Small method for treating amblyopia

Daily training

1. Covering therapy (covering one eye and looking at the other): it is an ancient and effective treatment method for amblyopia, and it is one of the simplest, most economical and most effective methods for treating amblyopia in children;

2. Fine vision training: it is a special application training for amblyopic eyes, which is conducive to visual development and improvement of vision. There are many fine vision training methods, which should be selected according to the age, intelligence and vision of amblyopic children, and the training methods can be changed frequently.

3. Correcting ametropia: Making the object clearly imaged on the retina is the key first step in the treatment of amblyopia. Atropine mydriasis optometry must be used before glasses. After obtaining accurate optometry degree, reasonable therapeutic glasses should be given. Re-inspection once every six months;

4, light brush training: further stimulate the macular area, especially for the fixation effect of the paracenter;

5. Red light scintillation training: Stimulate the cells in the central area of the fundus macula with red light with the wavelength of 630 nm. This area is the most sensitive area of the fundus, which can accelerate cell growth and improve children's vision through stimulation;

6. Grating training: use computer multimedia visual function to carry out fine vision training to gradually improve children's vision and visual function;

7. After-image enhancement treatment: If amblyopia is injected into the lateral center, after-image treatment can be performed. Amblyopia therapeutic apparatus is used for treatment, generally 1 ~ 2 times a day; Do each function for 5 minutes at a time; According to the degree of amblyopia, we can wear glasses or not.

The process of amblyopia treatment is boring, long and the curative effect is easy to repeat, which often leads to lifelong regret because children can't insist on treatment. Therefore, parents must urge their children to cooperate with the treatment according to the doctor's requirements so as not to affect the training effect.

Family training

1, threading training: hold a circle with a diameter of 1 cm, look at the circle with amblyopia, and thread it with a wire at the same time, and repeat training every day until you can quickly and accurately cross the circle;

2. Puncture training: This training can select those who have recovered from normal gaze or gaze training. Various animals or objects can be drawn with dotted lines on ordinary white paper as training maps. When training, cover your healthy eyes, hold a pen, see the pattern of amblyopia, and aim the nib at each point and stab it. This method is a simple and easy family training method. Generally, people with severe amblyopia can't get correct graphics at the beginning of training, but they can get accurate graphics after repeated training.

3. Embroidery training: In order to improve the vision of amblyopia, we can cover healthy eyes and use amblyopia eyes for embroidery (embroidery) training, which is also an effective family training method;

4. Assembly training method: The purpose of this therapy is to enhance assembly. Fix the patient's mandible, make it stare at a target, and then make the target gradually close to the tip of the nose. At this time, the eyes constantly strengthen the assembly force, so that the assembly can be repeatedly trained;

5, eye muscle training: eye muscle training is to let patients look at the target and follow the target (the target swing direction and speed can be adjusted according to different situations). Take a stick that can change the swing direction and rotation speed, first fix the child's head, then move the stick horizontally, rotationally or obliquely, let it look at the tip of the stick, and swing in all directions with the stick to train the eye muscles.

visual chart

Children with amblyopia, parents must race against the cure time!

3 ~ 6 years old is the golden age to treat amblyopia, and 12 years old is basically incurable.

Amblyopia training

Training principle

general rule

The younger the amblyopia treatment age, the better the effect. Treatment can be started as early as 1 ~ 2 years old. Refractory amblyopia, if treated after 6 years old, is difficult to reach 1.0, and it often needs to be treated with more than three generations of enhanced compound amblyopia instruments for a long time to obtain good results.

The principle of early. 3 ~ 6 years old is the golden age to treat amblyopia, and 12 years old is basically incurable. Children with amblyopia, parents must race against the cure time!

eyeglasses

1. Anyone with myopia, astigmatism, hyperopia and anisometropia of more than 50 degrees, 100 degrees, shall be fitted with glasses. Because refractory amblyopia and refractory amblyopia are usually difficult to improve vision, as long as it helps to improve vision, even if the effect is slight, it should be used as much as possible;

2. When hyperopia is accompanied by accommodative strabismus, glasses should focus on improving vision and then consider strabismus correction. You can try wearing glasses to correct it for 2 ~ 3 months. If the eye position is normal, it should be reduced by 200~300 degrees immediately to promote the improvement of vision. If the eye position is still deviated, the glasses should be lowered by about 200 degrees to improve the vision of better eyes first and temporarily give up the correction of strabismus. Because refractory amblyopia will be more difficult or even ineffective if it is treated after a certain age (almost incurable after 7 years old), and accommodative esotropia can be corrected at any age as long as it is fully relaxed. Of course, if we can correct the eye position before the age of 6 without hindering the improvement of vision, it is very important to establish and improve the stereoscopic vision function.

