The bag-in-the-lens implantation technique in children and babies was safe and kept the visual axis clear after cataract surgery. In the near future, 4.0 or 4.5 mm IOLs will be available that may improve the success rate of IOL implantation in the small eyes of babies.
Background: Childhood vision screening is aimed at the detection of reduced vision due to amblyopia, thus enabling early diagnosis and timely intervention. The purpose of the study was to review the demographics and visual parameters of children referred to the ophthalmologist at Community Health Centre Ljubljana from Slovenian community-based vision screening program and define the visual outcome after treatment in children with amblyopia. Methods: Retrospective medical records review of children referred from community-based vision screening program for further assessment. Medical records were reviewed to determine findings from ophthalmic assessments, treatment received, and visual acuity at the final visit. The main outcome measures were the cause of visual impairment and the visual acuity at the final follow-up visit. Results: From 439 children (mean age 7.3 +/- 3.7 years) referred from community-based vision screening program, 75 children (17%; mean age 5.3 +/- 2.6 years) had amblyopia and received treatment. They had amblyogenic refractive error (3.67 +/- 2.44 diopters of sphere and 1.86 +/- 1.23 diopters of astigmatism) with uncorrected visual acuity on average 0.32 +/- 0.28 logMAR in the worse eye. Visual outcomes after treatment were good with a visual acuity of 0.04 +/- 0.07 logMAR in the worse eye, 60% of them had a visual acuity of 0.00 logMAR (40/40). Conclusion: Children with amblyopia in the presented clinical sample were mostly diagnosed and treated before the school-age. These children showed significant improvement in visual acuity in the amblyopic eye.
Amblyopia is a reduction of vision in one or both eyes due to a failure of normal neural development in the immature visual system.Amblyopia occurs due to two basic conditions – abnormal binocular interaction (e.g., strabismus) and blurring or distortion of visual image due to uncorrected refractive errors or media opacities. Best-corrected visual acuities in amblyopic eyes range from mild deficits to severe vision loss.The principle of treating amblyopia involves clearing any image blur and encouraging use of the amblyopic eye with occlusion of the better-seeing eye. Paediatric Eye Disease Investigator Group (PEDIG) studies show that both part-time and full-time occlusions can produce similar results in the eye with severe amblyopia and occlusion can be prescribed initially at 2 hours per day for the moderate amblyope. Studies show that daily atropine and patching for 6 hours/day can be equivalent treatment options and that if pharmacologic blurring is used for treatment, initial treatment can begin with just weekend use of atropine for moderate amblyopia.Amblyopia can lead to permanent loss of vision; therefore vision screening is strongly recommended over the course of childhood to detect amblyopia early enough to allow successful treatment.
Diplopia means seeing two images of the same, one object. It is a symptom with numerous causes that can involve many different structures. The cause can lay in the eyeball itself: the cornea, the lens and the retina or behind the eyeball: in the orbit or intracranial. Diplopia is only a symptom that can indicate a life threatening ilness like an aneurysm, a dissection or a brain tumor. That is why when presented with it we have to do a thorough examination and look for a red flag that could indicate danger. This way we can make a timely intervention, saving the patients sight or life. This article describes the most crucial signs of a dangerous underlying condition that we cannot afford to miss, a practical guide to the historical assesment, as well as to the physical examination of a patient with double vision to help localize the cause.
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