The causes of amblyopia can be divided into the following aspects:
1. Strabismus amblyopia: when one eye is strabismic, the macular function of the strabismic eye is inhibited for a long time, and amblyopia is formed.
2. Refractive Parallax Amblyopia: Due to the large refractive error between the two eyes, amblyopia occurs gradually over time in the eyes with more severe refractive errors.
3. Visual deprivation amblyopia: in infancy, due to congenital cataract, or ptosis and blocking the pupil, resulting in poor visual development and causing amblyopia.
4. Congenital amblyopia: the pathogenesis is still not very clear. It may be due to small hemorrhagic foci in the retina at birth, which affects the normal development of visual function.
5. Refractive error amblyopia: mostly bilateral, occurring in the high refractive error without wearing corrective glasses. And most of the refractive error in hyperopia. There is no need for special treatment, wear appropriate glasses, vision can gradually improve.
Amblyopia is diagnosed by visual acuity examination and funduscopic examination. The most accurate and reliable test is the visual evoked potential or evoked response test.
The difference between amblyopia and myopia is that myopia is myopia if the visual acuity can be corrected to 1.0 by precise optometry, and amblyopia is amblyopia if it cannot be corrected.
Amblyopia is characterized by two types of amblyopia: central gaze and paracentral gaze, and different treatments for different types of amblyopia. Center gaze amblyopia, currently advocate covering the healthy eye, training the amblyopic eye. The patient can use the amblyopic eye to do some work with fine eyesight, such as tracing, threading a needle, etc. However, it is important to pay attention to the time of masking the healthy eye. However, it should be noted that the time of covering the healthy eye should not be too long, because the healthy eye will also produce amblyopia after covering it for too long. Alternate masking method can also be used, i.e. the amblyopic eye and the healthy eye are covered alternately to train the function of the amblyopic eye. Treatment for paracentric amblyopia includes postimaging, red filter film, suppression, and visual stimulators. These must be treated under the supervision of a physician. It is important to emphasize starting treatment at an early age, as macular function can still be restored with proper treatment in the early years. Beyond the age of 12, it is difficult to return to normal. In addition, the consequences of amblyopia caused by different etiologies are different. Strabismus, refractive error and refractive error amblyopia are better after timely treatment or corrective vision correction. The consequences of visual deprivation and congenital amblyopia are poorer.
(Prof. Jiazhen Liu, Shanghai Medical University)
What is amblyopia?
Amblyopia is a condition in which there is no organic lesion in the eye, but functional factors are predominantly responsible for distance visual acuity less than 0.9, and the corrected visual acuity is not normal; or there are organic changes and refractive anomalies, but the visual acuity is low and uncorrectable, which is not compatible with the lesion, is called amblyopia. Amblyopia is categorized into mild amblyopia (visual acuity of 0.8-0.6), moderate amblyopia (visual acuity of 0.5-0.2), and severe amblyopia (visual acuity less than or equal to 0.1). Amblyopia can occur throughout visual development, most often starting at age 1 to 2 years. The earlier the onset of amblyopia, the more severe it is.
How is amblyopia different from myopia?
Amblyopia and myopia are not the same thing. Myopia is due to eye regulation muscle ciliary muscle overstrain or genetic reasons such as eye axis lengthening caused by see far not clear, see near clear eye disease, wear a lens to correct the visual acuity can be returned to normal, and amblyopia is a kind of delayed development of visual function, disorders, often accompanied by strabismus, a high degree of refractive error, wear a lens visual acuity can not be corrected to the normal eye disease, the two diseases are fundamentally different.
Amblyopia is much more harmful to children's visual function than myopia. Because myopia is only vision loss at a distance, not accompanied by other visual function damage, vision correction is not limited by age; and amblyopia children not only have low vision, can not be corrected, may not have binocular monovision, no stereoscopic vision, the future can not be able to handle the driving, surveying and mapping, and fine work, not only affecting the work future, but also directly affects the quality of our population.
What are the causes of amblyopia, how many types of amblyopia are there, and how effective is the treatment?
