Amblyopia is commonly known as'lazy eye. It is a vision development disorder, which affects eyes and the brain during infancy and childhood. It signifies that the eye does not achieve a normal visual acuity even with refractive correction in form of glasses or contact lens. During normal visual development, the eye and brain learns to'see' and develop binocularity, that is the ability to perceive depth (stereoacuity). This occurs in the first 8 to 10 years of life. 

Each eye transmits a clear and identical image from retina to the brain, which fuses the two images into a single image with 3 dimensions (adding depth). When the image is formed on the retina of two eyes is too dissimilar, the brain cannot fuse the two images and suppresses the more blurred image. As a result, the worse eye does not learn to'see' and becomes'lazy. This condition is seen in 1-4% of population.

The common causes for dissimilar images or amblyopia are:
1. Misalignment of the eyes or squint: it is the primary reason for amblyopia is misalignment of the eyes. In case, both your eyes are not aimed in the same direction, the image captured by each eye is different, resulting in diplopia. The brain will see from the dominant eye and suppress image from the other eye. Over a prolonged period of time, the eye dissociates from the visual cortex of the brain.

2. Refractive amblyopia:
A. Unequal refractive error in both eye. When the eye power of both eyes differ by more than 1.5d of spherical equivalent, which results in dissimilar images between the two eyes. As a result, the visual development in restricted in the worse eye.
B. High refractive error or astigmatism in both eyes, since there is a blurred image in both eyes, the normal vision development does not occur in either eyes resulting in bilateral lazy eyes.

3. Cloudiness in visual system or visual deprivation amblyopia: any kind of obstruction or cloudiness in the normal visual axis of the eye tissues can lead to amblyopia. Disorder of any kind, which blocks a clear image from being focused blocks the formation of a clear image on your retina. Commonly due to congenital or developmental cataracts or corneal opacities or prolonged closure of one eye in early childhood (drooping of one eyelid, eyelid swelling, patching of one eye).

Treatment for amblyopia
For treatment of amblyopia, a child must be compelled to utilize his affected, weaker eye. This can be done by correction of causative factor such as, treating refractive error with glasses, surgical correction of misalignment of eyes followed by patching and vision therapy, cataract surgery.

Patching or occlusion of the good eye
This is done to force the brain to pay attention to visual input from the worse eye. This allows nerve connections between affected eye and brain to develop due to, which the eye'learns to see. Eye drops such as atropine are also used for blurring the vision of the good eye. Some form of vision therapy may also be required to train both eyes to see together and develop some degree of depth perception.

To be effective, treatment should be implement as early as possible, within the period of normal visual development best within first 8 years of life. Some visual gain has been seen in selected patients up to age of 14 to 18 years. This also highlights the importance of a comprehensive eye examination as a routine in young children.

About Amblyopia or Lazy Eye

The ability to see is one of our greatest powers and it needs to be valued and looked after. Sometimes this involves wearing glasses to improve our vision. Spectacles not only help us see better but also prevent straining and further deterioration of the eye muscles. Here are a few signs to watch out for that will indicate your need for spectacles. Keep in mind however that a comprehensive eye exam is the only way to determine the power required for your spectacles. 

-  Blurred vision
Blurred vision or the inability to focus on something in the distance is one of the first signs or eye deterioration. When it comes to children, watch out for complaints of inability to read the writing on class blackboards.

-  Frequent headaches
Unexplained headaches that come and go could be a sign that you need glasses. These headaches can usually be felt at the end of a long day or after watching television. 

-  Constant squinting
Squinting is a natural way to improve vision. This is because the act of squinting reduces extra light and light scattering thus allowing us to see something clearer. Thus, if you notice yourself squinting more than usual it is time to schedule an eye exam.

-  Difficulty working on a computer
Struggling to read figures and words on a computer screen is usually a sign of poor vision. Try adjusting your screen angle and the distance of the screen from your eyes to see if your vision improves or worsens. 


-  Difficulty adjusting to lights
Sudden increased sensitivity to lights can be a sign of many eye disorders with vision problems being the most common. 


-  Eye strain
Occasional pain in the eyes after a long day or as a result of an allergic reaction is nothing to worry about. However, if this pain persists for a few days, it could be an indication that you need spectacles. 
Deterioration of vision is usually a very gradual process and so you may not realize when it begins. However, the earlier you start wearing corrective glasses to improve your vision the easier it will be to control the deterioration of the eye muscles and you may even be able to rectify your condition completely. So, do not ignore any of these warning signs. Even if you do not have any of these symptoms, it is a good idea to get a thorough eye examination at least once a year.

Common Signs You Need Glasses

Ever noticed spots or strands that  float  into your line of vision. These are known as floaters. In most cases, they do not affect your vision, but can cause a lot of discomfort. Thus, in most cases they do not require treatment unless they affect your vision significantly. Floaters are more likely to stand out when looking at bright objects or something like a clear blue sky. Moving your eyes can shift the fluid in your eyes and move these floaters out of your line of sight.

Dust particles entering and irritating the eye should not be confused with floaters. Floaters can be described as flecks of a protein called collagen. These flecks can be seen when they are loosened from the back of the eye known as the vitreous. This can happen at any age but is more likely to affect people between the ages of 50 and 75. Being near sighted or suffering from cataract also increases your risk of seeing floaters. In rare cases, it can also be triggered by a disease in the eye, an injury to the eye, tumors or crystal deposits in the back of the eye.

