Indian Journal of Ophthalmology

ORIGINAL ARTICLE
Year
: 1985  |  Volume : 33  |  Issue : 1  |  Page : 45--46

Treatment for amblyopia


KK Khanna, Rajiv Mirchia 
 1, Circular Road, Amritsar, India

Correspondence Address:
K K Khanna
1, Circular Road, Amritsar
India




How to cite this article:
Khanna K K, Mirchia R. Treatment for amblyopia.Indian J Ophthalmol 1985;33:45-46


How to cite this URL:
Khanna K K, Mirchia R. Treatment for amblyopia. Indian J Ophthalmol [serial online] 1985 [cited 2020 Oct 20 ];33:45-46
Available from: https://www.ijo.in/text.asp?1985/33/1/45/27331


Full Text

Amblyopia exanopsia (loss of visual acuity due to non use of eye) is not an un-common eye condition. It is due to uncorrected ametropia or anisometropia. The traditio­nal treatment of this type of amblyopia is total occlusion of the sound or master eye for a long time alongwith corrective glasses to the amblyopic eye. This method, although effective has the major disadvantage of poor patient compliance in majority of cases. Moreover it can hamper with the develop­ment of binocular vision when patching is done for a long time in very young patient. This leads to find alternative methods for treating amblyopia like.

(i) Penalization technique[1],[2].

(ii) Minimal occlusion technique[3].

(iii) Minimal occlusion for 7 minutes and stimulation of amblyopic eye by CAM-Stimulator[4],[5]

(iv) Minimal occlusion and intensive visual stimulation of amblyopic eye[6].

This study presents our experience about minimal occlusion of the sound eye and stimulation of amblyopic eye by rapid flashing stimulation synoptophore.

 MATERIAL AND METHODS



Ten patients (Table 1) of amblyopia having less than 6/18 visual acuity due to ametropia or anisometropia with or without squint were taken up for this study. Cases with eccentric fixation were not included. Each case was refracted under cyclomid and maximal correction accepted was pres­cribed and worn constantly for a week before, during and after the treatment which consisted of minimal occlusion of sound eye and stimulation of amblyopic eye by rapid flashing with auto flashing device on synopto­phore for 15 minutes daily. During the treatment the sound eye w as patched and equivalent lens from trial case was placed in the lens holder in front of the amblyopic eye. To make the process interesting to the child different slides were inserted on the flashing side at each sitting. in all cases the treatment was given for 21 days. No occlu­sion was done beyond the period of stimula­tion of weak eye. Visual acuity for distance was tested before and after completion of the treatment with standard Snellen charts.

 OBSERVATIONS AND DISCUSSION



Conventional treatment of amblyopic eye by patching of sound eye invariably fails due to poor patient co-operation on account of social as well as educational reasons. Alternative technique of minimal occlusion with stimulation of amblyopic eye has been advocated by a group of ophthalmologists in Cambridge. It has been hypothesized[4] that as visual cortex is highly receptive to grating of a certain size and spatial orientation, CAM-stimulator improves visual acuity of amblyopic eye on physiologically based method of activating amblyope's visual neurons. However a few controlled studies[6],[7] proved that improvements obtained by CAM stimulator are due to non specific effects and stimulation of amblyopic eye with simple devices like rotating black and white pictures give comparable results. Taking a clue from this we stimulated the amblyopic eye with minimal occlusion of sound eye by rapid flashing with the help of synoptophore. The results are highly encouraging. Although the present series is too small for statistical analysis or comparison, it can be concluded that this simple method for treatment of amblyopia is quite promising.

References

1Jeanrot, N., Jeanrot, F. and Delfour, G., 1981, Orthoptics, Research and Practice. pp 86-88, Kimpton, London, 1981.
2Goel, B.S.. Maheswari, R., and Saiduzzafar, H, 1982, Ind. J. Ophthalmol, 31 : 307.
3Waston, P.G., Banka, R., Campbell, F.W. and Hess, R.F., 1978, Strabismus, Grune & Stratton, New York.
4Campbell, F.W.. Cleland, B., Cooper, G.F. and Enroth, C.C., 1968, J, physiol. 198: 237.
5Banks, R. and Barnett, F., 1981, Orthoptics, Research and practice. pp 46-49, Kimpton, London, 1981.
6Mehdron, E., Mialtheus, S., Schuppe, A., Klein, U and Kommerell, G., 1981, Treatment of amblyopia with rotating gratings, a controlled study, International Ophthalmology.
7Willshaw, H.E., Malmheden. A.. Clarke, J., Williams, A. and Dean, J., 1981, Brit. J. Ophthal­mol 64: 339.