The causes of amblyopia are relatively numerous and are summarized as follows: pediatric strabismus, higher hyperopia, myopia and astigmatism, congenital cataracts, severe eyelid ptosis, as well as congenital hypoplasia of the optic center and optic nerve.
There are also many ways to categorize amblyopia, which can be classified according to the etiology:
Strabismic amblyopia: the patient has or has had strabismus with amblyopia, but without fundus abnormalities. It is currently believed that this is because strabismus causes diplopia and visual disturbances that make the patient feel extremely uncomfortable, and the visual cortex of the brain actively inhibits the visual impulses transmitted from the macula of the strabismus, and the function of the macula of the eye is inhibited for a long time, forming amblyopia. This kind of amblyopia is a consequence of strabismus, which is secondary and functional, and therefore reversible, with a good prognosis. However, occasionally a few primary individuals do not show significant improvement in visual function even with aggressive treatment.
Refractive error amblyopia: Because of the unequal clarity of the objects formed in the macula of the two eyes, even if the refractive error is corrected, the size of the objects caused by refractive error is still unequal, resulting in the objects of the two eyes are not easy or can not be fused together as one, and the center of the optic cortex can only inhibit the refractive error of the larger eye's objects, and amblyopia occurs in the long run, and this type of amblyopia is functional, and is therefore reversible.
Visual deprivation amblyopia: in infancy and childhood, due to corneal clouding, congenital cataract, or ptosis blocking the pupil, resulting in light stimuli can not fully enter the eye, depriving the macula of the opportunity to receive normal light stimulation, resulting in a functional disorder and the occurrence of amblyopia.
Congenital amblyopia: the pathogenesis is still not very clear, Von Noorden speculated that newborns often have retinal or visual pathway hemorrhage, which may affect the normal development of visual function. Some congenital amblyopia is secondary to nystagmus.
Refractive error amblyopia: Mostly bilateral, occurring in patients with high refractive error without corrective lenses and equal or similar visual acuity in both eyes, refractive error amblyopia is most often seen in people with hyperopic refractive error. This kind of amblyopia has similar visual acuity in both eyes, and there is no binocular fusion obstacle, so it does not cause macular function inhibition, so after wearing appropriate corrective glasses, the visual acuity can be gradually improved without special treatment, but for a long time.
On the surface, the above five are amblyopia, but there is a fundamental difference in the pathogenesis. Strabismus and refractive amblyopia into both eyes of the light stimulus is equal, both macula involved in the occurrence of visual function, development process, so the prognosis is better. However, visual deprivation amblyopia occurs in infancy when the visual function has not yet developed to a perfect or mature stage, and the retina fails to get enough light stimulation and is not able to participate in the process of visual function development, resulting in amblyopia, which not only has low visual acuity, but also has a poor prognosis. The consequences of monocular disorders are more serious than those of binocular disorders. Therefore, when covering the eyes of infants and young children due to eye disease, special care should be taken to avoid the formation of deprivation amblyopia (especially for children under 6 months).
In summary, the prognosis for congenital and visual deprivation amblyopia is poor. Refractive error, strabismus, and refractive error amblyopia have a better prognosis, and the key lies in early detection, timely and correct treatment, most of the visual acuity can be improved, and the possibility of obtaining normal vision is quite large.
How can amblyopia be detected early?
Preschool checkups: Most children, especially those who grow up in kindergarten, can recognize a vision chart at age 3 after a simple vision education. Conditional kindergarten to the children's eyesight annual census screening, parents can also purchase a standard eyesight table, hanging on the wall in the light, in the 5m distance for children to identify. When checking, the eyes must be covered separately, not both eyes at the same time, to prevent monocular amblyopia from being missed, repeated and carefully checked several times, if one eye's visual acuity is lower than 0.8 for many times, then the child needs to be taken to the hospital for further examination. It is generally believed that the best check is no later than 4 years old.
