Many eye doctors believed until recently that if a child's vision was impaired because of a "lazy eye," the condition could not be corrected past the age of six or seven years. However, a study funded by the National Eye Institute, part of the National Institutes of Health, has found that amblyopia or "lazy eye" treatment can be effective in children age seven through 17. In fact, many of the 517 children studied at 49 eye centers showed improvement in their vision.
"Age alone should not determine whether or not to treat," said Michael Repka, M.D., a pediatric ophthalmologist at the Johns Hopkins Children's Center and a co-author of the study. Even teenagers benefit from treatment, said Repka.
Amblyopia is a common cause of vision loss in as many as 3% of children in the US. During infancy or childhood, the vision loss occurs when the brain favors one eye over the other. The other healthy eye does not receive brain input, limiting visual development. The most common causes of 'lazy eye" are nearsightedness, farsightedness, or a crossed or wandering eye (strabismus).
The reason vision in the amblyopic eye improves is due to the brain's plasticity, says Susan Cotter, O.D., a pediatric optometrist at the Southern California College of Optometry and co-author of the treatment study. Neuroplasticity means the brain can change with learning. By forcing the unused eye to work, the brain will process the sensory information and adapt. As a result, vision improves.
Children in the study were divided into two groups, randomly selected. One group wore only prescription classes. The other group either wore glasses and an eye patch or glasses, an eye patch and eye drops. The latter group was also instructed to read, draw, or do other close-up activities as well since "near-vision activities are visually stimulating," says Cotter.
The patch, eye drops and close-up work forced the test subjects to use their amblyopic eyes. Children wore the patch for two to six hours per day. Children 12 years and less also used eye drops.
However, "eye drops blur the eye all day which is why the teenagers wore only patches, which could be removed while driving," says Cotter.
If children in the study could read two more lines on the eye chart with the amblyopic eye, the treatment was considered successful.
According to the National Eye Institute, 53% of children in the study ages 7 through 12 who wore glasses and a patch for 2-6 hours per day, and did near-vision activities could read two or more lines on the eye chart after 24 weeks. But only 25% in this age group could do the same. Twenty-five per cent of children ages 13 through 17 who wore eye glasses and a patch had improved vision whereas 23% who wore only glasses improved. Of those children in this age group who had been previously treated for amblyopia, 47% who wore glasses and a patch and did close-up work had improved vision. On the other hand, only 20 % improved who were treated with only glasses.
"This study shows how important it is to screen children of all ages for amblyopia," said study co-chairman Richard W. Hertle, M.D., Children's Hospital of Pittsburgh.
If children also have strabismus and will undergo surgery to correct the eye muscle imbalance, they should be treated first for amblyopia, says Cotter. "Surgery doesn't help amblyopia. If the child has surgery and amblyopia still exists, one eye with 20/100 vision, for instance, will be blurry; consequently it will be difficult or impossible for the brain to fuse the two images together into one," says Cotter.
Atropine eye drops may serve to improve compliance because the child doesn't require monitoring. Adhesive patches are also used to increase compliance in young children as it is difficult for them to peek. "Children can't be monitored all day," says Cotter.
Although the adhesive patch is hypoallergenic, some children with sensitive skin experience irritation when the patch is removed. So some doctors allow their patients to switch to cloth patches. Cloth patches with side shields still block vision in the affected eye.
The number of hours that the children wore their patch was through self report. "This is a real world, treatment effectiveness study," says Cotter. "I do the same clinically."
A new study is planned to learn about the effects of near-vision activities on amblyopia.
Sources:
Article reviewed by
Susan Cotter, O.D.
Pediatric Optometrist
Southern California College of Optometry
Diana Clarke is a teacher and health educator. Her articles have appeared in newspapers and magazines, such as the San Jose Mercury News and the World of English.
