Amblyopia

Amblyopia is a medical condition that stems from abnormal visual development, when the vision of one eye is reduced from the lack of coordination between the brain and the eyes. Amblyopia, also known as lazy eye, is a consequence of any condition that reduces the clarity in vision—near-sightedness, far-sightedness, or astigmatism. Although the eye itself may appear normal, the brain favors one eye over the other thus enhancing the misalignment and lack of coordination in a person’s eyesight. The condition is evident from infancy to early childhood and can be appear in both eyes. It can be treated to prevent mild to moderate vision loss, starting from childhood.

Brief History

Amblyopia is a result of abnormal visual development in children to young adults. The abnormality of one or both eyes is often unrecognized given that several of its symptoms are also associated with other mild ailments, such as tiredness or low visual impairment. Amblyopia is associated with strabismus, deprivation or refractive vision. Strabismus, the principal origin of amblyopia, is the muscular imbalance of the eye positions that cause either or both eyes to cross in or turn out, thus diminishing the singular coordination of both eyes. Conversely, visual deprivation stems from the formation of a cloudy area in the eye lens, also known as a cataract, to weaken the vision of the eye. Refractive vision is the imperfection in each eye from near-sightedness, far-sightedness, or astigmatism, which affect the eye surface. Amblyopia affects the functional ability of patients, with slower reading speeds and weakened fine motor skills reported more than those who have strabismus.

An eye with amblyopia creates new nerve pathways between the brain and eye that do not function properly and are not readily prepared to transfer signals between both nerve destinations. By creating these additional pathways, the brain tends to favor one eye over the other, thus reducing the visual clarity in the amblyopia-affected eye. Through time, the brain may inadvertently ignore any signals from the weaker eye, causing it to wander and eventually have poorer vision than its contemporary. Treatment often entails eye patches, eye drops, or new prescription glasses or contact lenses. In worse cases, amblyopia patients may require surgical treatment to manage and correct the coordination between both eyes and the brain.

Amblyopia symptoms are associated with and can stem from existing eye conditions, such as near-sightedness or far-sightedness. Persons with amblyopia have an eye that tends to wander in another direction, have eyes that do not appear to be working congruently, or have poor depth perception. Amblyopia characteristically affects one eye over the other, however it is possible to have the condition in both eyes. The symptoms of amblyopia may not always be evident and the condition is best prescribed after an eye exam, given that wandering eyes may also be symptoms for other conditions, such as an eye tumor.

Symptoms may begin to appear starting from infancy to early adulthood. Routine checkups with general practitioners and pediatricians are often accompanied with a general vision check, especially for children and young adults with a family history of visual deficiencies, such as crossed eyes, cataracts, and other eye conditions. Primary care doctors may refer the patient to an ophthalmologist or optometrist to validate the manifestation of amblyopia, especially in infants who appear to have a single wandering eyes beyond the first few weeks of birth. To alleviate any serious visual conditions, it is often recommended for children to begin consulting an eye specialist for regular checkups starting at the ages of 3 to 5.

Impact

Amblyopia is common, with 5 percent of the general population diagnosed with the condition, and studies indicate a wide range of impacts. The diagnosis of amblyopia in children has greater effects on parents than the children, with increasing stress and anxiety being a major strain in the parent-child relationship. Sibling teasing and bullying were also noted to cause familial stress, as the amblyopic child often received more parental attention during the time of treatment. However, the impact of amblyopia treatment is associated more with specific family dynamics, whereby higher compliance from the child receives more praise and attention to improve the parent-child relationship.

Peer interaction for amblyopes (those with the condition) has increased occurrences of bullying and changes in appearance, given that amblyopes wear glasses or a patch to correct the visual condition. This change of appearance makes the condition more obvious and often receives negative comments that leave some amblyopes isolated from peers and social interactions. However, improvements and acceptance to those wearing glasses have increased with modern-day fashion. Although the age at which these interactions have not been corroborated, amblyopes who are of school-age have feelings of low self-esteem and negative self-image. Emotional and psychological feelings—depression, frustration, and embarrassment—have implicated a lack of compliance for young adult amblyopes to continue receiving treatment. Although the emotional effect of receiving treatment can also be noted, in terms of the sensation one feels due to patches, eye drops, or glasses, the social and emotional impact of receiving treatment has greatly surpassed other implications. Such implications affect amblyopes’ career choice and educational attainment, depending on the time of treatment (that is, during primary or secondary school, or into adulthood).

Adults who have undergone amblyopia treatment as children may not fully understand the importance of such treatments and refuse compliance in wearing glasses or eye patches. Treatment compliance and success is directly correlated to the parent’s understanding of the ailment and significance of receiving treatment, though full compliance from both the parent and child has no direct correlation with the quality-of-life of the child, given that the outside interactions with peers are not always clear for assessment. However, fully understanding the implications for those who have received treatment as a child is unattainable, given that adults who had amblyopia in their youth may have memories that were tainted by succeeding adult experiences and events.

Bibliography

"Amblyopia." National Eye Institute 2015. Web. 3 Dec. 2015. https://nei.nih.gov/health/amblyopia.

Carlton, J., and E. Kaltenthaler. "Amblyopia and Quality of Life: A Systematic Review." Eye 25.4 (2011): 403–413. PMC. Web. 5 Dec. 2015. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3078103/.

Clarke, Michael P. "Review of Amblyopia Treatment: Are We Overtreating Children with Amblyopia?" British and Irish Orthoptic Journal 7 (2015): 3–7. Print.

Kulp, Marjean T. et al. "Should Amblyopia Be Treated?" Ophthalmic and Physiological Optics 34.2 (2014): 226–32. Print.

"Lazy Eye (Amblyopia)." Diseases and Conditions. Mayo Foundation for Medical Education and Research 2015. Web. 3 Dec. 2015. http://www.mayoclinic.org/diseases-conditions/lazy-eye/basics/definition/con-20029771.

Richards, Michael, Herbert Goltz, and Agnes Wong. "Audiovisual Integration in Amblyopia." Journal of Vision 15.12 (2015): 127. Print.

Xiao, Ou, et al. "Prevalence of Amblyopia in School-Aged Children and Variations by Ethnicity: A Multi-Country Refractive Error Study in Children." Investigative Ophthalmology & Visual Science 55.13 (2014): 5976. Print.