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

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 patternAmount of occlusionReview time Alternating squint or Holding fixation} No occlusion indicatedReview 6 – 12 weeks Taking up fixation quicklyObserveReview 6-12 weeks Taking up fixation slowlyConsider 2 hours occlusion dailyReview 4-6 weeks Not taking up fixationConsider inverse occlusion See separate guidelines (section 10.3) Age group: 2 ½ years to 5 ½ years of age: VAAmount of occlusionReview time VA better than 0.6 LogMAR2-4 hoursReview 6-8 weeks VA less than 0.6 LogMAR4-6 hoursReview 4-6 weeks Age group: 5 ½ years of age and upwards: VAAmount of occlusionReview time VA better than 0.6 LogMAR2-4 hoursReview 6 weeks VA less than 0.6 LogMARConsider 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 2 weeks

Amblyopia Treatment Atropine

Amblyopia Treatment VisitDateVA Test Used Prescribed Daily Occlusion from Last Visit Average Actual Daily Occlusion Total Actual Hours of Occlusion Since Last Visit Prescribed Daily Occlusion Reason Occlusion Stopped Orthoptist RL

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