3. The top distance of hyperopia or myopia glasses should be as small as possible, that is, the lenses should be as close to the eyes as possible, which can reduce the tremor of glasses caused by excessive jitter when walking and hinder the improvement of vision. The method is to use a hard metal frame, lower the nose pad and shorten the distance from the temple to the ear bend;

4. Horizontal nystagmus: hyperopia, myopia and hyperopia astigmatism should be properly undercorrected, while myopia astigmatism can be completely corrected. At the same time, more attention should be paid to reducing the distance between corneal apexes and increasing the stability of lens holder. If you can use contact lenses, the effect will be better, because wearing glasses with higher height will cause the object image to vibrate greatly, which will affect the improvement of vision.

5. When choosing high myopia or hyperopia, it must be emphasized that the horizontal shift of optical center is not more than 2mm, and the up-and-down shift is not more than 1mm, so as to avoid inhibition caused by poor fusion of binocular objects and images and hinder the improvement of vision.

Cover your eyes.

It should be emphasized that only one eye is healthy (above 0.9) and the other eye's vision is less than two lines, which can cover healthy eyes. Because it is difficult to improve the vision of refractory amblyopia, if the vision of a good eye is less than 0.9, it is necessary to cover the good eye in order to treat the poor eye, which will cause the vision of the good eye not to improve, resulting in low vision of both eyes in the future, which will affect life and study. Therefore, for refractory amblyopia with great difference in binocular vision, the eye with good vision should be cured first, and then the poor eye should be treated by covering the good eye (healthy eye) to ensure that at least one eye will have normal vision in the future and will not have a great impact on future life and study.

Matters needing attention

1, visual development has a critical period. After the critical period, the treatment effect is very poor. Therefore, once the child is found to have amblyopia, amblyopia training should be carried out immediately. Some parents are afraid of affecting their children's study or work, so it is very wrong to postpone amblyopia training.

2. When the vision of amblyopia patients is quite different, the eyes with better vision must be covered during amblyopia training.

3. Children with amblyopia must wear appropriate refractive correction glasses. Amblyopia training can not change the refractive state of patients.

4. Amblyopia training is a long-term process, and the therapeutic effect is closely related to children's interest and compliance with training methods. Therefore, it is very important to choose the training methods that children are interested in. Traditional training methods are generally single in form and lack of interest, which makes it difficult for children to persist in training and affects the therapeutic effect. However, computer multimedia technology has advantages that traditional methods do not have, such as diverse forms and interesting training. It should be a wise choice to choose multimedia training software about amblyopia.

5. After amblyopia is cured, it usually takes one to two years of follow-up. During the follow-up, patients should go to the hospital for regular review. Once you find that your vision is declining, you can use the original amblyopia training method and stick to it for a week, and your general vision will be improved again. If there is no improvement, please consult relevant experts for further diagnosis and treatment.

6. Pay attention to organically combine family training with hospital training. Because amblyopia training must be carried out every day without interruption, due to the limitation of objective conditions, it is impossible for every child to carry out every training in the hospital. Proper training at home is necessary and an important guarantee for the therapeutic effect. Generally, in the initial stage of new training, it is directly carried out under the guidance of hospital doctors or optometrists. After the child understands the purpose and method of training, he can transfer the training to his home to continue.

7. The ultimate goal of amblyopia training is not to improve the vision of amblyopia eyes, but to establish binocular visual function. It is difficult to ensure that the vision of amblyopic eyes will not decrease after improvement without establishing binocular vision function. Therefore, when the visual acuity of weak eyes is improved from dominant eyes to no more than 2 lines, binocular visual function training should be carried out in time.

Training skills editor

1. For newly diagnosed children, comprehensive and detailed routine ophthalmological examination should be carried out, including visual acuity, anterior segment and fundus examination, to exclude organic lesions and prevent misdiagnosis and missed diagnosis.

2. Routine optometry with 1% atropine eye ointment, and wear appropriate corrective glasses. For monocular amblyopia, the key to amblyopia treatment is to wear appropriate corrective glasses and strictly cover the healthy eyes. Children with amblyopia are generally difficult to accept, especially those who have just started treatment. Covering healthy eyes will affect their normal study and life. Younger children will cry and refuse to cover them, while older children will refuse to cover them because it will affect their appearance. Patiently explain to children and parents the importance of covering for amblyopia treatment, and explain it according to children's preferences and understanding. Tell children that if their eyesight can't be restored, they can't be drivers, artists and designers in the future, let them know the importance of amblyopia and actively cooperate with the treatment.

