Ambylopia

AMBLYOPIA: 

AMBLYOPIA

Accommodation: 

Accommodation Ability of the eye to increase or decrease its dioptric power through crystalline lens to focus clearly.

Three things happen in accommodation simultaneously: 

Three things happen in accommodation simultaneously 1- Size of pupil (decreases-miosis) 2- Movements of eye balls (convergence) 3- Lens changes its shape (more globular)

Size of pupil: 

Size of pupil Pupil controls amount of light. Bright light --- constricts Dim light---- dilates Accommodation ------ constricts

Movement of Eye Balls: 

Movement of Eye Balls EYES MOVE inwards to focus on near object Outwards to focus distant objects with help of extraocular muscles so that same image falls on retina.

LENS : 

LENS Lens is held in position by zonules which are attached to ring ciliary muscle . Contraction of ciliary muscle result in decrease in size of ring , so tension of zonules is decreased------------

LENS CHANGES: 

LENS CHANGES RESULT: Lens become more Globular with increase in its refracting power

Emmetropia : 

Emmetropia Parallel rays of light from infinity ( 6m ) fall on the retina and form a sharp image when eye is in resting state without accommodation

AMETROPIA: 

AMETROPIA When parallel rays of light fall in front of or behind retina (with accommodation at rest) instead of falling on retina 3 types Hypermetropia Myopia Astigmatism

HYPERMETROPIA: 

HYPERMETROPIA Condition of eye in which parallel rays of light focus behind the retina with accommodation at rest.

PowerPoint Presentation: 

Parents brought a male child aged 2 years with complaints of inward deviation of eyes for the last one month. According to them child has perfectly straight eyes at times and seems to develop inward deviation while watching TV or some close object.

Examination: 

Examination On examination the child seems to have straight eyes but when he is presented with a toy close to his eyes his left eye deviates inwards. On cycloplegic refraction his refractive error is +3.00 in right eye and +4.00 in his left eye.

AMBLYOPIA (Greek word ): 

AMBLYOPIA (Greek word ) Amblys --- Lazy Ops--- Eye Amblyopia--- Lazy Eye 3-4% of population suffers from this condition

Amblyopia: 

Amblyopia Amblyopia is unilateral or bilateral decrease of best corrected visual acuity caused by form vision deprivation and/ or abnormal binocular interaction, for which there is no pathology of the eye or visual pathways.

TYPES OF AMBLYOPIA: 

TYPES OF AMBLYOPIA Strabismic Anisometropic Stimulus deprivation Bilateral ametropia Meridional

Anisometropic Amblyopia: 

Anisometropic Amblyopia As one image is more blurred, it is not possible for the brain to fuse the two images resulting in suppression of one image. The cortical area is deprived of visual input and result id aniometropic amblyopia

Characteristics of Anisometropic amblyopia: 

Characteristics of Anisometropic amblyopia Easily overlooked as one eye has good visual acuity Mostly remain undetected resulting in un necessary loss of vision in a perfectly good eye. Only way of prevention is early detection through screening programs.

Strabismic: 

Strabismic Strabismic - both eyes are looking at different objects, image from the deviating eye is suppressed at cortical level resulting in under development of visual cortex of that eye Deviated eye is not looking at object of regard

Other Types: 

Other Types Stimulus deprivation :- same mechanism Bilateral ametropic :- same mechanism Meridional : - image blur in one meridian

Management : 

Management Diagnosis- visual assessment of individual eye( method appropriate to age Cycloplegic refraction Glasses Patching according to age & depth of amblyopia (part/ full time) Injection Neurocholine

ISSUES: 

ISSUES Non compliance Decreased visual level  child  uninterested in patching Late detection means more patch and less compliance Monocular telescope is the new concept in enhancing compliance and good results

PowerPoint Presentation: 

A boy 14 years of age reports to eye OPD with complaint of reduced acuity in his left eye. He was alright according to him , then suddenly he discovered decreased vision when on day he was rubbing his right eye. On examination his vision in right eye is 6/6 and 6/60 in left eye. Retina and anterior segment are normal on examination.

PowerPoint Presentation: 

His refraction in RE is + 0.25 D Sph. and LE refraction is +1.00 +3.50/90 (high hypermetropic astigmatism). Diagnosis is meridional amblyopia. Two hour daily patch with watching TV with the help of monocular telescope is suggested.

PowerPoint Presentation: 

Patient reports for check up after 6 months. He complied with the instructions and did patch for 2 hour daily with monocular telescope. On examination his visual acuity (in his left eye) with glasses is 6/6 .

PowerPoint Presentation: 

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