Early detection of anomalies. Amblyopic children often have other manifestations besides low vision, such as strabismus, tilting the head, squinting, or sticking very close to the eye, etc. Once you find out that your child has strabismus, you will need to take your child to the hospital for further examination. Once you find that your child has strabismus, you should go to the ophthalmology department of the hospital as soon as possible for examination and diagnosis, because about 1/2 of strabismus is combined with amblyopia. The other anomalies mentioned above should also be taken seriously, and should be examined by the ophthalmologist at the hospital to see if they are caused by eye diseases.
In addition, for infants and young children who can not cooperate with the examination of vision, can be made to cover the test, roughly understand the situation of binocular vision: intentionally cover one eye, so that the child can see with one eye, if very quiet and cover the other eye when the child is crying or tearing and grasping the cover, then suggests that the uncovered eye is very poor vision, and should be sent to the hospital as soon as possible for examination.
In short, the early detection of amblyopia depends on the close cooperation of parents, kindergartens, schools, hospitals, and most of all, the parents themselves, who spend a lot of time with their children.
Can amblyopia be cured, and at what age is it best treated?
It is well documented that factors that may affect the prognosis are: family history (amblyopia or/and strabismus), disease in infancy, type of amblyopia, original visual acuity, refractive error, type and degree of strabismus, age at first diagnosis, and the nature of the gaze. It has been clinically verified that the original visual acuity of the amblyopic eye (the lighter the amblyopia, the higher the efficacy), the nature of the gaze, so whether or not the amblyopia can be cured is related to many of the factors mentioned above, in which the efficacy of amblyopia treatment is closely related to age, the younger the age, the better the treatment effect, and the treatment of the adult is hopeless. This is because children's visual function is not stable during the visual development period, and both amblyopia and normalization are easy to occur. After 13 years of age, children's visual function has been well developed, this age and then treatment, visual acuity is not easy to improve, fine stereo vision can not be established.
Therefore, the best time to treat amblyopia is between the ages of 1 and 5 during visual development.
The best time to treat amblyopia is between the ages of 1 and 5 during the visual development period. Moreover, amblyopia treatment is not an overnight task, but a long-lasting battle, and preschoolers have more time to cooperate with the treatment, while some treatments will be affected by the learning process, which will make the treatment difficult and affect the efficacy of the treatment.
Why is it necessary to dilate the pupils to check for amblyopia?
As with strabismus, the pupil dilation is the basic test for amblyopia. The reasoning is the same as that of children with strabismus, the purpose is to accurately test the actual refractive error, only in this way can we determine whether there is amblyopia, and can be equipped with the right glasses, and wearing the right glasses is also an important condition related to the effect of amblyopia treatment.
It has already been mentioned that for children under 13 years of age who have strong regulation, atropine ophthalmic ointment (water) should be applied, and other pupil-dilating drugs are not suitable for amblyopic children. Atropine pupil dilation, individual children may have facial redness, and even low fever phenomenon, which is a normal reaction, do not have to stop halfway, dilated pupil optometry can be discontinued, such as the reaction is too strong for atropine poisoning, need to go to the hospital to deal with. After dilating the pupil, the amount of light in the eye increases, fear of light, regulation of paralysis will cause visual near objects, these symptoms are temporary, usually 15-20 days after stopping the drug, the pupil can be restored. Therefore, for school-age children, it is best to arrange for pupil dilation during the winter and summer vacation, so as not to affect the study.
What are the treatments for amblyopia?
There are many treatments for amblyopia, including masking, suppression therapy, grating therapy, retroillumination and red filtering therapy, fine work training and synoptic machine training, etc. Depending on the type of amblyopia, you may need to choose one or more of these treatments.
