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Indian Journal of Ophthalmology Jul 2023The optimal method of treatment for a child depends on the patient's age at the time of diagnosis, the onset and type of amblyopia, and the degree of compliance... (Review)
Review
The optimal method of treatment for a child depends on the patient's age at the time of diagnosis, the onset and type of amblyopia, and the degree of compliance attainable. In deprivation amblyopia, the cause of visual impairment (e.g., cataract, ptosis) needs to be treated first, and then the disorder can be treated such as other types of amblyopia. Anisometropic amblyopia needs glasses first. In strabismic amblyopia, conventionally amblyopia should be treated first, and then strabismus corrected. Correction of strabismus will have little if any effect on the amblyopia, although the timing of surgery is controversial. Best outcomes are achieved if amblyopia is treated before the age of 7 years. The earlier the treatment, the more efficacious it is. In selected cases of bilateral amblyopia, the more defective eye must be given a competitive advantage over the comparatively good eye. Glasses alone can work when a refractive component is present, but occlusion might make the glasses work faster. The gold standard therapy for amblyopia remains occlusion of the better eye although penalization is also evidenced to achieve equal results. Pharmacotherapy has been shown to achieve suboptimal outcomes. Newer monocular and binocular therapies based on neural tasks and games are adjuncts to patching and can also be used in adults.
Topics: Child; Adult; Humans; Amblyopia; Visual Acuity; Sensory Deprivation; Strabismus; Refraction, Ocular; Treatment Outcome
PubMed: 37417105
DOI: 10.4103/IJO.IJO_338_23 -
Vision Research Oct 2023This Special Issue describes the impact of visual impairment on visuomotor function. It includes contributions that examine gaze control in conditions associated with...
This Special Issue describes the impact of visual impairment on visuomotor function. It includes contributions that examine gaze control in conditions associated with abnormal visual development such as amblyopia, dyslexia and neurofibromatosis as well as disorders associated with field loss later in life, such as macular degeneration and stroke. Specifically, the papers address both gaze holding (fixation), and gaze-following behavior (single saccades, sequences of saccades and smooth-pursuit) that characterize active vision in daily life and evaluate the influence of both pathological and simulated field loss. Several papers address the challenges to reading and visual search; describing how the patterns of eye movements in these real-world tasks adapt to visual impairment and highlighting how they could serve as diagnostic markers of visuomotor function.
Topics: Humans; Eye Movements; Saccades; Vision, Ocular; Pursuit, Smooth; Amblyopia; Vision, Low
PubMed: 37506496
DOI: 10.1016/j.visres.2023.108296 -
Ocular Immunology and Inflammation Dec 2023Juvenile idiopathic arthritis (JIA) is the most common cause of uveitis in children. While symptoms are usually mild, persistent eye inflammation could lead to severe... (Review)
Review
Juvenile idiopathic arthritis (JIA) is the most common cause of uveitis in children. While symptoms are usually mild, persistent eye inflammation could lead to severe complications and impaired vision. It is essential that JIA patients at risk are diagnosed with uveitis early, receive adequate treatment, and avoid developing complications, such as cataract, glaucoma, and amblyopia. The purpose of this mini-review is to summarize the screening strategies and clinical management for JIA-associated uveitis (JIA-U) as well as the current state of molecular markers linked to this condition. Because glaucoma is one of the most common causes of visual loss in JIA-U, special focus will be put on this serious complication. We conclude by describing the current evidence regarding the long-standing question of whether chronic anterior uveitis without arthritis may be the same disease entity as JIA-U.
Topics: Child; Humans; Arthritis, Juvenile; Uveitis; Glaucoma; Endophthalmitis; Uveitis, Anterior
PubMed: 37966463
DOI: 10.1080/09273948.2023.2278060 -
Strabismus Sep 2023Postural control is a complex skill based on the collaboration of dynamic sensory mechanisms, namely the visual, vestibular, and somatosensory systems. (Review)
Review
BACKGROUND
Postural control is a complex skill based on the collaboration of dynamic sensory mechanisms, namely the visual, vestibular, and somatosensory systems.
METHODS
A literature survey regarding postural stability in strabismus and amblyopia was conducted using databases in order to collect data for a narrative review of published reports and available literature.
RESULTS
The results of the literature survey were analyzed to provide an overview of the current knowledge of postural stability in strabismus and amblyopia. The results revealed that although postural control depends on the fundamental integration of three essential components (the visual, vestibular, and somatosensory systems), the role of vision is critical in postural stability. Once normal binocular vision is undesirably disrupted in childhood by some reason, especially in strabismus and/or amblyopia, balance is also affected. Abnormal balance affects coordination in gross and fine motor controls in school-age children and results in weakened academic performance and delayed social progress. It also impacts a child's general health, self-esteem, and safety.
CONCLUSIONS
Binocular vision is imperative for the maturation and preservation of balance control in children, as balance performance is reduced in strabismus and/or amblyopia.
Topics: Child; Humans; Amblyopia; Strabismus; Vision, Binocular; Data Management; Databases, Factual
PubMed: 37489251
DOI: 10.1080/09273972.2023.2236138