Amblyopia Treatment for Children: Key Insights and Tips

Treatment for Amblyopia in Children

Hello, my daughter is three and a half years old and underwent a vision test.
After being dilated, it was found that she has over 200 degrees of astigmatism and over 400 degrees of hyperopia in both eyes, requiring corrective glasses.
I later noticed that some ophthalmology clinics dilate the eyes and then perform the refraction test immediately, while others dilate for three consecutive nights and do not dilate on the day of the refraction test.
What is the difference between these methods, and which one is more accurate?
Additionally, because my daughter has a smaller head, the clinic did not have suitable glasses for her.
The doctor provided a prescription for us to get glasses elsewhere.
Should we directly use the post-dilation measurements on the prescription to get the glasses? If we go to an optical shop and find that the measurements differ, which measurements should we use? Should we adjust the prescription at the optical shop to the degree that allows her to see clearly?
Once the glasses are made, how long should we wait before returning to the ophthalmology clinic to check if her vision has improved? Should we consider getting new glasses with a different prescription? Thank you very much for your help in clarifying these questions!

Rex, 30~39 year old female. Ask Date: 2011/04/26

Dr. Guo Jinliang reply Ophthalmology

Based on the situation described in the letter, the examination by the physician indicates a problem with amblyopia, and it is recommended to wear glasses for treatment.
The purpose of dilation is primarily to relax the muscles and obtain a more accurate prescription.
There should not be significant differences in the methods used for dilation.
After the physician conducts the examination and issues a glasses prescription, it is advisable to follow the prescribed measurements for the lenses.
The process of treating amblyopia can be challenging, and generally, the treatment is most effective before the age of six.
The follow-up schedule and the timing for changing glasses can vary from person to person, so it is best to discuss this with your physician for a better understanding of the entire process.

Reply Date: 2011/04/26

More Info

Amblyopia, commonly known as "lazy eye," is a condition that affects vision in one or both eyes, often due to a lack of proper visual stimulation during early childhood. It is crucial to address this condition early, as untreated amblyopia can lead to permanent vision impairment. Your daughter's recent diagnosis of significant refractive errors, including astigmatism and hyperopia, necessitates careful management to ensure her visual development is on track.

Understanding the Differences in Eye Examination Techniques
The methods of performing refraction tests after dilation can vary among eye care providers. The two common approaches you mentioned are:
1. Immediate Refraction After Dilation: In this method, the eye care professional performs the refraction test shortly after administering the dilating drops. This approach can provide a quick assessment of the eye's refractive error while the pupil is still dilated. However, it may not always yield the most accurate results, especially if the child is not fully cooperative or if the drops have not fully taken effect.

2. Refraction After Multiple Days of Dilation: This method involves dilating the eyes for several days before performing the refraction test. This approach allows for a more stable and accurate measurement of the refractive error, as it ensures that the effects of the drops have fully taken hold. It is particularly beneficial in children, as their eyes may respond differently to dilation.

In general, the second method is often considered more accurate for assessing refractive errors in children, as it allows for a more thorough evaluation of the eye's focusing ability.

Prescription and Fitting of Glasses
When it comes to fitting glasses for your daughter, it is essential to follow the prescription provided by the eye care professional. If the prescription was determined after dilation, you should use those measurements when ordering glasses. However, if you go to an optical shop and they perform their own refraction, it is possible that the measurements may differ due to various factors, including the child's cooperation and the equipment used.

Here are some tips for navigating this process:
- Follow the Prescription: Use the prescription from the eye doctor that was obtained after dilation. This is the most accurate representation of your daughter's refractive needs at that time.

- Discuss Any Discrepancies: If the optical shop's measurements differ significantly from the prescription, discuss this with the optician. They may suggest adjustments based on how well your daughter can see with the new lenses.

- Trial and Error: Sometimes, it may take a few adjustments to find the perfect prescription that allows your daughter to see clearly. Be open to trying different lenses if necessary.

Follow-Up Care
After obtaining the glasses, it is crucial to schedule a follow-up appointment with the eye care provider. Typically, children should be re-evaluated every 6 to 12 months, especially if they are undergoing treatment for amblyopia. The eye doctor will assess whether the glasses are helping improve her vision and whether any adjustments to the prescription are needed.

Importance of Compliance
Encourage your daughter to wear her glasses consistently, as this is vital for treating amblyopia. The brain needs to receive clear visual input from both eyes to develop properly. If she is prescribed patching therapy or other treatments, ensure that these are followed as directed.

Conclusion
In summary, the method of refraction after dilation can significantly impact the accuracy of the prescription. Always adhere to the prescription provided by the eye care professional, and be proactive in follow-up care to monitor your daughter's vision. Early and consistent treatment is key to successfully managing amblyopia and ensuring your daughter has the best chance for healthy vision development.

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