What parents need to know about amblyopia!

Today, the news that the daughter of a famous Taiwanese actress was diagnosed with congenital amblyopia became a hot topic on Weibo and attracted a wave of heated discussions. The actress published a long article revealing that her daughter was found to have amblyopia during a physical examination, with a high parallax of 600 degrees in both eyes. She lamented that fortunately it was discovered in time and the golden treatment period was not missed. She has now been fitted with glasses and is receiving relevant treatment. At the same time, the actress reminded parents to check their children's eye conditions regularly to detect and intervene early.

1. What is amblyopia and what are its symptoms?

During the period of visual development, a child's abnormal visual experiences such as monocular strabismus, anisometropia, high refractive error and form deprivation cause his vision with glasses to fall below the normal visual level for children of the same age. If no organic lesions that could cause poor vision are found after ophthalmic examination, then that eye can be diagnosed as amblyopia.

Therefore, when parents find that their children have these symptoms: blurred vision, double vision, fear of light, tilting the head to see things, strabismus, squinting, looking at things close, reading difficulties, uncoordinated walking, etc., the child is likely to have amblyopia and must go to a professional ophthalmology hospital for medical treatment in time, otherwise it will seriously affect the fate and quality of life of the child. Especially monocular amblyopia is easily ignored by parents, and many are not discovered until the child becomes an adult. Therefore, after the age of 3, you should take your child to a professional ophthalmology hospital for a comprehensive eye examination to achieve early detection and early treatment, and don't miss the best healing period.

2. Why do you need to wear glasses to treat amblyopia?

Among the causes of amblyopia, 80% are due to refractive errors. Because children have pathological hyperopia, astigmatism or myopia, the parallel light from the outside world cannot be accurately focused on the retina after passing through the eye's refractive system. The photoreceptor cells on the retina cannot be effectively trained, and the information transmitted to the brain can only be a blurred image. Therefore, in order to give the photoreceptor cells on the retina a chance to exercise their functions, we must first correct those pathological hyperopia, myopia and astigmatism, so that the external light can be accurately focused on the retina. Therefore, a pair of suitable glasses is essential.

When your child has the right glasses, please treat them like a pacemaker for a heart patient! There are many cases where amblyopia treatment fails, not because the child does not cooperate, but because the parents reject it. When many parents hear that their children need to wear glasses, their first reaction is: "Won't it be ugly for such a young child to wear glasses?"

Beauty and health are always more important. When children grow up, there are many ways to let them take off their glasses. However, once the best time for amblyopia treatment is missed, the child will live in a blurry world for the rest of his life. Therefore, from the moment the child receives treatment, parents and friends should temporarily discard the idea of ​​"whether the glasses can be taken off" and treat the glasses as a part of the child's body! This is very, very important! !

3. Why is patching necessary for amblyopia treatment?

Our brain is very "snobbish". When we use both eyes to see things, the brain will choose the eye that focuses accurately, because only when the eye that focuses accurately transmits information to the cerebral cortex can the image be clear. Over time, the brain abandons the other eye that does not have a clear image, and that eye is marginalized, which is medically called "suppression". In this case, we can only artificially suppress the good eye (covering, suppressing film, drugs), weaken the good eye's gaze function, give the bad eye a chance, and constantly exercise and enhance its function to improve vision. Therefore, in the process of amblyopia treatment, strict covering is a very important link.

Covering principle

Generally speaking, the principle of covering children aged three to six is: cover for a few days according to their age, and then let go for one day. For example, a three-year-old child should be covered for three days, let go for one day, and so on. Children over seven years old should be covered for two weeks, and let go for one day.

However, compared with the treatment of wearing glasses alone, the compliance of many children who need occlusion is much worse. Studies have found that among children who wear glasses alone to treat amblyopia, more than 80% can achieve good treatment results, but among children who need occlusion treatment, this probability drops to 60%. Many children will peek with their non-amblyopic eye during the occlusion process, or even take off their glasses.

So how can you get your child to cover up? Remember: try not to scold or even physically punish a child who "peeks". If you want your child to do something he doesn't want to do, you must combine it with a happy experience, not just a painful one.

