1. AMBLYOPIA Binocular Vision Anomalies Ralph P. Garzia

2. Amblyopia definition traditional –best corrected ≤20/40 or –2 line difference in VA modern –<20/20 + –behavioral or performance deficits

3. The father of amblyopia treatment George Louis Leclerc, Conte De Buffon (1707-1788) In 1742 suggested that the good eye be occluded to force use of the amblyopic eye.

4. Amblyopia - mechanisms neurocompetition form deprivation

5. Epidemiology - prevalence depends Flom & Neumaier ≤20/401% others0.2-4.7% acceptable level 2.0%

6. Amblyopia of extinction Amblyopia of arrest Chavesse’s visual acuity levels, 1939 it’s right & wrong arrested development of visual acuity- irreversible extinguished visual acuity development- reversible

7. Classification based on etiology Strabismic amblyopia –esotropia –hypertropia, hypotropia –exotropia Anisometropic amblyopia –hyperopic –astigmatic –myopic

8. Anisometropia & amblyopia

9. Classification based on etiology Refractive amblyopia –hyperopic –astigmatic –myopic

10. Classification based on etiology Deprivation amblyopia –congenital cataract –congenital nystagmus –congenital ptosis –occlusion Hysterical amblyopia –juvenile onset –non-malingering syndrome of Streff, John

11. Amblyopia - distribution 1/3 strabismic amblyopia 1/3 anisometropic amblyopia 1/3 remainder most of these are combined strabismic and anisometropic

12. Amblyogenic conditions constant, unilateral strabismus significant anisometropia bilateral isometropia form deprivation

13. Components of visual acuity loss sensory loss eccentric fixation oculomotor dysfunctions perceptual disturbances

14. Amblyopia as a syndrome reduced visual acuity reduced contrast sensitivity reduced oculomotor function reduced accommodative function increased crowding effects decreased fixation stability eccentric fixation spatial distortion