amblyopia in children
Introduction
Introduction to pediatric amblyopia There is no obvious organic change in the eye, and a distant vision correction of 0.8 is called amblyopia. If early detection, adherence to correction, 80-90% of children can be cured, restore normal vision function, if delayed treatment (such as more than 10-12 years old) will have low vision for life, and seriously affect children's learning, work and Life, and regret for life. basic knowledge The proportion of illness: 0.045% Susceptible people: children Mode of infection: non-infectious Complications: conjunctivitis keratitis
Cause
Pediatric amblyopia
Amblyopia caused by organic lesions (30%)
It is due to incomplete development of the retina, optic nerve and even cerebral cortex: it can also be caused by birth injury caused by birth or other causes of retinal hemorrhage, visual acuity is affected by amblyopia, and sub-ambly treatment is more effective. long.
Functional amblyopia (35%):
Caused by eye lesions after birth, most of them can restore normal vision if treated promptly.
Refractive amblyopia (35%):
Because of the high myopia, hyperopia and astigmatism in both eyes, there is no correct correction in childhood, which causes the macular area to appear blurred for a long time, and form amblyopia over time.
Prevention
Pediatric amblyopia prevention
Adjust mood
Keeping your mood comfortable People's psychological activities are important factors affecting the physiological function of the internal organs. When the spirit is happy, the blood will add a health-friendly chemical. On the contrary, when anger, depression, and sorrow, emotions are in chaos, which will seriously interfere with the function of organs in the human body. In the state of depression, it will inhibit the secretion of digestive juice and peristalsis, causing loss of appetite. Over time, it will lead to malnutrition in pregnant women. In turn, affecting fetal development may lead to amblyopia. Therefore, pregnant women should pay attention to regulating emotions, to maintain a good mood, to maintain a good psychological state, to avoid the impact of adverse emotions on the body's function.
Regulating diet
Ensure that the nutrition of pregnant women is directly related to the development of the visual organs of the fetus. If the pregnant woman is partial, picky, or anorexia, it will lead to malnutrition, and the lack of certain trace elements will affect the development of the fetus and even lead to deformity. For example, trace element zinc is an indispensable element of fetal eyeball growth and development and visual function. If zinc deficiency in pregnant women, it may lead to fetal amblyopia. Pregnant women should make their own health and good fetal development, they must ensure adequate nutrition, take the initiative to achieve a balanced diet, not partial eclipse, not picky eaters, food is light and nutritious, do not overeat spicy acid, coffee and other irritating food. Zinc-rich foods include meat, fish and shrimp.
Quit smoking
Develop a good habit of alcohol can consume a lot of zinc, pregnant women who often drink alcohol can make the body's trace element zinc deficiency, so that the fetal visual organs are poorly developed into amblyopia. Studies have confirmed that tobacco contains a very toxic "cyanide". In long-term smokers, cyanide is easy to accumulate in the body. Once it is accumulated too much, cyanide poisoning will occur slowly and lead to tobacco toxic amblyopia. In particular, smokers and alcoholics are more likely to develop tobacco-toxic amblyopia. Therefore, if you want your baby's eyes to develop well, pregnant women should not only quit smoking and drinking, but also try to stay away from passive smoking.
Prevent diseases, prevent healthy pregnant women from infecting certain viruses
Can directly affect the development of fetal visual organs, resulting in infantile amblyopia. Therefore, pregnant women should not travel frequently to places where population is concentrated and people are at a high level to avoid infection.
Complication
Pediatric amblyopia complications Complications Conjunctivitis keratitis
1, corneal inflammation: eye burns, eyelids have obvious itching and burning sensation, eye pain, visual impairment, tears, photophobia.
2, conjunctivitis symptoms: There is a foreign body sensation in the eye, conjunctival hyperemia, huge nipple of the conjunctiva, obvious tingling and burning in the eyelids.
3, far vision decreased, near vision is normal.
4, visual fatigue can occur external oblique or co-rotation exotropia, strabismus is mostly a high degree of myopia.