Many smart parents will set up some reward mechanisms. If the child insists on covering the eyes for a week or a month, they will buy the child a toy or promise to take the child to the playground. This is called a positive incentive mechanism in psychology. In order to reduce the inferiority complex caused by covering the eyes of children, some parents will cover one eye of the children's toy dolls, and even cover one eye themselves, so that the children will feel that they are not alone. In addition, it is also a good choice to let children choose some eye masks they like, or download their favorite patterns from the Internet and stick them on the surface of the eye patch or eye mask.

Some cute eye masks on Taobao

In short, let the child feel that wearing glasses is a fun and interesting game, not a painful torture. As for the choice between eye patches and eye masks, children with good compliance can choose eye masks, and those who have just started treatment or are not very cooperative can also choose eye patches.

4. How to evaluate the effectiveness of amblyopia treatment?

Although many parents can cooperate with doctors well in treatment, they have no idea about the effect of treatment. Many parents have always thought that the evaluation of the effect of amblyopia is to see whether the degree of glasses has decreased. Therefore, when the doctor says: "Your child's glasses have not changed significantly, and there is no need to change glasses." The first reaction of parents is: "My child's condition has not improved at all?" Please remember that the most important evaluation of the effect of amblyopia is corrected vision (vision with glasses), followed by contrast sensitivity and recovery of binocular stereoscopic vision function, which has little to do with naked eye vision and refractive power.

For example

When a child with amblyopia first started treatment, his naked eye vision was 0.2, his corrected vision was 0.2, and his eyes were hyperopic at +7.00 D. After three months of treatment, there was no significant change in naked eye vision and hyperopia, but the corrected vision reached 0.6, which means the treatment was effective.

Therefore, parents should first focus on correcting their vision! Parents should teach their children to read the eye chart as early as possible, which is crucial for evaluating the effectiveness of amblyopia treatment.

So the question is! Under what circumstances can amblyopia be considered cured?

Ahem! Pay attention.

01The corrected visual acuity of both eyes is above 0.9

02Both eyes are in normal position

03Have good binocular vision and stereoscopic vision function

04Three-year follow-up: no visual acuity regression

5. Can I take off my glasses immediately after my amblyopia is cured?

When the corrected vision of a child's amblyopic eye reaches normal, many parents relax their vigilance, thinking that everything is fine, and no longer go to the hospital for follow-up on time, or even blindly take off their glasses. This is often a behavior that fails at the cost of success. Even after recovery, you must insist on wearing glasses. Taking off glasses too early can easily lead to recurrence of amblyopia. In fact, data show that within one year after vision reaches normal levels, the recurrence rate of amblyopia caused by blindly stopping treatment is as high as 25%, especially amblyopia caused by anisometropia and high-grade compound hyperopic astigmatism. Therefore, when to take off the glasses and when to cancel the cover need to be done according to the doctor's advice.

6. Amblyopia training is also important

The training for amblyopia mainly focuses on monocular stimulation and binocular coordination training. In the early stage of treatment, the monocular stimulation training of the amblyopic eye is the main focus. When the corrected vision of the amblyopic eye improves, binocular vision training is gradually introduced. In order to effectively help children recover good binocular vision function during the amblyopia treatment stage, Wuhan Aier Eye Hospital's strabismus and pediatric ophthalmology department has specially launched a 3D multimedia training system and a 4D strabismus and amblyopia correction system. The system tailors personalized training parameters for each patient according to the patient's visual conditions, and changes them at any time during the training process as the vision changes, making the training more targeted, direct, accurate, fast and stable.

Patients undergoing visual function training

The treatment should be formulated comprehensively according to the child's age, corrected vision, strabismus and amblyopia type. Generally speaking, children with poor vision can be arranged to have 4-5 sessions per week in the early stage of training. After the vision is improved to a certain extent in the middle stage of training, the frequency can be gradually reduced to 3-4 times per week. In the later stage of training, when the vision is consolidated and the function is improved, 1-2 times per week is sufficient.

Final message

Amblyopia treatment is a long process

During this period, children will find it boring and parents will also be very tired. Not only do they have to take them to the hospital for regular checkups, but they also have to urge them to cover their eyes strictly according to the requirements, and spend time with them to do amblyopia training. The editor hopes that every parent will not give up easily, help their children build confidence, and give them the courage to overcome the disease. I believe that through the joint efforts of families and hospitals, every child with amblyopia will be cured one day.