The most important method of monocular amblyopia treatment is the traditional masking method, i.e., masking the child's focusing eye, which is divided into full masking and transient masking. Refractive amblyopia should first be fully corrected for refractive error, and then the smaller refractive eye should be covered, regardless of whether it is hyperopic or myopic. Formal deprivation amblyopia, such as unilateral cataracts, should first be treated with cataract extraction surgery. Optical and medication suppression therapy is based on the principle of using optics and medication to weaken the visual acuity of the focusing eye while promoting the visual function of the non-focusing eye, and it is more suitable for older school-age children who cannot be treated with the masking method. CAM therapy is also known as the physiological basis of vision therapy. The visual cells of the human cerebral cortex respond to stimuli with strong contrast and high spatial frequency. People design a black and white grating disc with strong contrast and rotate it in all directions to stimulate the amblyopic eye to improve visual acuity, and this method is effective for central gaze. When the treatment of amblyopic children with paracentric gaze is ineffective using the masking method, posterior image therapy can be used. The posterior image method of treating amblyopia requires a longer period of time and special equipment, which is not easy for young children to cooperate. The treatment of paracentric amblyopia can also use the red filter film method, the principle is to use the macular center cone cells sensitive to red filter film. The principle is to use the macular center cone cells are sensitive to the red filter film. When used to cover the gaze eye, the non-gaze eye corrective lens before adding a piece of red filter film with certain specifications (wavelength of 600 ~ 640mm), prompting the macular center gaze, in order to improve visual acuity. Treatment of paracentral gaze with masking is still controversial, but masking the gaze eye to promote visual acuity in the amblyopic eye is still a commonly used method after the failure of other methods.
In addition, fine work training, fixation training, vision enhancement therapy, binocular visual function training, and synoptic machine training (including simultaneous vision training and elimination of inhibition training, fusion enhancement training, stereoscopic enhancement training, and treatment of abnormal retinal correspondences) also play an important role in amblyopia treatment.
Pharmacological treatment of amblyopia is commonly used clinically, vitamin B1, vasodilators, nitrostenol, oxygen therapy, anabolic hormone, etc. It is also hypothesized that inhibitory amblyopia is related to mood swings, and it is recommended to try hypnotherapy.
To date, in addition to the above traditional methods of treatment of amblyopia, there is also a new generation of helium-neon laser, CAM (high-frequency contrast stimulation) and other optical and electrical therapy. In terms of medication, since the 1990s, when it was first reported that levodopa could improve amblyopia, people are now actively conducting systematic basic and clinical studies on the pharmacokinetics, safety, and tolerability of levodopa in the treatment of amblyopia. The role of traditional Chinese medicine and acupuncture, ear pressure and other therapies in the treatment of amblyopia has also attracted more and more attention from the medical profession.
Why do I need lenses for amblyopia?
As mentioned earlier, amblyopia is often associated with refractive error, and the examination of amblyopia must be dilated optometry, the purpose is to accurately test the actual refractive error, in order to match the appropriate glasses. The only way to improve visual acuity is to wear glasses to correct the refractive error on the basis of amblyopia training at the same time, so that the clear image of the object to repeatedly stimulate the retinal attention center to improve visual sensitivity, so the treatment of amblyopia must wear glasses.
What is meant by masking therapy?
Covering therapy is a simple and easy basic method of treating amblyopia, and is also recognized by experts at home and abroad as the most effective method of treating amblyopia, which can be applied alone or in conjunction with other training. The specific method is to use black cloth to make a rectangular or oval eye mask. The eye mask is put on the eye to be covered, and then glasses are put on. The purposes of masking therapy include: masking the dominant eye, forcing the use of the amblyopic eye, giving the amblyopic eye to fixate alone; eliminating the inhibition of the amblyopic eye from the dominant eye; blocking the abnormal correlation between the retinas of the two eyes, re-adjusting and re-establishing the normal correlation between the retinas of the two eyes and the relationship of the two eyes with each other, and striving to restore the visual function of the two eyes; adjusting the degree of visual acuity of the two eyes to make the visual acuity of the two eyes close to equilibrium; inhibiting the strabismic alternation and training monovision to fixate. The phenomenon of fixation is suppressed, and the monocular fixation movement is trained.
What is posterior image therapy?
Posterior image therapy is a common treatment for amblyopia. It is designed according to the principle that a posterior image can be formed when the human retina is irradiated by bright light, and the process of producing the posterior image can make the inhibition of the macular region of the fundus of the eye to be eliminated to varying degrees, which will improve the visual acuity. The effect is twofold: correcting eccentric fixation and improving visual acuity.
