Amblyopia refers to the condition in which in one or both
eyes decrease vision. Patients with amblyopia absent
бинокулярное зрение – способность мозга правильно
match two images (of both eyes) together. This
the ability is necessary to be able to estimate the depth
sequence of objects in the field of view, the volume of the picture,
integrity of perception. Byчему появляется амблиопия и что
is it, consider next?
What is amblyopia?
Amblyopia is a reduction in the visual acuity of one or both eyes,
not amenable to optical correction, arising for no apparent reason
(primary) or due to the absence of normal conditions for
functioning of the retina (secondary).
As we have noted above, in people with amblyopia, completely
there is no binocular vision. Именно оно дает возможность
full perception of the surrounding reality,
stereoscopic vision, that is, the ability to determine
distances between objects.
This in turn is accompanied by an increase in visual acuity.
Only with good binocular vision is it possible to work
in several specialties, in particular, driver, surgeon,
The following are necessary for the formation of binocular vision.
- the same visual acuity in both eyes (not lower than 0.4 on
- same refraction (degree of farsightedness or myopia)
in both eyes;
- symmetrical position of the eyeballs; .
- equal sizes of images in the left and right eye –
- Normal functional ability of retinal, conductive
paths and higher visual centers.
- The arrangement of two eyes in one frontal and horizontal
�A “lazy eye” is common, not medical.
term used to describe amblyopia, because the eye with
impaired vision does not seem to perform the necessary work for
ensure normal vision.
The reasons возникновения амблиопии могут быть разные. Most
common – squint. Amblyopia with strabismus is
its consequence. Вместе с тем оно может быть и причиной
It is proved that the squint and amblyopia, like anomalies
refractions are purely functional problems. From what
they always decrease with stress relief, which
are followed, it follows that for their elimination there may be
used any methods conducive to achieving relaxation and
As in the case of refractive errors, the squint disappears, and
amblyopia is adjusted as soon as a person achieves
enough to remember an absolutely black point, mental
Распространенность заболевания трудно оценить. By
It is estimated from 1-3.5% of healthy people.
children and 4-5.3 percent of children with other eye problems. Among
2 forms are common in all forms – dysbinocular,
refractive. These forms account for about 90% of cases.
For reasons, several forms of secondary
- strabizmatic (disbinokulyarnaya),
- обскурационная (депривационная): развивается обычно при
corneal opacity (eyesore), with congenital lens opacity
(congenital cataract), with ptosis.
- анизометропическая: развивается на фоне анизометропии
high degree. It develops in the eye with more pronounced
anisometropia, not amenable to correction;
- hysterical: formed with mental disorder
states: hysteria, neurosis. Only in the treatment of this type
amblyopia in adults can fully recover normal
Провоцирующие факторы развития amblyopia:
- Retinopathy of prematurity;
- Burdened family history of anisometropia,
isomethropia, strabismus, congenital cataract.
- Mental disorder;
- Cerebral paralysis;
- Congenital cataract;
To establish the cause is extremely important, because it depends
Symptoms of amblyopia
amblyopia of the right and left eyes
Amblyopia is also sometimes called the “lazy eye”, because
the development of the disease is almost complete
turning off from the process of seeing one eye, the second eye while
becomes “leading” and takes over all visual
Manifestations of amblyopia are different, possibly asymptomatic
- Visual acuity decreases (there is no improvement during correction),
- color perception and dark adaptation are disturbed,
- возникает косоглазие (сходящееся, расходящееся и others).
Typical symptoms of amblyopia are:
- deterioration in the vision of one (right or left), and maybe immediately
- difficulty of perception of volumetric objects, estimates of the distance to
- double vision
- increased eye fatigue during activities requiring
- learning difficulties.
Visual impairment in amblyopia can vary from mild
reduced visual acuity to almost its complete loss
(light perception) and the impossibility of visual fixation.
Monolateral amblyopia usually does not cause much
obstructive symptoms, as good visual acuity
provided with a healthy eye.
Amblyopia can be temporary and goes away after a few days.
or months. In general, reduced vision in any type of amblyopia
able to be insignificant or very pronounced, to blindness.
Degree of amblyopia eyes
Allocate functional, organic and hysterical amblyopia.
Byтенциально функциональная амблиопия поддается лечению, в то
time as organic in most cases is
By потере остроты зрения выделяют следующие степени:
- 1st degree amblyopia occurs when acute
view is 0.8-0.9. This степень называется очень
- In the second degree, visual acuity decreases to the level –
- Amblyopia 3rd degree, which is called the average,
corresponds to visual acuity of 0.3-0.4.
- In stage 4, visual acuity ranges from 0.05 to 0.2;
- Самая последняя стадия — 5. Максимальная степень
disease, in this case, vision is reduced to 0.05 and below.
Practically not amenable to correction.
Amblyopia in adults
Amblyopia of the eye is primarily a childhood disease,
adults are quite rare. When unilateral form
disease disease is diagnosed in one eye. With
bilateral amblyopia disease affects both eyes.
