Visual Impairments : Lazy Eye

Lazy Eye or Amblyopia is for vision in an eye that did not develop normal sight during early childhood. It is the most common cause of visual impairment amongst children, affecting 2-3 out of every 100 children. Unless it is successfully treated in early childhood, amblyopia usually persists into adulthood. It is also the most common cause of monocular (one eye) visual impairment among young and middle-aged adults.

When one eye develops good vision while the other does not, the eye with the poorer vision is called amblyopic. Usually, only one eye is affected by amblyopia, but it is possible for both eyes to be “lazy.” This condition is called bilateral amblyopia.

An example of vision with Amblyopia

 

Amblyopia in children and adults

Newborn infants are able to see, but as they use their eyes during the first months of life, their vision improves. During early childhood years, their visual system changes quickly and their sight continues to develop.

In order to have normal vision, it is important that both eyes develop equal vision. If a child has amblyopia and cannot use his or her eyes normally, vision does not develop properly and may even decrease. After the first nine years of life, the visual system is normally fully developed and usually cannot be changed.

If amblyopia treatment is not begun as early as possible, several problems can develop that can seriously affect vision from childhood into adulthood:

  • the amblyopic eye may develop a serious and permanent visual defect;
  • depth perception (seeing in three dimensions) may be lost, because good vision in both eyes is needed;
  • if the stronger eye becomes diseased or injured, it can mean a lifetime of poor vision.

People with amblyopia in one eye are more than twice as likely to lose vision in the healthy eye from trauma. If the vision in one eye should be lost later in life from an accident or illness, it is essential that the other eye have normal vision.

 

What is refractive (or anisometropic) amblyopia?

Refraction is when the eye focuses light onto the retina to form a visual image. A refractive error occurs when the light is not properly focused in the eye and vision is blurry. When a child has refractive, or anisometropic, amblyopia, it means he or she has a different amount of refractive error in each eye. When this is the case, the brain will use the better-seeing eye and essentially “turn off” vision from the weaker eye. At first, eyeglasses may help by correcting the refractive error in both eyes, allowing them to work equally together. Then the amblyopia may be further treated to help improve vision and depth perception.

Photographs from an MTI photoscreener demonstrating anisometropia.

Treatment

How is amblyopia treated in children?

Treating amblyopia involves forcing the child to use the eye with weaker vision. There are two common ways to treat amblyopia:

Patching

An adhesive patch is worn over the stronger eye for weeks to months. This therapy forces the child to use the eye with amblyopia. Patching stimulates vision in the weaker eye and helps parts of the brain involved in vision develop more completely.

Previously, eye care professionals thought that treating amblyopia would be of little benefit to older children. However, results from a nationwide clinical trial showed that many children from ages 7 to 17 years old benefited from treatment for amblyopia. This study shows that age alone should not be used as a factor to decide whether or not to treat a child for amblyopia.

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A boy wearing a patch as part of his treatment.

Atropine

A drop of a drug called atropine is placed in the stronger eye to temporarily blur vision so that the child will use the eye with amblyopia, especially when focusing on near objects. NEI-supported research has shown that atropine eye drops, when placed in the unaffected eye once a day, work as well as eye patching. Atropine eye drops are sometimes easier for parents and children to use.

Atropinetreatment

Can amblyopia be treated in adults?

Studies are very limited at this time, and scientists don’t know the success rate for treating amblyopia in adults. During the first seven to ten years of life, the visual system develops rapidly. Important connections between the eye and the brain are created during this period of growth and development. Scientists are exploring whether treatment for amblyopia in adults can improve vision.

Use in VR

I want to be able to use this information and implement it into the virtual reality simulation that I am creating. As well as using the quality of vision in the simulation I could also show a mirror and users can look at their own eyes, as both Amblyopia and Cataracts has physical changes to the eyes too. I feel this would be very impacting on the user as they won’t be used to having a physical impairment and it should impact them more when they see their own face with a lazy eye or cataracts. As well as this I think I should include facts and information throughout the simulation so there is extra information on the subject for the users.

Vivid Vision already runs a program with Virtual Reality to help to treat Amblyopia, I have chosen not to help treat the impairment, but to raise awareness for visual impairments through the use of a simulation in virtual reality.

 

 

https://nei.nih.gov/health/amblyopia/amblyopia_guide

https://www.aao.org/eye-health/diseases/amblyopia-lazy-eye

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