Many eye doctors believed until recently that if a child's vision was impaired because of a "lazy eye," the condition could not be corrected past the age of six or seven years. However, a study funded by the National Eye Institute, part of the National Institutes of Health, has found that amblyopia or "lazy eye" treatment can be effective in children age seven through 17. In fact, many of the 517 children studied at 49 eye centers showed improvement in their vision.
"Age alone should not determine whether or not to treat," said Michael Repka, M.D., a pediatric ophthalmologist at the Johns Hopkins Children's Center and a co-author of the study. Even teenagers benefit from treatment, said Repka.
Amblyopia is a common cause of vision loss in as many as 3% of children in the US. During infancy or childhood, the vision loss occurs when the brain favors one eye over the other. The other healthy eye does not receive brain input, limiting visual development. The most common causes of 'lazy eye" are nearsightedness, farsightedness, or a crossed or wandering eye (strabismus).
The reason vision in the amblyopic eye improves is due to the brain's plasticity, says Susan Cotter, O.D., a pediatric optometrist at the Southern California College of Optometry and co-author of the treatment study. Neuroplasticity means the brain can change with learning. By forcing the unused eye to work, the brain will process the sensory information and adapt. As a result, vision improves.
Children in the study were divided into two groups, randomly selected. One group wore only prescription classes. The other group either wore glasses and an eye patch or glasses, an eye patch and eye drops. The latter group was also instructed to read, draw, or do other close-up activities as well since "near-vision activities are visually stimulating," says Cotter.
The patch, eye drops and close-up work forced the test subjects to use their amblyopic eyes. Children wore the patch for two to six hours per day. Children 12 years and less also used eye drops.
However, "eye drops blur the eye all day which is why the teenagers wore only patches, which could be removed while driving," says Cotter.
If children in the study could read two more lines on the eye chart with the amblyopic eye, the treatment was considered successful.
According to the National Eye Institute, 53% of children in the study ages 7 through 12 who wore glasses and a patch for 2-6 hours per day, and did near-vision activities could read two or more lines on the eye chart after 24 weeks. But only 25% in this age group could do the same. Twenty-five per cent of children ages 13 through 17 who wore eye glasses and a patch had improved vision whereas 23% who wore only glasses improved. Of those children in this age group who had been previously treated for amblyopia, 47% who wore glasses and a patch and did close-up work had improved vision. On the other hand, only 20 % improved who were treated with only glasses.
"This study shows how important it is to screen children of all ages for amblyopia," said study co-chairman Richard W. Hertle, M.D., Children's Hospital of Pittsburgh.
If children also have strabismus and will undergo surgery to correct the eye muscle imbalance, they should be treated first for amblyopia, says Cotter. "Surgery doesn't help amblyopia. If the child has surgery and amblyopia still exists, one eye with 20/100 vision, for instance, will be blurry; consequently it will be difficult or impossible for the brain to fuse the two images together into one," says Cotter.
Atropine eye drops may serve to improve compliance because the child doesn't require monitoring. Adhesive patches are also used to increase compliance in young children as it is difficult for them to peek. "Children can't be monitored all day," says Cotter.
Although the adhesive patch is hypoallergenic, some children with sensitive skin experience irritation when the patch is removed. So some doctors allow their patients to switch to cloth patches. Cloth patches with side shields still block vision in the affected eye.
The number of hours that the children wore their patch was through self report. "This is a real world, treatment effectiveness study," says Cotter. "I do the same clinically."
A new study is planned to learn about the effects of near-vision activities on amblyopia.
Sources:
Article reviewed by
Susan Cotter, O.D.
Pediatric Optometrist
Southern California College of Optometry
Diana Clarke is a teacher and health educator. Her articles have appeared in newspapers and magazines, such as the San Jose Mercury News and the World of English.
