Amblyopia and Strabismus
Our specialized approach to treating amblyopia and strabismus
involves advanced, non-invasive treatment options with successful long-term results.
It is common for parents to be unaware of their child’s vision problem, especially if the child was not examined by an eye specialist in early childhood. So when a child is diagnosed with amblyopia or strabismus, parents may become anxious wanting to know if their child will ever be able to see clearly or have “straight eyes”.
At Clarendon Vision Advanced EyeCare, our doctors are at the forefront of the most advanced treatment options available for treating amblyopia and strabismus with positive results. In the past, amblyopia or strabismus treatment consisted of patching a child’s eye or using strong prescription eye drops. Today, these treatments are considered outdated and have shown poor patient compliance with minimal long-term outcomes. Speak to our doctors about the difference our advanced treatment can make on your child’s vision and self-esteem.
What is Amblyopia?
Amblyopia (also known as lazy eye) is a treatable, neurodevelopmental form of vision loss. It is caused when there is a disruption in binocular (two eye) vision in infancy/toddlerhood either by misalignment of the eyes (strabismus), or when one eye has a greater farsightedness/nearsightedness and/or astigmatism, or blockage of light, such as infantile cataracts. It typically occurs in one eye (but can occur in both eyes) even when best corrected with glasses or contacts
Signs and Symptoms of Amblyopia
Reduced eyesight in one or both eyes of varying degrees
Deficiency in binocular vision often resulting in reduced depth perception
Poor eye hand coordination which may affect sports performance
Trouble with coordination, tripping and accident prone
Difficulty with learning and school performance
What is Strabismus?
Strabismus (also known as crossed eye) occurs when both eyes are unable to properly team and align together. This results in one or both eyes appearing to cross-in or wander-out of alignment. If left untreated, strabismus can have a devastating effect on overall visual development and significantly impact one’s performance and self-esteem.
When the eyes are unable to align properly, as is the case in strabismus, there is an increased risk of also developing amblyopia (lazy eye). When an eye misalignment is present, the brain receives different images leading to double vision. This confusion leads the brain to suppress or ignore the image that the brain is receiving from the deviated eye.
Signs and Symptoms of Strabismus
Eye deviation of one or both eyes inward/outward/upward/downward
Suppression of binocular vision (information from one eye is “turned off” by the brain)
Double vision or shadowy/overlapping vision
Poor or no depth perception often affecting sports
Defective eye movement/tracking ability
Poor eye hand coordination
Difficulty with school performance
Reduced reading fluency
Skills Necessary for Efficient Visual Function
Visual Acuity
Visual acuity is determined based on the amount of refractive error (nearsightedness, farsightedness or astigmatism) one has. Presence of refractive error may cause blurry vision. When a child has blurry vision in only one eye the brain may “turn off” the information coming from that eye; therefore, the child may not be able to articulate the problem or even be aware of it. If left untreated, reduced visual acuity will interfere with learning, sports and overall wellbeing.
Eye Teaming
If the eyes are unable to work together efficiently as a team, they run the risk of causing poor misalignment, and even an eye turn which may be intermittent or constant. This eye misalignment will in turn cause the brain to “turn off” or suppress the information coming from the deviated eye to avoid double vision. If left untreated, this compromised binocularity will cause reduced visual spatial ability and self-esteem problems.
Eye Tracking
When the eyes don’t track accurately for visual tasks such as reading and learning, numbers, letters and text can get mixed up. The child will skip, repeat or misread small words and lose their place while reading. Reduced eye tracking skills also impacts scanning the environment and makes it difficult for a child to copy from the board. This makes it difficult to have sustained attention and focus on schoolwork.
Depth Perception
Being able to judge depth accurately is important for many life skills including school and sports performance as well as driving. Depth perception is impaired when eyes misalignment is present as in strabismus or vision is reduced due to amblyopia. This faulty visual system will struggle to orient the body in space causing reduced depth perception.
Standard Treatment Options
Standard treatments used for amblyopia and strabismus that include patching and atropine drops may not produce the desired results parents are looking for. These outdated treatments often produce poor or marginal results and any gained vision improvements tend to regress when treatment is discontinued.
Patching or penalizing vision with prescription eye drops discourages the development of binocular vision. Compromised binocularity or two-eyed vision is the reason why the brain is looking “to escape” this confusion by creating suppression.
Furthermore, children who are using patching are self-conscious and often feel frustrated, anxious, angry, and run the risk of being bullied. This in turn causes poor compliance, and therefore, poor results.
Our Advanced Treatment Approach
Our treatments for amblyopia and strabismus are evidence based and proven effective for nearly all ages. Treatments are geared towards addressing the underlying cause of the problem which is suppression caused by reduced binocular function.
Treatments may include:
Prism Lenses
These special types of lenses support the performance of the visual system by moving light to a position most comfortable for the eyes which relieves visual stress. They may further support the development of binocular vision while the patient is engaged in other therapies.
SHAW Lenses
These unique iseikonic (image balancing) lenses relieve visual stress induced by prescriptions that are significantly different between the two eyes. By equalizing the image size that the brain is receiving from both eyes while using SHAW lenses we are effectively building binocular function.
Vision Therapy
An office-based customized treatment program (along with support of home activities) is designed to rebuild efficient binocular vision and other related visual development delays. Therapy is designed to be engaging and eye patching is minimal. Gains in visual acuity, binocularity and overall visual function are effective and long-term.
VIVID Virtual Reality
Virtual reality games are used often as an adjunct therapy for amblyopia and strabismus. This interactive, engaging and exciting technology is greatly effective at minimizing suppression and encouraging the development of binocularity. It can also be prescribed as a home therapy under doctor’s supervision.
In this video, Dr. Fortenbacher of Wow Vision Therapy presents an informative review of amblyopia and how it can be treated using advanced optometric methods also available at Clarendon Vision Advanced EyeCare.
This video highlights the latest advanced technology used for treating amblyopia in patients of all ages, including adults.
Treatment Outcomes & Patient Successes
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