Amblyopia: Causes, Symptoms, Treatment and Cost

Amblyopia is a vision disorder in which an individual’s vision does not develop to its normal clarity, often due to lack of use. It is the leading cause of visual impairment in childhood and the most common cause of impaired vision among children.

There are three main types of amblyopia:

• Strabismic Amblyopia :this occurs when a child’s eyes are misaligned or not straight (strabismus) and a clear image appears only in one eye and not the other. Strabismic amblyopia may be able to be corrected using eye exercises, glasses, or patching if caught early enough.
• Refractive Amblyopia : this occurs when there is a significant difference between refractive strength in one eye compared to the other, such as when one eye is significantly more near-sighted or far-sighted than the other. Refractive amblyopia can typically be corrected with eyeglasses but may require patching depending on severity.
• Deprivational Amblyopia :this occurs when something physically blocks an object from entering either eye; for example, if one’s eyelid droops blocking part of their vision, or if an object covers the actual lens of their eye blocking any incoming light signals from reaching their retina for processing resulting in poorer vision quality for that affected by deprivation amblypia typically require surgical correction or patching depending on severity.

Amblyopia is caused by the disruption of normal binocular vision development, meaning that the vision in one eye fails to develop properly compared to the other.

The most common causes include strabismus (eyes not aligning properly), or refractive errors (unequal focus between two eyes).

Other causes include deprivation/deprivation amblyopia (obscuring a natural clarity of vision) and form deprived amblyopia (disruptions of binocular function).

The primary symptom of amblyopia is reduced vision in one or both eyes.

Other symptoms may include lack of depth perception, eye strain, or double vision in the affected eye(s).

In addition, an individual with amblyopia may have difficulty judging distances or focusing on near objects.

• Encourage children to wear their prescribed glasses;
• Showing a child 100 hours of vision therapy to strengthen the weaker eye;
• Creating visual habits like reading, providing puzzles, and encouraging outdoor activities;
• Making sure regular eye exams are performed before three years of age for early detection and treatment;
• Limiting time spent on one-eyed activities such as verbal or video games and television watching;
• Offering a patch over the stronger eye at specified times during the day to strengthen the weaker one;
• Educating parents about strategies to create family rules that limit near-work activities while emphasizing far-distance vision exercises;
• Prescribing occlusion therapy—like patching or pharmacologic drops—to reduce vision development differences between eyes if they do not respond to other treatments.

• Patient's current medical history: This is an important step to determine any pre-existing conditions and/or risk factors related to the development of amblyopia. It is important to assess any past eye injuries, operations, family history of amblyopia or any other serious eye problems.
• MRI: MRI scans are commonly used to help diagnose and monitor people with amblyopia. These scans can show any swelling, blockages or other abnormalities in the eye, as well as changes in blood flow to the brain that may be linked with vision problems related to amblyopia.
• Optic Coherence Tomography (OCT): Optic Coherence Tomography (OCT) is an imaging technique that uses light waves to obtain cross-sectional images of the structures within the eye. OCT is used to diagnose amblyopia by evaluating ocular features that predispose someone to developing amblyopia such as strabismus or anisometropia, which are associated with the development of the visual problem.
• The 1-2-3 test: This test assesses vision acuity by asking the patient to correctly identify numbers in order from 1 to 3 that appear on a standard eye chart, requiring the person to be able to read numbers of various sizes and shapes accurately.
• Stereo Tests: Stereo tests measure how well each eye works separately and together, testing binocular vision at multiple distances with varying levels of brightness. Employing the use of pictures made up of random dots (random dot stereograms), this type of visual acuity assessment can determine whether the patient has amblyopia or strabismus (in which one or both eyes turn outward or inward).

Possible complications of Amblyopia include:

• Reduced vision in the “lazy” eye
• Difficulty with depth perception, 3-D vision or other depth cues, and stereopsis
• Problems with tracking moving objects, coordinating both eyes simultaneously, and visualizing motion sequences
• Poor reading ability, poor academic performance in school, and difficulty driving a car at night
• Permanent eye damage due to lack of nerve stimulation.

• Amla juice: Drinking two teaspoons of fresh amla juice every day can help improve vision weakened by amblyopia as it is rich in antioxidants that protect the eyes from free radicals.
• Triphala: Triphala churna is a herbal combination used to treat many eye disorders including amblyopia due to its anti-inflammatory properties which helps in improving vision naturally.
• Bilberry: Regular consumption of a bilberry supplement can improve eyesight as it improves circulation and strengthens the tiny blood vessels in the eyes.
• Ghee: Applying ghee daily into the inner corner of your eye while performing gradual yoga movements may help improve amblyopic vision as ghee improves lubrication around the eyes allowing them to be more flexible during these stretches.

• Leafy greens: Leafy greens such as kale and spinach are rich in vitamins A and C, essential for vision development.
• Orange-colored fruits and vegetables: Carrots, squash, cantaloupe, sweet potatoes, oranges, and other orange-hued foods are all high in beta carotene and lutein – both of which are important nutrients for healthy eyesight.
• Omega-3 fatty acids: Sources of omega-3 fatty acids like salmon, tuna, mackerel, flaxseeds, walnuts and eggs help keep eyes healthy by providing essential fats that reduce inflammation while improving the functioning of blood vessels in the eyes.
• Dairy products: Dairy products like milk and yogurt contain riboflavin (vitamin B2) which helps the body to process carbohydrates into energy that is used throughout the body; this includes some energy being allocated to support better vision integrity.

