Amblyopia Dx and Mx

Question 1

What is amblyopia (lazy eye)?

Answer 1

It is a type of poor vision, which occurs in just one eye. This also has no obvious cause can be detected by physical examination of the eye

Question 2

What is organic amblyopia?

Answer 2

This is due to a disease (macula dystrophy)

Question 3

What is congenital amblyopia?

Answer 3

This is a bilateral development anomaly due to incomplete development of the fovea

Question 4

What is toxic amblyopia?

Answer 4

Due to chemical interactions at the fovea e.g tobacco, methanol, chloroquine

Question 5

How do you diagnose amblyopia?

Answer 5

When there is reduced VA:
- 6/9 or worse
- greater than one line difference between eyes
- using pinhole to confirm VA reduction is not just refractive

Question 6

What are the classifications of amblyopia?

Answer 6

Shallow = 6/9 to 6/18

Moderate = 6/24 to 6/48

Deep = 6/60 or worse

Question 7

What is the clinical assessment of Ambylopia?

Answer 7

• Accurate objective refraction and binoc balance - ret
• BVVA R&L
• Objective motor BV assessment : cover test & hirschberg

Question 8

What is the management of amblyopia?

Answer 8

Usually undertaken in HES but may fall within the scope of an optometry practice

Needs paediatric clinical knowledge and a strong rapport is required

Question 9

What is the atropine 1% eye drops penalisation strategy?

Answer 9

• Blocks parasympathetic innervation to ciliary muscle & pupil
• Loss of accommodation ability plus hydriasis
• Near blur if emmetropic or hyperopic
• Distance blur too if substantially hyperopic