Describing the symptoms it should be noted that quite often
the person does not realize that he has developed the disease.
Pathology detection occurs by chance. The patient becomes
leading one eye, and the brain can only perceive images
coming through it.
One of the signs in adults is double vision. Celebrated
he is in patients with severe strabismus as a result of inability
Brain two too different images combine into one.
Sharply lasting from several hours up to months
impaired vision can also be a sign of lazy syndrome
With истерической амблиопии взрослые жалуются на резкое снижение
of view, what happens a short time after
hysteria, nervous breakdown.
Adult amblyopia is diagnosed when there are complaints about
visual impairment, as well as during the examination.
Treatment in adults is much more difficult than in children. If measures for
to eliminate the causes of development of amblyopia not taken on time
restore vision fails.
How is amblyopia in children
In children, amblyopia is manifested by the following symptoms:
- hanging upper eyelid;
- nonsynchronous movements of the eyeballs, involuntary movements
- the child tilts its head or squints when trying to examine
- complaints of rapid fatigue, headache when reading,
performing hard work that requires increased
зрительного напряжения (вязание, вышивание и others).
Amblyopia Treatment у детей необходимо начинать
с её дифференциации и выявления органических
нарушений, которые также могут сопровождать и косоглазие,
и астигматизм, и дальнозоркость. Make it possible
лишь с применением объективного метода определения характера
зрительного восприятия на уровне зрительной коры головного
мозга — исследования зрительных вызванных потенциалов (ЗВП).
Byдобно электрокардиограмме, ЗВП объективно отражают работу
neurons of the visual cortex.
Treatment is especially effective at the age of 7 years, while the eye is still
is formed. Byсле 7 лет глаз, как правило, уже сформирован и
the effect of the treatment will already be insignificant, and the prognosis of treatment
will deteriorate more and more every year and afterwards
may result in irreversible vision loss.
Diagnosis and correction of amblyopia is carried out by an ophthalmologist.
- determination of visual acuity on the tables,
- color perception study
- eye biomicroscopy,
- intraocular pressure measurement
- tonometry and definition of dark adaptation.
In transitory light, the eyes are examined to determine the extent
transparency of the lens and cornea. If they are detected
непрозрачность, потребуется выполнение УЗИ eyes.
With подозрении на косоглазие выполняют определение угла
strabismus according to Girshberg or with the help of a synaptophor.
Treatment is impossible without an ophthalmologist, and untimely
терапия амблиопии приводит к стойкой потере зрительных
functions. Standard methods are to combat all
possible diseases that could lead to the formation of
Restoration of visual acuity and improvement of visual functions
depends on the following factors:
- strict implementation of all recommendations by the patient;
- type of amblyopia;
- correct fixation of the eye;
- age of manifestation of amblyopia;
- initial visual acuity;
- the age of the patient at which treatment was initiated;
- treatment methods.
Если у больного диагностирована refractional либо
anisometropic amblyopia, then therapy mainly includes
non-surgical methods. Visual acuity is necessarily corrected.
with the help of contact lenses, glasses, special night lenses.
Treatment of pediatric amblyopia is directly related to elimination
reasons for its development. With obscuration is
surgical treatment: cataract removal, elimination of ptosis and
In children with a therapeutic purpose, contact or nighttime is often used.
lenses. Laser correction may be performed.
A child with amblyopia should receive 3-4 courses of pleoptic
treatments per year. If the treatment is out of time or the child
does not wear glasses, and conducts occlusion inconstantly, then achieved
visual acuity may be significantly reduced.
The treatment is carried out to achieve approximately the same severity.
view of both eyes. When hysterical amblyopia are assigned
sedatives, psychotherapy is conducted. Choosing the best
method of therapy should be entrusted to a qualified ophthalmologist.
Only a specialist will be able to choose the optimal scheme, conduct
dynamic observation and adjust as necessary
Operation на глазных мышцах для лечения косоглазия возможна, она
can straighten uneven eyes. The operation itself is usually not
helps for complete cure for amblyopia. Surgery to
make eyes straight can only help make eyes work
together as a team. Children with amblyopia strabismus, need
тщательный мониторинг и treatment.
Forecast зависит от причин и времени выявления заболевания. Than
The earlier the amblyopia correction is started, the more successful the result will be.
The greatest effect is achieved during treatment to achieve
a child of 7 years, until the formation of the eye.
As with the prevention of any other disease is important
rational mode of the day, proper rest, healthy food,
vitamin supplements, fresh air, normal conditions
for employment and work, as well as strict time control,
held at the TV or computer.
- Do not forget to visit an ophthalmologist for preventive examinations
up to two times a year.
- There is a need for constant follow-up examination of children in
age from 1 month. If pathology is detected, treatment should be
carry out immediately
- If a child under 5 years old has even a small squint
need to be monitored regularly by an ophthalmologist.