The specific method is to first dilate the pupil of the amblyopic eye, and make the fixation eye look at a target in the distance, to ensure that the fixation eye in the treatment of fixation does not move. If the eccentric fixation is obvious in the center of the concave irradiation can be set in front of the fixation eye fixation target, try to keep the fixation eye does not move. The examiner illuminates the fundus of the amblyopic eye in a dark (semi-dark) room with a retro-illumination mirror, so that the black dot shadow falls in the center of the central concavity to protect the central concavity, and then irradiates it with a strong light (6V,15W) for 20-30 seconds. If fixation is poor or nystagmus is present, irradiation can be performed with the posterior image mirror following the central concavity. After irradiation, cover the healthy eye, make the child look at the cross vision mark drawn in the center of the white screen, and ask the patient whether the posterior image appears? What is the duration of the posterior image? The relationship between the posterior image and the crosshair, etc.?
The duration of the afterimage can indicate the degree of amblyopia. It is very difficult to produce an afterimage in high amblyopia, and even if it occurs, it disappears quickly.
What is meant by suppression therapy?
The principle of suppression therapy is to inhibit the vision of the good eye by changing the lens prescription and medically dilating the pupil, forcing the use of the amblyopic eye in order to promote the recovery of visual function. The theoretical basis for this is that when one eye is used to see near and the other to see far, there is no need to produce compensatory changes in the visual function of the two eyes because they are both used monocularly. If refractive error is artificially created in both eyes, it is possible to prevent the formation of amblyopia and abnormal retinal correspondence.
Can a child with amblyopia wear glasses and still take them off?
This question is also a common concern for parents of children with amblyopia. In fact, most children with amblyopia can remove their glasses when they grow up. This is because amblyopia children later combined with hyperopia is common, and with the growth of amblyopia children's age, the development of the eyeball, the degree of hyperopia will gradually reduce the degree of spectacle lenses will also be reduced, the vision gradually return to normal, the glasses will be taken off. Of course, the cure of amblyopia children in the development of eye hygiene, and caused by myopia, and then need to wear myopic glasses.
There are also children with amblyopia who need to wear glasses for the rest of their lives. This type of amblyopia is often combined with high hyperopia of more than +6.00D and astigmatism of more than ±2.00D. Even with age, the eye development can not compensate for the serious refractive errors, so adults still need to wear lenses to correct their vision.
In childhood, amblyopia is treated in a timely manner, vision can be corrected in this type of eyes, although adults still need to wear lenses, but it is much better than when young and untreated, and want to wear glasses in adulthood, but can not match.
What do children with amblyopia need to be aware of when wearing lenses?
The lenses must be dilated and the optometrist must choose the right frame according to the different pupil distances. It is best to go to the hospital with the instrument to check whether the glasses degree is consistent with the prescription.
The glasses must be worn consistently and without interruption. The first time to wear the treatment of amblyopia glasses visual acuity does not improve much, and even some wear glasses after the visual acuity instead of decline, especially in the high degree of hyperopia glasses, these are normal situations. Wearing glasses requires a period of adaptation process, as long as you insist on wearing glasses, vision will gradually improve.
Regular re-pupilization and adjustment. The children with amblyopia are in the developmental stage, and the refractive error of both eyes changes with age, so you can't wear a pair of glasses all the time and not change them. In general, children under 3 years of age should have their pupils dilated once every six months, and children over 4 years of age should have their pupils dilated once every year, and each time, according to the change of refraction and the correction of amblyopia and strabismus, it will be decided whether to change the lenses again or not.
What are the steps involved in treating amblyopia in children?
The principle of amblyopia treatment is to treat amblyopia first, then strabismus. For congenital strabismus, it is the first surgical correction of strabismus, then amblyopia training. For the combination of high number of strabismus amblyopia, the first treatment of amblyopia for a period of time, to be partially improved visual acuity, surgical correction of strabismus, eye position correction and then continue to treat amblyopia.