Irritable bowel syndrome is a debilitating and distressing condition, which... Read More
(NC)-In most cases insect bites are harmless and if left... Read More
There is the underlying assumption that modernity translates into better... Read More
Tea tree oil is the essential oil comes from the... Read More
NEW YORK, N.Y., February 18, 2004 ? On a visit... Read More
It was Saturday morning and while I was making breakfast,... Read More
Equine Cushings disease is caused by a tumor in the... Read More
How does a mind contemplate itself? That's a philosophical question... Read More
In 2003, there where more than 890 million doctor visits... Read More
Pain is the body's warning signal that something is wrong.... Read More
Pharmaceutical giant Bristol Myers Squibb has announced that they will... Read More
OxyContin is a narcotic drug, an opiate, that has been... Read More
How many of us have taken aspirin or a similar... Read More
We have all talked a lot about the problems in... Read More
Irritable bowel syndrome sufferers often find that they have to... Read More
Leading online pharmacy companies are providing consumer with a secure,... Read More
Addictions come in many forms. It's important to recognize the... Read More
Let's face it: purchasing prescription drugs in the U.S. can... Read More
In the next few years paramedics, first responders and military... Read More
This must be a mistake! How could his drug costs... Read More
Vioxx is a nonsteroidal anti-inflammagory drug (NSAID) that reduces inflammation,... Read More
When the legislation was passed for Bush's prescription drug benefit... Read More
If you joints are constantly killing you, here are three... Read More
There is a large amount of talk lately in regard... Read More
Before a child can be appropriately diagnosed with cerebral palsy,... Read More
Heat has long been used to provide temporary relief of... Read More
There's a whole group of drugs out there called benzodiazepines.They... Read More
Over the past few years, stem cells have been getting... Read More
This is a short overview of a questionnaire used for... Read More
Most people are well aware that an estimated 45 million... Read More
Hypnotherapy is one of the best known and most widely... Read More
When Aspirin Isn't EnoughIt's surprising how clearly we can recall... Read More
Notice friends getting contact lenses and pulling out eye glasses?"What... Read More
There are high arch feet and low arch feet and... Read More
It is very interesting this hypochondriac attitude which permeates our... Read More
Medical Care:Treatment options depend on the stage of ingrown toenails,... Read More
The news has been full of the recent FDA findings... Read More
Remember the last time you stubbed your toe? OUCH! It's... Read More
Are you spending a fortune on prescription arthritis medicines? Are... Read More
A time will come when our children's children will look... Read More
Since 1982 Accutane has been a reliable, if not controversial,... Read More
In September, 2004, pharmaceutical giant Merck voluntarily withdrew its painkilling... Read More
In patients with corneal thickness below a certain minimum, performing... Read More
Depression is a disorder marked by sadness, low energy, impaired... Read More
Many people today realize the importance of keeping their blood... Read More
Our modern preservatives and other pollutants like yellow dye no.... Read More
Infant acid reflux is quite common. People of all ages,... Read More
We all know that there's no such thing as cheap... Read More
I couldn't resist the title's corny riff on the name... Read More
Bextra, also known as valdecoxib, is a... Read More
Vioxx, Celebrex, and Bextra: An editorial regarding dangerous drugsGenerally my... Read More
NIH Official Altered Drug StudyDr. Edmund Tramont, director of the... Read More
When a health care professional uses lab coats it conveys... Read More
While the recent Lamisil commercial featuring Digger, a disgusting cartoon... Read More
Risperdal is an atypical anti-psychotic drug that balances the levels... Read More
Looking for the best doctor to suite your medical needs... Read More
A wee bit of fluoride makes teeth and dentists happy,... Read More
Doctors have been encouraged to prescribe the cholesterol-lowering drugs called... Read More
Naturopathic Medicine is an holistic approach that relies on natural... Read More
Acid reflux disease, also known as Gastroesophageal Reflux Disease or... Read More
Heat has long been used to provide temporary relief of... Read More
Results of a new study comparing the effectiveness of Pfizer... Read More
Last year I told an acquaintance that at the age... Read More
Warning: This article is for information only and can not... Read More
For many of us change is a difficult process. In... Read More
Technology. We live in a grand time of technological development.... Read More
Medicine |