Amblyopia Treatment Past Present and Future Anne Southgate

Amblyopia Treatment Past, Present and Future Anne Southgate Sylvie Cringle Orthoptic Department, HEFT

Amblyopia – what is it? • Definition: – Defective visual acuity which persists after correction of any refractive error and removal of any pathological obstacle to vision. Also termed ‘lazy eye’ • Types

Amblyopia Treatment • Removal of obstacle to vision • Glasses • Occlusion (patching) – Conventional – Inverse • Stimulation • Atropine penalisation • Optical penalisation

Early Amblyopia Treatment • Total to form and light • Total to form • Partial to form • Atropine • Timing • Last resort

Amblyopia Treatment

Amblyopia Treatment • Then

Amblyopia Treatment • Now

Amblyopia Treatment • Then

Amblyopia Treatment • Now

Amblyopia Treatment • Then and now

Amblyopia Treatment Age group: Up to 2 ½ years of age (and/or when vision test cannot be relied on): Fixation pattern Alternating squint or Holding fixation} Amount of occlusion No occlusion indicated Review time Review 6 – 12 weeks Taking up fixation quickly Taking up fixation slowly Not taking up fixation Observe Consider 2 hours occlusion daily Consider inverse occlusion Review 6 -12 weeks Review 4 -6 weeks See separate guidelines (section 10. 3) Age group: 2 ½ years to 5 ½ years of age: VA VA better than 0. 6 Log. MAR VA less than 0. 6 Log. MAR Amount of occlusion 2 -4 hours 4 -6 hours Review time Review 6 -8 weeks Review 4 -6 weeks Age group: 5 ½ years of age and upwards: VA VA better than 0. 6 Log. MAR VA less than 0. 6 Log. MAR Amount of occlusion 2 -4 hours Consider up to 6 hours occlusion per day dependant on other clinical considerations i. e. density of suppression, area of fixation, behaviour of child, parental views etc Review time Review 6 weeks Review 2 weeks

Amblyopia Treatment • Atropine

Amblyopia Treatment Visit Date VA R 1 2 3 4 5 6 7 8 Test Used L Prescribed Daily Occlusion from Last Visit Average Actual Daily Occlusion Total Actual Hours of Occlusion Since Last Visit Prescribed Reason Orthoptist Daily Occlusion Stopped

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