ehealthyland.com

A diagnosis of amblyopia is made with a complete eye examination including a physical exam of the eye, a medical history, and a vision test. An optometrist or an ophthalmologist can perform the examination.

A basic eye exam usually begins with a medical history and questions about the patient’s health and past and current eye problems. The parent of an infant or young child answers these questions. School aged children may be able to specify if they have problems seeing out of one eye, or if they have problems reading or seeing the blackboard.

Eye movement is tested by moving a light or object through the patient’s field of vision and assessing the eye’s ability to follow it. This allows the doctor to determine if the eye muscles are working properly. Tests that access binocular vision how the eyes work together are also done. In strabismus, the stronger eye may do all the looking, or the weaker eye may align itself intermittently.

If the patient is old enough, a vision test involving reading letters from an eye chart may also be utilized. This helps determine if either eye has a refractive error (e.g., nearsightedness). If the patient is not old enough to know letters, other objective methods are used to determine the refractive error.

Other tests may be performed if disease is the suspected cause. These tests depend on the results of the initial exam, symptoms, and the appearance of the eye.

An eye exam by a pediatrician or the 20/20 eye chart screening is not adequate for the detection of amblyopia (and other visual conditions). The most important diagnostic tools are the special visual acuity tests other than the 20/20 letter charts currently used by schools, pediatricians and eye doctors. Examination with cycloplegic drops can be necessary to detect this condition in the young. Since amblyopia usually occurs in one eye only, many parents and children are unaware of the condition. Many children go undiagnosed until they have their eyes examined at the eye doctor’s office at a later age. Comprehensive vision evaluations are highly recommended for infants and pre-school children.

All children should be screened before they are school age. Your child’s doctor or the vision program at school will check three aspects of your child’s eye health.

1.That the eyes are moving normally.
2.That both eyes see equally well.
3.That your child’s eyes let light all the way through.

If there’s a problem in any of those three areas, the doctor or school nurse may recommend a visit to an eye specialist. If you feel that something could be wrong with your child’s vision, call your doctor even if he or she has been screened at school.

Family history of amblyopia is a risk factor for amblyopia. Parents cannot tell just by looking at their child if they have amblyopia. Early diagnosis and treatment are the keys to the best visual outcome.

It is not easy to recognize amblyopia. A child may not be aware of having one strong eye and one weak eye. Unless the child has a misaligned eye or other obvious abnormality, there is often no way for parents to tell that something is wrong. Because children with outwardly normal eyes may have amblyopia, it is important to have regular vision screenings performed for all children. While there is some disagreement regarding the age children should have their first vision examination, their eyes can, in actuality, be examined at any age, even on the first day of life.

Some people recommend that children have their vision checked by their pediatrician, family physician, ophthalmologist, or optometrist at or before six months of age. Others recommend testing by at least the child’s fourth birthday. There may be a critical period in the development of vision, and amblyopia may not be treatable after age eight or nine. The earlier amblyopia is found, the better chance there is for a positive outcome. Most physicians test vision as part of a child’s medical examination. If there is any sign of an eye problem, they may refer a child to an eye specialist.

There are objective methods, such as retinoscopy, by which to measure the refractive status of the eyes. This form of examination can help diagnose anisometropia. In retinoscopy, a hand-held instrument is used to shine a light in the child’s (or infant’s) eyes. While the doctor uses hand-held lenses, he can obtain a rough prescription. Visual acuity can be determined using a variety of methods. Many different eye charts are available (e.g. tumbling E, pictures, or letters). In amblyopia, single letters are easier to recognize than when a whole line is shown. This is referred to as the “crowding effect” and helps in diagnosing amblyopia. Neutral density filters may also be held over the eye to aid in the diagnosis. Sometimes visual fields to determine defects in the area of vision will be performed. Color vision testing may also be done. Again, it must be emphasized that amblyopia is a diagnosis of exclusion.