalmologists.

Lazy eye therapy -Patch or Glasses:

At the start of the lazy eye therapy, it is not possible to tell if glasses or a patch, or both are needed for correcting the vision as the amount of patching depends on a number of factors (which are not fully understood).  Children with bilateral amblyopia (amblyopia in both the eyes) are advised to wear the glasses for a longer period of time to improve their vision.

Occlusion therapy or patching has been the mainstay for the treatment of amblyopia since the 18th century.

1.    Patching may be full-time or part-time. Patients are monitored at the interval of 1 week per year of age.
2.    Compliance is principal. Lack of use of the patches result showing no improvement of the visual acuity. Opaque contact lenses, adhesive tapes are some of the options available to enhance compliance.

Lazy eye therapy-A look at the scientific research:

Researchers looked the scientific database for lazy eye therapy, in order to compile the research articles published in MEDLINE, EMBASE, etc. The results of the study were as follows:
   
In unilateral refractive amblyopia, use of refractive correction alone proved beneficial. The effect of the use of partial occlusion and glasses alone when started simultaneously has shown similar results.

Occlusion therapy improves vision in patients with amblyopia.

Further investigations for treatment of both unilateral and bilateral amblyopia are needed.

Lazy eye therapy-Amblyopia Treatment Studies:

Children:

Early lazy eye therapy among children is important to prevent vision loss. In severe amblyopia, full time patching have shown similar effects to that of 6 hours of patching. In moderate amblyopia, regular use of patch improved visual acuity.

Older children:

Lazy eye therapy among older children (7-13 years), use of 2-6 hours of patching has shown to improve the visual acuity. This prescription (2-6 hours of patching) also appears good for children in the ages 13 and 18 years. Long-term studies are needed.

Recurrence rates:

25% of the children with amblyopia, who were treated successfully, experienced a recurrence within the first year of the discontinuation of therapy. 

More information at http://www.revitalvision.co.uk/amblyopia/