Noticing the odd floater is not something to worry about. However, if you notice a sudden increase in the number and frequency of floaters in your eye, see flashes of light, have pain in the eyes or experience a loss of side vision, consult a doctor immediately. This could also be a sign of a more serious condition like a detached retina that requires immediate medical attention. Excessive floaters can be removed through a surgery known as a vitrectomy or laser vitreolysis. A vitrectomy involves the removal of vitreous gel from the middle of the eye and replacing it with silicone oil or a gas bubble. The surgery last 2 or 3 hours, but you may require an overnight stay in the hospital.

Laser vitreolysis is a more recent form of treatment for this condition. This pain free procedure involves the projection of a laser beam into the eye that focuses on large floaters to break them apart or vaporize them. This procedure can be performed as an outpatient and is considered safer than a vitrectomy. The form of treatment suited to a person will depend on a number of factors including their age, what the floaters look like, where they are located and the frequency of their appearance.

Eye Floaters - When Should You Consult A Doctor?

Amblyopia is decreased vision in one or both eyes due to abnormal development of vision in infancy or childhood.It is commonly known as lazy eye, in which a child's vision does not develop properly, usually in one eye. If it is left untreated, a child's vision will never develop correctly in the affected eye.

What are the types of Amblyopia are there?
There are several different types and causes of Amblyopia, such as Strabismic Amblyopia, Deprivation Amblyopia and Refractive Amblyopia.
The end result of all forms of Amblyopia is reduced vision in the affected eye(eyes).

How does Lazy Eye occurs?
Lazy eye occurs when your brain favors one eye, often due to poor vision in your other eye. Eventually, your brain might ignore signals from your weak or lazy eye. The condition can result in vision impairment and loss of depth perception.

What are the Symptoms of Lazy Eye?
Lazy eye may be hard to detect until it becomes severe. Early warning signs include:
1. Tendency to bump into objects on one side
2. An eye that wanders inward or outward
3. Eyes that appear not to work together
4. Poor depth perception
5. Double vision
6. Squinting

What Causes Lazy Eye?
A number of conditions and factors can lead you to rely on one eye more than the other. These include:
1. Constant strabismus or turning of one eye
2. Genetics or a family history of lazy eye
3. Different levels of vision in each of your eyes
4. Damage to one of your eyes from trauma
5. Drooping eyelids
6. Vitamin A deficiency
7. Corneal ulcer or scar
8. Eye surgery
9. Vision impairment, such as nearsightedness, farsightedness, or astigmatism
10. Glaucoma, which is high pressure in your eye that can lead to vision problems and blindness

How is Amblyopia diagnosed?
When it first occurs, parents and children often don't notice the condition. It's important to get routine eye exams as an infant and child, even if you show no outward symptoms of eye problems.
Family history of amblyopia is a risk factor for the condition.

How Is Lazy Eye Treated?
Glasses/Contact Lenses
Eye Patch
Eye Drops
Surgery
Other treatments include:
Atropine penalization therapy (also used for maintenance)
Optical blurring through contact lenses or elevated bifocal segments

What Is Amblyopia? Are You or Your Child Suffering From It?

78% of urban youth are in front of the computer screen/ mobile screen for about 12 hours a day. Such extensive strain to the eyes can have long term effects on vision.  Act now to protect your eyes by following these tips-

1) Ensure appropriate glasses or contact lens prescription which is also adequate for computer use. 
2) For prolonged exposure, use glasses to help with contrast, glare, and eye strain when using a computer.
3) Adjust your computer such that your eyes are level with the top of the monitor. This allows you to look slightly down at the screen.
4) Avoid any glare on your computer from windows or lights. Use an anti-glare screen if required.
5) Choose a comfortable, supportive chair. Position it so that your feet are flat on the floor.
6) If your eyes feel dry, blink more often.
7) Every 20 minutes, rest your eyes by looking 20 feet away for 20 seconds. At least every 2 hours, get up and take a 15-minute break.

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Protect Your Eyes While Working. 7 best ways.

Cataract is generally associated with old age. However, in some unfortunate cases, children could be affected by cataract as well. A cataract can be defined as a cloudy or opaque layer that forms on the eye's natural lens that lies behind the iris and the pupil, leading to eventual loss in vision. Cataract can affect children in one eye or both eyes.

Cataract can be a congenital birth defect or can develop as the child grows older. The latter case is known as pediatric cataracts. The exact cause of cataracts in children is not known, but it has been associated with a number of genetic disorders, low birth weight and infections during pregnancy. Traumatic events such as an injury to the eye can also cause cataracts.

The earlier a cataract is diagnosed and treated, the better it is. It is easier to identify a cataract that affects both eyes than a cataract that affects only one eye. If a congenital cataract is not treated in time, the part of the baby's brain used for sight may not develop properly. Hence it is crucial to recognize cataract symptoms.

Here are a few you should look out for:

    Not looking directly or responding to large, colourful objects.
    Not being able to find small objects while crawling.
    Excessive squinting or shielding their eyes to bright sunlight.
    Eyes that do not focus on the same point.
    White reflex instead of a red reflex in photographs.
    Uncontrolled movement of the eye.

Cataracts that are too small to affect sight can be treated with eye drops to dilate the pupil. However, this provides only temporary relief. Surgery is the most preferred form of cataract treatment. This surgery can be performed even in the first few weeks of a baby's life. The child is put under anesthesia and a microsurgical instrument is used to break the lens into small pieces and remove it.

This surgery is followed by the use of lenses or glasses to help the eye regain its power to focus again. In some cases, the lens may be implanted to replace the natural lens. In cases where cataract affects only one eye or one eye is more severely affected than the other, there may be a tendency to develop amblyopia or lazy eye syndrome. In such cases, it becomes necessary to patch the good eye shut and stimulate vision in the eye that has undergone surgery.

Cataract in Children

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