How can parents cooperate in amblyopia treatment?
The treatment of amblyopia is not overnight, in addition to the doctor's examination, guidance, but also need to actively cooperate with the child and parents, otherwise not only double the effort, but also may be halfway.
The treatment of amblyopia can not be separated from the cooperation of parents, in the treatment, parents should do the following:
(1) After the glasses are ready, we must supervise the child to insist on wearing, and according to the doctor's orders to regularly re-dilated pupil check.
(2) Some children because of the masking treatment caused by the surrounding children's teasing, nicknames, and thus do not want to adhere to the treatment or in front of the parents to put on the eye mask, and behind the back and removed, so that the parents do not know. This is often the reason why the treatment effect is not obvious. In such cases, it is necessary to patiently educate the child and convince him or her to consciously adhere to the treatment. In addition, it is also necessary to contact the teacher, please ask them to do a good job of children's work, urge the child to adhere to the treatment.
(3) wear glasses, cover the treatment at the same time, must strengthen the fine work training. Correct the wrong view that too much eye use makes eyesight decline. In fact, the more the amblyopic eye is used, the faster the visual acuity improves. Parents in addition to supervise the child to complete the training on time, but also can often change the new form, homemade or purchase some auxiliary therapeutic appliances to improve the interest of the child training.
(4) If the use of optical drug suppression therapy, in addition to insisting on wearing glasses, according to the doctor's orders punctually with a prescribed concentration of atropine eye dilated pupils.
(5) Parents should bring their children to the hospital regularly for follow-ups as prescribed by the doctor, and bring along the records of relevant examinations and treatments for the doctor to determine the efficacy of the treatment and adjust the treatment program at any time. Generally, the follow-up examination should be held once a month. After the visual acuity returns to normal, half a year still requires a monthly review to prevent the recurrence of amblyopia, and then gradually changed to 3 months, half a year review once, until the visual acuity remains normal for 3 years, amblyopia is considered completely cured.
What are the criteria for amblyopia cure and how long does it take for the treatment to be effective?
According to the evaluation standard of amblyopia treatment efficacy formulated by the Chinese Medical Association, Chinese Ophthalmology Association, and National Childhood Amblyopia and Strabismus Prevention and Control Group in September 1987, the treatment efficacy of amblyopia treatment is as follows:
(1) Ineffective: the visual acuity regresses, remains unchanged, or improves by only one line;
(2) Progress: the visual acuity improves by two lines or more;
(3) Basically cured: visual acuity returns to ≥0.9; and
(3) Basic recovery: the visual acuity is restored to ≥0.9;
(4) Cured: the visual acuity remains normal after 3 years of follow-up.
Note: If possible, other visual function training can be received at the same time, in order to fully restore the function of binocular monovision.
At present, the total cure rate of amblyopia treated by comprehensive therapy in China is about 80%, and the number of those who have established stereopsis reaches 81.07%.
The duration of amblyopia treatment is closely related to the type of amblyopia, age, degree, treatment method and the degree of cooperation with the treatment. In general, if the treatment is ineffective for 6 months, it can be regarded as ineffective.
According to the observation of Professor Meng Xiangcheng of Harbin Medical University, the treatment time is estimated as follows: those with central fixation generally see the effect within 1 month of the start of treatment; those with non-central fixation see the effect in about 2 months; in general, the shortest 1 month, the longest is 1 year. The average is about 5 months. Monocular farsighted amblyopia, strabismus amblyopia, generally within 3 months, to achieve optimal vision up to 50%.
Generally in the 13 ~ 15 years of age are obtained good results, amblyopia treatment, although the age of small, good treatment results, but for those who are late to the diagnosis of amblyopia children and adolescents under 15 years of age, do not easily give up the treatment, active treatment will also be received a certain effect.
How to prevent recurrence after amblyopia is cured?
