11/29/18

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Fixing amblyopia before six


Fixing amblyopia before six



The final result after 6 months to 2 years Patching is certainly an improved function in the majority of cases. However, when the patch is removed, the two eyes often do not work as they should, 3D vision is often not achieved and the other eye suppresses the amblyopic eye, eventually leading to a reduction in visual acuity.

More importantly, there is only a limited time window in which patching therapy works. Children are only patched up to the age of 12 years. Adults with amblyopia are not offered treatment.

The current treatment approach is based on the assumption that amblyopia is the major problem and the loss of binocular function is the secondary consequence.


The fact that reducing patch amblyopia does not automatically result in improved use of the two eyes raises a question of validity.

There is reason to believe that the logic must be reversed, namely that the main problem is that the two eyes either stop cooperating due to an ocular misalignment or an out-of-focus eye, the secondary consequence being amblyopia. The link between interrupted binocular vision and amblyopia is oppression.

The outdated belief that lazy eyes need to be treated at a very young age, or not at all, still exists today due to the following theories and practices:

First, amblyopia develops only in childhood, usually before the age of eight. Since amblyopia occurs in childhood, it has been assumed that the disorder can only be treated in early childhood.
Second, laboratory studies in the 1960s on animals such as cats and monkeys indicated that at the beginning of life there was a "critical phase" in which the visual system developed. In the studies, when one eye of an animal was occluded (covered) shortly after birth, the two-eye visual system did not develop normally. That is, it was seen that fewer neurons in the visual cortex of the animal's brain reacted to the eye, which was occluded after removal of the cover. This lack of response in the brain of the animal could be reversed in the study, but only if the subject's occluded eye was uncovered or opened during the critically considered short developmental period in infancy. These experimental results on animals were then transferred to humans and it was assumed that amblyopia can only be reversed if the patient was treated very early in life.

However, most children with amblyopia were not exposed to the severe degree of visual impairment produced by these famous laboratory experiments with cats and monkeys. The experimental animals were often freed on the first days of life on an eye of vision. In contrast, most children with sluggish eyes receive enough visual stimuli through their affected eye. In these laboratory experiments, the most dramatic negative effects on normal brain and visual development were observed when one eye of the animal was occluded in the first weeks after birth. Animals that were later blinded in one eye of vision showed fewer changes in "brain wiring" or neural pathways. These laboratory tests are a good model for Deprivationsamblyopie as z. B. occurs when a congenital cataract is present, which blocks the sight in one or both eyes at birth. In these cases, early cataract removal surgery is important to restore as much function as possible to the affected eye. However, deprivation amblyopia occurs in only one in eighty (1 in 80) amblyopes. The vast majority of amblyopes have strabismic or anisometropic amblyopia. These conditions develop months or even years after birth. Therefore, the effects of these conditions on the brain wiring may be much lower than those observed in animal experiments. While early intervention is always best, numerous studies have shown that visual improvement can still occur in older adults.

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