5, high myopia often appear vitreous liquefaction, turbidity, and cataracts and consciously black eyes flutter or decreased vision.
Symptom
Pediatric amblyopia symptoms common symptoms visual acuity vision often foggy
1. The visual acuity is lower than normal. Not only the naked eye has low vision, but the corrected visual acuity is also lower than normal and reaches the diagnostic criteria for amblyopia.
2, vision "crowding phenomenon", that is, the ability of amblyopia to identify a single visual letter is significantly higher than the ability to recognize the letters. For example, the same is the E letter of 0.3 lines. If only a single letter is displayed for the child, the amblyopic eye is easy to recognize, and once the E letter is displayed in a line, it is difficult for the amblyopic eye to distinguish the direction of the opening.
3. The contrast sensitivity of amblyopia is reduced.
4. There is an electrophysiological change in the amblyopic eye. The latency of the P100 wave of the visual evoked potential is prolonged and the amplitude is decreased.
5, the nature of the gaze is abnormal. When a normal person looks at the target, the object falls on the fovea of the eyes and forms a clear vision. Among the patients with amblyopia, some patients do not take foveal gaze, and the foveal gaze, macular gaze, and peripheral gaze can be found by projection. The more the gaze point deviates from the fovea, the lower the vision, and the more difficult the treatment.
6. The binocular vision function is abnormal. Amblyopia not only causes low vision, but also jeopardizes the normal development of binocular vision, resulting in tertiary visual function defects. For example, Titmus or TNO and other near stereoscopic abnormalities, or after visual function examination with the same visual machine, found that the child does not have a class III stereoscopic function, the level II fusion function is small or unable to fuse, and even does not have a level I simultaneous vision function. . The binocular vision function is a high-level visual function possessed by human beings, ensuring that the two eyes cooperate with each other and play their due role in work and life. Impaired or lost this function will affect the quality of learning, life and work.
Examine
Pediatric amblyopia examination
Vision check
Open-eye vision and corrected vision are first-hand information that doctors should obtain. At the time of initial diagnosis, it is necessary to check the naked eye vision. Once the corrective glasses are worn, it is generally only necessary to check the corrected visual acuity at the time of returning.
Eye position and eye movement function check
Used to exclude strabismus and eye muscle abnormalities.
Anterior segment and fundus examination
It belongs to the routine examination of ophthalmology, except for organic diseases of the eye. The gaze nature check is especially necessary for fundus examination.
Refractive state check
Mainly dilated optometry. The purpose of dilated optometry is to understand the refractive nature and degree of the patient's refractive error, the presence or absence of anisometropia, and the correction of vision. It is an indispensable routine examination for amblyopia diagnosis. At the same time, for patients with corrective ametropia, getting the correct prescription of glasses through dilated optometry and wearing appropriate glasses is the premise and primary method of amblyopia treatment.
Other eye exams
Includes all exams for ophthalmology majors. After performing the above basic examination, if it is necessary to further exclude other eye problems, you can choose other inspection methods of ophthalmology to further investigate. Such as intraocular pressure measurement, fundus photography, fundus fluorescein angiography, OCT, corneal topographic examination.
Whole body examination and imaging examination
Whole body examination.
Diagnosis
Diagnostic diagnosis of amblyopia in children
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
The diagnosis of amblyopia needs to be strictly in accordance with the definition and classification criteria of amblyopia in China, and attention should be paid to the discrimination of visual acuity caused by organic lesions. Special attention should be paid to the differentiation of children with amblyopia, retinitis pigmentosa, yolk-like macular degeneration, Stagard's disease, cone-of-sight cell malnutrition, leber's disease, uveitis, optic nerve or macular dysplasia. Clinically, children who have long-term treatment of visual acuity in the external hospital according to amblyopia are not increased or even progressively reduced. After careful examination in our hospital, they are diagnosed as fundus lesions such as Stagard disease and retinitis pigmentosa.