3. To make amblyopia interested in treatment, the hospital should create a comfortable and excellent training environment for children, and at the same time give children a space to play, play and read, so that children's lives can be enriched without getting tired of treatment, and play fairy tales and nursery rhymes that children like to listen to in the training room to increase their fun. For children who are afraid of treatment for the first time, they can be led to visit the training room to eliminate their fears and feel happy here, so as to receive treatment.

4. Let parents know the causes, treatment methods, how to prevent the recurrence of amblyopia and its harm to children, let parents enter the children's training environment and extracurricular activities environment, understand the children's training situation and life, and let the families of newly diagnosed children talk with the families of trained children and exchange views with each other. The communication between patients is more reliable than that between doctors and patients, which increases their confidence in treatment.

5. Check the eyesight and eyes of amblyopic children regularly, understand the growth of children's eyesight, adjust the covering and treatment in time, and improve the curative effect.

6. For children who can't receive group comprehensive training, they can take family-based training, make regular follow-up visits, give correct guidance, often urge children and parents by telephone, increase communication between doctors and patients, increase trust, and more importantly, help children recover their normal vision as soon as possible.

Instrument principle editing

Amblyopia can be regarded as a kind of "atrophy" of vision or "deep sleep" of visual cells in essence. The function of amblyopia instrument is to awaken "sleeping" visual cells with color markers to indirectly increase vision or to exercise "atrophied" vision with icons to directly increase vision. Therefore, the principles of amblyopia instruments can be summarized into three categories:

1, icon function exercises "reducing" vision.

Such as tracing, threading, beading, jack, grading fine vision training, contrast sensitivity training and other functions. Among them, graded fine vision training has the greatest visual enhancement effect, because it can adjust the threshold visual standard of 0. 1~ 1.5 according to the level of vision (the threshold visual standard is the "e visual standard" that children can just see, but it is difficult and has the greatest visual enhancement effect), so the visual enhancement effect is the best. However, other visual enhancement functions of icons are limited in the treatment of severe amblyopia because they cannot be graded and quantified according to vision.

2. The color light function "wakes up" visual cells, such as light brush, red flicker counter, afterimage black spot light, visual physiological grid light, etc., which can selectively excite cone cells or visual central cells and indirectly increase vision. Among them, the optical brush has the best visual enhancement effect, because the optical brush has three visual enhancement effects:

(1) You can choose to stimulate cone cells to change eccentric gaze into central gaze (so the optical brush is called eccentric gaze corrector abroad);

(2) Clear brushing while staring can exercise the central vision;

(3) Rotating light brush can excite the visual central cells and eliminate the inhibition of the brain. Red flash can increase the sensitivity of cone cells and visual physiology (grid diagram), stimulate visual central cells and eliminate brain inhibition; The two functions are simple and not as strong as a light brush. After-image can protect macula and inhibit peripheral rod cells (including eccentric fixation points), which has a strong role in correcting eccentric fixation and is the best eccentric fixation correction function at present.

3. Establish and restore stereoscopic vision.

Through amblyopia training, the binocular monocular three-level functions (simultaneous vision, fusion vision and stereoscopic vision) are trained to establish and restore stereoscopic vision. [ 1]

Treatment point editor

Hyperopia amblyopia

1, function

(1) is refractory amblyopia;

(2) It can cause accommodative esotropia.

2, treatment points

(1) Early treatment can start from 1~2 years old at the earliest, but the effect is poor after 6 years old, and 4~5 generations of enhanced amblyopia instruments are needed.

(2) Wear 2/3 hyperopia glasses,

(3) Early treatment with the third generation amblyopia instrument such as bifocal flying point or bifocal flying light. , more than 3 times/day.

(4) Vision

(5) Stereoscopic training should be carried out as soon as possible after binocular vision is above 0.5.

Suffer from esotropia

1, function

(1) is refractory amblyopia;

(2) Often one eye has good eyesight and the other eye has poor eyesight;

(3) Wearing corrective glasses can correct strabismus, but it does not affect the improvement of eye vision.

2, treatment points

(1) wear full-degree corrective glasses for 3 months to correct strabismus: if strabismus is corrected, it will be treated with the third-generation composite instrument after reducing 150 degrees, three times a day. If strabismus cannot be corrected, first wear 2/3 hyperopia glasses to cure strabismus, and then cover strabismus to treat strabismus.

(2) Vision

Classification editing of amblyopia

myopic amblyopia

Features:

(1) is refractory amblyopia.