• Fried and junk food: High in saturated fat, sugar, and salt, and can be a trigger for eye strain.
• Foods high in sugar: Can cause inflammation and can also increase risk of age-related macular degeneration (AMD).
• Alcohol: Increases tension in the eyes which can worsen vision problems.
• Caffeine: Can cause dehydration, which reduces the clarity of vision.
• Processed snacks like chips and pretzels: High in sodium which can cause dryness around the eyes and muscle fatigue leading to Amblyopia symptoms like headaches and eyestrain.

• Eye Patching: This is the most common and effective method of treating Amblyopia. It involves placing a patch over the better-seeing eye in order to improve vision in the weaker eye by forcing it to work more.
• Bifocal Lenses: These lenses can help reduce aniseikonia, which is caused by differences in the size of images seen by both eyes resulting from unequal refractive errors, improving binocular vision and potentially improving vision in amblyopic patients.
• Vision Therapy: Also known as “orthoptic intervention” or “eye training,” this therapy strengthens visual skills and encourages better coordination between both eyes. It often includes activities like patching, focusing on objects or images with one or both eyes open at once, using various lenses and contact lenses, incorporating vertigo-reducing exercises, and more.
• Refractive Surgery: In certain cases where vision can't be improved by other methods available, a surgery may be recommended to correct refractive errors in order to improve amblyopic vision.

• Primarily, Amblyopia can be addressed by a comprehensive eye examination from an optometrist or ophthalmologist.
• An optometrist is typically more qualified to diagnose and treat vision problems like Amblyopia, while an ophthalmologist usually deals with more complicated issues.
• If necessary, the doctor may refer patients to other specialists such as an orthoptist or low vision specialist for further examination and treatment of symptoms associated with Amblyopia.

• Atropine: Atropine works by causing the pupil in the affected eye to dilate, allowing more light to enter the eye and stimulating vision acuity. When administered over a period of weeks or months, Atropine can help resolve amblyopia and improve vision in the affected eye.
• Pirenzepine: Pirenzepine is a medication that is used to treat amblyopia. It works by inhibiting the action of an enzyme called cholinergic receptor m2 that helps regulate light signals in the brain. By blocking this enzyme, pirenzepine allows light signals to more effectively reach the brain, improving vision in those with amblyopia.
• Topical cycloplegics: Topical cycloplegics are a type of medication that is used to temporarily paralyze the muscles of the ciliary body, which are responsible for ready focusing. This allows the eye to remain in a relaxed state and can aid in refraction during binocular vision assessment, exercise therapy or other amblyopia treatments. Common topical cycloplegics used for this purpose include cyclopentolate, tropicamide and homatropine.

The length of time it takes to recover from Amblyopia depends largely on the individual and the severity of the condition.

Generally, a recovery period can last anywhere from a few weeks to several years. During this period of treatment, activities such as eye-tracking exercises and reading can also be beneficial in stimulating vision development in the affected eye. Improvement may occur slowly over time but with dedication and consistency, recovery is possible!

• The results of treatment for amblyopia are usually not permanent and can require periodic reinforcement or rehabilitation.
• This is because the vision deficits caused by amblyopia can return if the patient's vision acuity begins to decline. In some cases, however, patients may see long-term improvements if they adhere to prescribed eye exercises and/or treatments regularly.
• It is important to note that recurrence of amblyopia symptoms can occur even after successful treatment, requiring timely management with appropriate follow ups.

Post-treatment guidelines for amblyopia include the following:

• Monitor the patient’s progress and adjust glasses if necessary.
• Discourage unnecessary patching of the good eye; patching should not be used if it causes any psychological distress to the patient.
• Regularly evaluate vision in both eyes using conventional tests, such as monocular visual acuity testing and binocular testing such as stereoacuity testing, depth perception/visual spatial orientation, color vision, and near vision tests.
• Participate in scheduled follow-up visits with the ophthalmologist or optometrist to make adjustments to motion controlled glasses and monitor vision development.
• Provided necessary supplemental activities such as eye exercises or educational materials designed specifically for children with amblyopia related problems including their parents; these activities are aimed at encouraging compliance with eyeglass wear and helping improve long-term outcomes from surgery/treatment.

The cost of Amblyopia treatments in India depends on many factors including the type of treatment chosen, the severity of the condition and other costs related to treatment such as eye tests, medication and follow-up visits. In general, treatments may start from around ₹ 1000 up to ₹ 5000 or more.

The side effects of amblyopia treatments vary depending on the type of treatment prescribed.

Common side effects include dizziness, headaches, temporary blurred vision, eyestrain and eye dryness.

In some cases, there may be more serious complications such as double vision and light sensitivity.

If you are suffering from any complications relating to amblyopia then you should consult a doctor nearby as they can cause complications like 'Reduced vision, permanent eye damage' in which treatment course can range from a few months to years depending on the severity of the situation.