Amblyopia (low vision) – A visual impairment that affects up to 5% of children

Here you can find out everything you need to know about amblyopia in children.
It is particularly important for parents to recognize early signs in order to take countermeasures with the right treatment method.
We also show you the most common causes, explain how a painless and playful diagnosis is possible and which treatment approaches are particularly promising.

Definition of amblyopia: what is a visual impairment in children

Amblyopia, also known colloquially as “amblyopia”, is a visual disorder that mainly develops in childhood or is congenital.
This eye disorder occurs when visual development is impaired and the brain cannot use both eyes equally.
Usually one eye is affected by amblyopia while the other has normal visual acuity.
The causes can be varied, including structural problems in the eye, unequal visual acuity between the eyes or disorders in the eye muscles.
If amblyopia is not recognized and treated early, it can lead to permanent problems.
Therefore, timely diagnosis and appropriate therapy, often in the form of occlusion therapy or other measures, is crucial to promote the best possible development in affected children.

Causes of amblyopia: risk factors

Amblyopia can be triggered by various causes that impair normal visual development.
The most common causes of amblyopia are

• Strabismus (squint): When a child suffers from strabismus, one eye deviates from its normal alignment.
  In such cases, the brain can suppress the image from the deviating eye to avoid double vision.

• Anisometropia: This occurs when the two eyes have different visual acuity.
  The brain favors the eye with better vision, while the other eye remains underdeveloped.

• Blocked vision: A physical blockage, such as from a clouding of the lens of the eye (cataract) or other eye condition, can prevent clear vision through the affected eye and lead to amblyopia.

• Refractive error / defective vision: Uneven refractive errors in the eyes, such as farsightedness or astigmatism, can also lead to amblyopia if they are not corrected.
• Genetic factors: Amblyopia can also have genetic causes.
  If amblyopia runs in the family, there is an increased risk of children developing this visual disorder.

Symptom by symptom: How do you recognize amblyopia in children?

Poor eyesight is often more or less asymptomatic, especially in the early stages.
This means that it can sometimes be very difficult for parents and educators to recognize whether the child has vision problems.
It is therefore advisable to take the child to the ophthalmologist at regular intervals to ensure that their vision is developing normally.

If you notice the following symptoms of amblyopia, it is time to make an appointment with your trusted ophthalmologist.
Why it is so important to diagnose and, if necessary, treat amblyopia in good time: more on this in a moment.

Early detection of amblyopia: what parents notice

• Squinting in everyday life: When the child has problems aligning the eyes in a coordinated manner and focusing on objects consistently.
  Strabismus – or squinting – is often relatively easy to recognize.
  It is a clear indication that amblyopia may be present.
• One-sided vision: Affected children often try to see more with the “healthy” eye.
  This is noticeable when playing or reading, for example.
• Eye twitching (nystagmus): Uncontrolled twitching or movement of the eyes can also indicate problems with vision – including amblyopia.
• Restricted mobility of the eyes: When one eye cannot look in all directions or move without restriction.
• Avoidance behavior: As soon as children notice that they have problems with their vision, avoidance behavior often occurs.
  They try to rely as little as possible on visual impressions.

Amblyopia diagnosis at the ophthalmologist: don’t be afraid of the examination

Children often have a certain fear of medical examinations.
However, this is unfounded here.
The diagnosis of amblyopia is completely painless for your little patient and is approached in a playful manner.
However, a visit to the ophthalmologist is essential – a reliable self-diagnosis is not possible.

1. Eye test (visual acuity measurement): Determining the visual acuity of the eyes with a visual acuity chart to see if the eyes function differently.
2. Strabismus test: Check whether the eyes can be aligned in a coordinated manner or whether the child is squinting.
3. Refraction test: Do you have short-sightedness (myopia), long-sightedness (hyperopia) or astigmatism (curvature of the cornea)?
   Irregular refractive errors can lead to amblyopia.
4. Mobility test: Playfully determine whether the eyes can move as they should.
5. Reaction of the pupils: Test of neurological function by the change in pupils when exposed to light.

If there are still uncertainties after these painless and brief examinations, it may still be necessary to work with an imaging procedure in exceptional cases.
For example, an eye examination or optical coherence tomography (OCT for short).

Treatment of amblyopia

There are now different and effective approaches to treating recognized amblyopia as effectively as possible.
Which form of amblyopia treatment is used depends on the cause and severity of the amblyopia.
By far the most common treatment is Occlusion therapy is carried out. However, the use of atropine eye drops can be promising.
The vision of the “healthy eye” is temporarily restricted by the drops.
This forces the brain to concentrate on the visual impressions of the “weaker eye” and to accelerate development.

If the cause of amblyopia is a visual defect such as short-sightedness, long-sightedness or astigmatism, it may be sufficient to correct it with the help of glasses or contact lenses. glasses or contact lenses to compensate.
Visual development can then continue as normal and the visual impairment decreases.

In addition, reference is often made to Vision training set: These are visual exercises and games that are particularly suitable for children and help to improve eye perception and coordination.

Occlusion therapy for weak vision

Occlusion therapy is by far the most commonly used treatment for amblyopia.
This involves temporarily covering and occluding the healthy eye with a patch to stimulate and support the weaker eye.
The aim is to improve the visual development of the eye at risk of amblyopia and to permanently increase visual acuity.
Occlusion therapy is carried out in three phases:

1. Phase: Diagnosis and prescription
2. Phase: The good eye is covered with glasses or a plaster.
   The period is determined by the ophthalmologist.
   The therapy usually lasts from a few weeks to a few months.
3. Phase: Intermediate and final check-up.
   The progress is checked at regular intervals by the ophthalmologist.
   Until the desired correction has been achieved.

Occlusion treatment works so well because it forces the weaker eye to participate more actively in the visual process and strengthen neuronal connections in the brain.

Why is early treatment important?

The earlier you start treating amblyopia, the greater the chances of success.
This is due to several factors.
Above all, the eye is in a critical developmental phase in childhood, when amblyopia usually occurs.
If the interaction between the brain and eye cannot develop normally, this could lead to long-term problems.
This is because the child’s brain is particularly plastic.
This means that it is able to adapt and learn quickly.
Accordingly, it is easier for the brain to counteract amblyopia at a young age – ergo: the success rate of treatment increases.

If amblyopia remains untreated for too long, it can, in the worst case, lead to permanent problems that are difficult to compensate for by conventional means.
In addition to the purely visual effects that the visual impairment has directly, such a weakness can also reduce the child’s social and academic performance.
Those who do not see well are less able to learn and the developmental milestones in a child’s life become more difficult to achieve.