(2) Myopia developed rapidly during the treatment;

(3) continuous lifelong development;

(4) Blindness: retinal degeneration, hemorrhage, hole and detachment.

Treatment points:

(1) Early treatment,

(2) Wear full-degree corrective glasses

(3) Combined use of telephoto lens (preferably integrated into the lens of amblyopia instrument).

(4) eye muscle exercise training.

(5) Combination of amblyopia instrument and amblyopia program therapy.

Interlaced amblyopia

Features:

(1) is refractory amblyopia;

(2) Severe inhibition (inhibition from good eyes and brain centers).

Treatment points:

The eye with high degree is more inhibitory, and the eye with low degree is basically normal.

(1) covering normal eyes;

(2) More than 3~5 generations of compound amblyopia instruments are selected, and special training icons for low vision can be customized;

(3) Two-dimensional or three-dimensional color phototherapy was mainly used in the early stage, but special training icons customized for low vision can be used to strengthen training.

strabismus amblyopic

Features:

(1) can form eccentric fixation, resulting in visual acuity below 0.2, which becomes refractory amblyopia.

(2) It can cause accommodative esotropia.

(3) It can cause postoperative strabismus to recur easily.

Principles of treatment:

Different kinds of strabismus have different treatments.

(1), binocular alternating strabismus (esotropia or exotropia): its amblyopia is generally mild, and the treatment is the same as routine.

(2) Central fixation strabismus: After the better eyes are cured, the eyes are covered and treated with more than three generations of compound amblyopia instruments.

(3) Eccentric fixation strabismus: Cover your eyes to cure strabismus, and use color codes (it is best to move color codes such as sensitive color codes and light brushes. ) to correct the eccentric gaze. Enlarge the threshold target with auxiliary mirror+viewing angle (customized, only three generations).

(4) Hyperopia with esotropia: Try to wear full hyperopia corrective lenses for 3 months. If strabismus can be completely corrected, hyperopia will be gradually reduced and amblyopia will be treated at the same time. If strabismus cannot be completely corrected, conventional glasses should be used to give priority to the treatment of good eyes, and the strabismus can only be covered after the good eyes are cured. Ensure that at least one eye is healthy (vision is above 1.0). Can cope with daily work and study like normal people.

Trembling amblyopia

Nystagmus is one of the most serious eye diseases, which belongs to refractory amblyopia. Although it can't be cured, it can improve vision, preferably to 0.5~0.8. Because nystagmus can't be fixed at one point, it is often accompanied by head deviation or strabismus, so the special requirements of nystagmus (such as vision observation, optician, glasses adjustment, optician, selection of therapeutic instruments, customization of nystagmus target, head position during treatment, etc. ) should be followed to achieve good results, and its vision improvement is usually slow, so parents must be patient to achieve good results.

Features:

(1) Refractory amblyopia;

(2) It is easy to cause or accompany strabismus;

(3) It is easy to form extreme views.

Treatment points:

(1) The degree of glasses is reduced by 50 degrees to 100 degrees compared with conventional glasses (myopia is conventional glasses);

(2) The glasses are equipped with eccentric heads, and the vertex of the lens is as far away as possible.

(3) Use the binocular amblyopia instrument as soon as possible, preferably for more than three generations. 4~5 generations of compound instruments can customize the special training target of nystagmus;

(4) Treating amblyopia with migraine;

(5) Encourage migraine and reduce fibrillation.

Cataract surgery

Features:

(1) can be refractory or refractory amblyopia.

(2) It is easy to cause exotropia (disuse).

(3) It is easy to cause nystagmus.

Treatment points:

(1) Put on your glasses as soon as possible (you can start before 1).

(2) Treat with special color light function as soon as possible.

(3) After the visual target can be recognized, the enhancement process of "Graded Vision-Contrast Sensitivity" is performed under the auxiliary mirror.

After glaucoma surgery

Features:

(1) Refractory amblyopia;

(2) The optic nerve is very fragile, and vision is easily lost;

(3) Constant residual high intraocular pressure;

(4) Often accompanied by myopia.

Treatment points:

(1) Early treatment;

(2) If you have myopia, you need to correct it all;

(3) Continue to control intraocular pressure;

(4) targeted programming+amblyopia treatment;

(5) Treatment of colored amblyopia, when the visual acuity is greater than 0.3, add threshold target treatment.

Treatment standard

1, recovery: visual acuity remained normal 1.0, and there was no decline after three years of follow-up;

2 Basic cure: visual acuity ≥ 0.9;

3. Progress: the vision is improved by more than two lines;

4. Ineffective: the vision is decreased, unchanged or only improved by one line.

Transfer from medical equipment maintenance forum

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