In order to prevent the recurrence of amblyopia, the following points should be noted:
(1) Covering therapy should wait for the vision to return to normal and then gradually remove. First, open 2 hours a day, 1 month after the consolidation of the effect of the extension of the open time to 4 hours a day, and later to 6 hours, 8 hours, until the whole day to open or from full cover to half cover to consolidate the effect of the treatment. During the consolidation period, the fine work is not relaxed.
(2) The first 6 months after normal vision need to be reviewed once a month, and then changed to 3 months, half a year, until the tracking review 3 years until a complete cure.
(3) If it is found that the vision of the amblyopic eye decreases, the healthy eye can be covered again and the amblyopic eye can still be improved to the original level.
(4) For strabismic amblyopia, in addition to vision enhancement therapy, efforts are made to train monovision function and fusion of both eyes. If you find that vision loss, then you should resume after-image therapy, after-image therapy should not be suddenly stopped, should gradually reduce the number of times and lengthen the interval, slowly stop, stop should often use the amblyopia eye to watch movies, television, write small words, do fine work, or painted black and white lines on the carousel to do painting games, through these simple and easy to use methods to stimulate the macular function, to prevent regression.
How to choose the treatment of amblyopia Health Times 2002-06-11 16:51:23
There are many ways to treat children's amblyopia, but whichever of them has indications and limitations, the appropriate method should be chosen according to the nature of the amblyopia. However, the treatment of amblyopia in children takes a long time and costs more, so it is most convenient and economical to prioritize home treatment, which can not only reduce the burden of parents, but also adhere to the treatment.
The following two traditional methods are commonly used:
(1) Covering therapy: Covering therapy is an old and effective method of amblyopia treatment, which is one of the simplest, most economical and most effective methods of treating amblyopia in children.
① Monocular strict masking method: applicable to refractive amblyopia and strabismus amblyopia children. These children often have good vision in one eye and poor vision in the other eye due to deeper suppression.
The method is: use the black cloth eye mask to cover the better eye, force the amblyopic eye to look at things, so that it is stimulated to exercise, and gradually eliminate the inhibition, so that the visual acuity is improved, for the amblyopic children under 3 years of age, can be covered for 3 days and then released for 1 day. 3 years of age and above can be covered for 3 days to 5 days and released for 1 day. In the course of treatment, should check the amblyopic eye vision changes, review every half month, at the same time to pay attention to the healthy eye vision, to prevent the occurrence of vision loss caused by the cover.
② Alternate masking method: for refractive error amblyopia and monocular strabismus amblyopia. If the amblyopia binocular vision is equal, you can use binocular equal amount of alternating cover, the left and right eyes were covered for 3 days; if the binocular vision is different, according to the specific circumstances of the use of 4:l method, that is, cover the eyes of the better eyes for 4 days, and then change to cover the eyes of the poorer eyes for 1 day, so that the poorer eyes to see more to be able to exercise, and prompted to improve the visual acuity faster, in order to achieve the purpose of the balance of the binocular vision to improve.
③ Half-cover method: for children with amblyopia whose visual acuity rises to 0.7 or above. The use of semi-transparent plastic film to cover the healthy eye, artificially causing the healthy eye vision is lower than the amblyopic eye, so that the amblyopic eye has more opportunities to see things, is conducive to the establishment of binocular vision function and improve.
④Short cover method: for those whose vision in the amblyopic eye has returned to normal but is still lower than that in the healthy eye, in order to consolidate the effect of treatment, the healthy eye can be covered when doing homework or reading, and not covered in normal times.
(2) fine eye training: it is a kind of special application exercise for amblyopic eyes, which is good for visual development and improve visual acuity. There are many fine eye training methods, which should be chosen according to the age, intelligence and visual acuity of the amblyopic children. For example, using red silk thread to wear sewing needles, the size of sewing needles can be decided according to the visual acuity. Embroidery, tracing, painting and calligraphy can also be practiced. Fine eye training must be done with the amblyopic eye, once a day for 10-15 minutes. Fine eye training is an important part of the success of children's amblyopia treatment, parents should pay attention to this simple and easy to implement training, and always pay attention to unremitting.