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  • Updated 08.21.2022
  • Released 01.30.2003
  • Expires For CME 08.21.2025

Amblyopia

Introduction

Overview

Amblyopia is poor vision caused by abnormal visual experience during childhood brain development (02). This common disorder occurs in an estimated prevalence of 21.4% (36; 13; 32; 31; 15). Unless treated during childhood, the loss of vision is almost always permanent. Amblyopia treatment often requires penalization of the better-seeing eye to stimulate central visual processing in the worse-seeing, amblyopic eye. New treatment options for amblyopia are becoming available that use virtual reality headsets.

Key points

• Amblyopia is a reduction in visual acuity secondary to abnormal central visual processing in one or both eyes due to refractive error, strabismus, or visual deprivation.

• Treatment of amblyopia involves addressing the underlying cause of vision loss with or without penalization of the better-seeing eye.

• Amblyopia treatment is most effective at younger ages.

• Vision loss from amblyopia can be permanent if it is not treated in a timely fashion.

Historical note and terminology

The term “amblyopia” is derived from the Greek amblys, meaning “blunt,” and ops, meaning “eye,” indicating a “dullness” or incomplete loss of vision rather than complete blindness (10). The early clinical understanding of this disorder is traced to George Louis Leclerc, Comte de Buffon, who in 1743 proposed the use of occlusion of the sound eye to “force” the amblyopic eye to see better (10). The understandings of amblyopia was advanced by the work of Hubel and Wiesel, who won the Nobel Prize in 1981 for their experiments blocking light from a single eye in kittens and young monkeys. Hubel and Wiesel demonstrated anatomic changes in the visual cortex as well as impairment of vision in the young animals that had been temporarily deprived of vision. In contrast, blocking visual input in adult animals made no difference on the anatomy of the visual cortex or the vision. Hubel and Wiesel concluded that there exists a critical period of neuroplasticity in early life during which visual stimulation is required for normal visual cortex development (53; 54). As a result of their work and subsequent studies by other investigators, the concept of amblyopia as a developmental visual disorder was established (48; 29; 43).

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