Organic amblyopia

Introduction Congenital amblyopia or organic amblyopia, due to macular hemorrhage at birth, resulting in irregular arrangement of cone cells, occurs before the formation of both eyes after the birth of the baby, so the prognosis is not good. Although some retinal and central nervous system can not detect obvious lesions, it is still considered to be an organic disease. It can not be found because of the existing examination methods. This type is conserved amblyopia and the treatment is ineffective. For infants and young children who can not cooperate with the examination of vision, you can use the cover test to get a general understanding of the binocular vision: intentionally cover one eye, let the child look at the eye, if it is quiet and cover the other eye but crying or tearing the cover, then Prompt unobtrusive eyesight is very poor, go to the hospital as soon as possible.

Cause

The pathogenesis is not yet fully understood. Von Noorden speculated that neonates often have retinal or visual pathway bleeding, which may affect the normal development of visual function. Some congenital amblyopia is secondary to nystagmus.

an examination

Related inspection

Eye and temporal area CT examination corneal reflection method vision retinoscopy vision vision screening instrument

General examination: visual inspection. External eye and fundus examination. Refractive examination. Strabismus examination. Check the nature of the fixation. Double eye single vision check. Retinal correspondence check. Fusion function check. Stereoscopic inspection.

Differential diagnosis

First, strabismic amblyopia

Occurs in a single eye, the child has strabismus or has strabismus, is common in patients with monocular constant strabismus under the age of four, because the cerebral cortex actively inhibits the visual impulse of the squint, long-term inhibition of the formation of amblyopia, visual inhibition and amblyopia are only quantitative The difference is generally that the inhibition can be relieved when the squint is injected, and the amblyopia is the persistent vision loss. The earlier the age of strabismus occurs, the faster the inhibition occurs and the deeper the degree of amblyopia.

Second, anisometropic amblyopia

Because of the different visions of the two eyes, the retinal imaging of the two eyes is different in size and resolution. The imaging of the macular part with higher diopter is large and blurred, which causes insufficient fusion of the two eyes and can not form a single eye, which leads to passive suppression. Those with a light phase above 3.00D often have amblyopia and strabismus. Passive and active suppression exist simultaneously. The depth of amblyopia is not necessarily related to the degree of anisometropia, but it is related to the nature of gaze. The paracentral observer has a deeper degree of amblyopia. The nature of this type of amblyopia is similar to that of strabismic amblyopia. It is functional and reversible. Clinically, it is sometimes difficult to distinguish whether amblyopia is caused by anisometropia or secondary to strabismus. If this type can be found early, wearing glasses in time can prevent it.

Third, ametropia amblyopia

Mostly binocular, children or adults with high myopia, myopia and astigmatism without corrective glasses, most of myopia is above 6.00D, hyperopia is above 5.00D, astigmatism is 2.00D or both have astigmatism. The binocular vision is equal or similar, and there is no binocular object like fusion dysfunction, so it does not cause functional inhibition of the macula. If appropriate glasses are worn in time, the visual acuity can be gradually improved.

Fourth, disuse of amblyopia (form deprivation amblyopia)

In infancy, due to ptosis, corneal opacity, congenital cataract or too long covering time after eyelid surgery, light stimulation can not enter the eyeball, hinder or block the macula to receive form stimulation, resulting in amblyopia, so Also known as interruption of visual irritating amblyopia.

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