Many people today realize the importance of keeping their blood... Read More
Dizzy Dean, the great baseball pitcher of the 1930s-1940s, once... Read More
Teen drug abuse is at an all time high, but... Read More
What's Insomnia?Identifying insomnia is a little like the old joke... Read More
Everything can be found on the Internet. At various sites... Read More
A neuroma is an inflamed nerve. In the foot, the... Read More
OxyContin is a narcotic drug, an opiate, that has been... Read More
Whether you're a weekend athlete, or a gardener that overdid... Read More
Cord BloodCord Blood is the blood that remains in the... Read More
(NC)-In most cases insect bites are harmless and if left... Read More
Thirty percent of human population has a high blood pressure... Read More
As computers, Internet and technology have become increasingly more available... Read More
Checklist of Treatments for Alzheimer's DiseasePart 2 of 82. Vitamin... Read More
I have been swallowing three varieties of blood pressure pills... Read More
Marketing Authorisation: Medicinal Products The case of R (on the... Read More
Over the past few years, stem cells have been getting... Read More
Endocervical polypsEndocervical polyps are the most common benign neoplasms of... Read More
"The more we do to you, the less you seem... Read More
Don't laugh. Both get a lot of coverage in the... Read More
More and more people have started travelling to India for... Read More
It was Saturday morning and while I was making breakfast,... Read More
Even in clinical trials, Lotronex displayed a tendency towards causing... Read More
Each year hospitals end up killing twice as many people... Read More
For years, it's been known that regular daily exercise is... Read More
What an oxymoron the Physicians Committee for Responsible Medicine has... Read More
When Aspirin Isn't EnoughIt's surprising how clearly we can recall... Read More
The most common type of arthritis is osteoarthritis (OA). This... Read More
Cold-Eeze is a homeopathic solution to the common cold. It... Read More
A wee bit of fluoride makes teeth and dentists happy,... Read More
This is a true story.Yesterday, I picked up a new... Read More
An estimated 85 million Americans have acquired the herpes simplex... Read More
Any teenager will tell you that acne can drive you... Read More
Sjogren's syndrome is an autoimmune disorder ? a disorder in... Read More
Medical Billing SoftwareThe practice is running smoothly, with patients coming... Read More
According to the Los Angeles Times, the California Association of... Read More
Thalidomide is responsible for causing more than 10,000 children to... Read More
A generic drug can be defined as an identical, or... Read More
When a patient has a serious illness and there is... Read More
"If you have to deal with chronic neck pain, it... Read More
The recent withdrawals of the prescription medications Vioxx and Bextra... Read More
What is a coronary heart attack?Are you at the risk... Read More
Over the past few years, stem cells have been getting... Read More
How to find a doctor? There's no magical route to... Read More
If you joints are constantly killing you, here are three... Read More
A thick, yellowish nail with splotchy white areas is a... Read More
With more medical advantages, an adjustable bed finds more functions... Read More
1. Support the affected arm during activities of daily living.... Read More
The central location of the city of Chicago has made... Read More
In the next few years paramedics, first responders and military... Read More
A neuroma is an inflamed nerve. In the foot, the... Read More
What is R.I.C.E. and why do you need it? One... Read More
Heel pain, medically termed plantar fasciitis, is a common and... Read More
A hypnotic "trance" is not something that is foreign to... Read More
Australian scientists say they have identified a toxin which plays... Read More
Things are moving forward and new and advanced procedures are... Read More
Naturopathic Medicine is an holistic approach that relies on natural... Read More
When an unconscious patient arrives in the ED, every hospital... Read More
Pfizer is currently marketing Neurontin as an oral medication for... Read More
As much as 95% of the population suffers from some... Read More
1. Seeing a doctor who's not board-certified or a doctor... Read More
Overview Melatonin is a natural hormone, which is produced and... Read More
The vaccine industry insists that their vaccines against the flu... Read More
Although you make a patient feel better, there isn't usually... Read More
There are high arch feet and low arch feet and... Read More
We've all seen patients who were far beyond the reach... Read More
Pain is the body's warning signal that something is wrong.... Read More
Medicine |