amblyopia

[wrangler418]

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I'm having trouble conceptualizing amblyopia. I know it's "decrease in visual acuity not correctable by normal means" or something like that, and it's caused by disuse of an eye for whatever reason, but I understand it's DIFFERENT from a refractive error. What's the difference? In other words, when someone closes their dominant eye and looks through their amblyopic eye, what do they see? Is it just really blurry?

On a side note, does anyone find pediatric ophthalmology a lot more difficult than the rest of ophthalmology? I'm just shadowing a peds ophthalmologist for the week and a lot of the stuff is just really difficult to grasp, especially the eye motility stuff because there's such a nebulous link between cause and effect in these concepts. I had very little trouble understanding the cornea and comprehensive oph stuff on my 3rd year rotation, but this is a little beyond me. starting to make me worry a bit

 

[KLPM]

My understanding of amblyopia has always been that it is not a problem with the eye itself but a problem of visual pathway development. That is why it is a problem that arises from childhood when these pathways are still developing. As to what someone like that sees I can't answer that but I'd imagine there is a spectrum from bad to very bad. I will ask my sister the next time I see her because she has ambylopia.

I wouldn't say paediatric ophthalmology is necessarily harder. It's more like a different way of thinking about things (which people then interpret as hard I know). But I think with enough patience and work it had be manageable.

 

[JMK2005]

I'm having trouble conceptualizing amblyopia. I know it's "decrease in visual acuity not correctable by normal means" or something like that, and it's caused by disuse of an eye for whatever reason, but I understand it's DIFFERENT from a refractive error. What's the difference? In other words, when someone closes their dominant eye and looks through their amblyopic eye, what do they see? Is it just really blurry?

On a side note, does anyone find pediatric ophthalmology a lot more difficult than the rest of ophthalmology? I'm just shadowing a peds ophthalmologist for the week and a lot of the stuff is just really difficult to grasp, especially the eye motility stuff because there's such a nebulous link between cause and effect in these concepts. I had very little trouble understanding the cornea and comprehensive oph stuff on my 3rd year rotation, but this is a little beyond me. starting to make me worry a bit

as the above poster said, amblyopia a problem with the connections between the eye and brain and this happens during the times when the hardwiring to the brain in happening (less than 8-9 years old). amblyopia is separated by cause (refractive, strabismic, sensory). You treat amblyopia by patching the good eye and forcing the patient to use the bad eye - re-wiring the pathways. patching works well in young patients when there is more plasticity and does not to work well after 10 years old.

All fields of pedatrics is hard because kids are fussy. the exam is harder and you have to do things quickly. a lot of the exam is done while pt is unaware and just talking to the parents. like anything, if you have an interest or a passion, that will motivate you to get good at ti.

 

[MstaKing10]

as the above poster said, amblyopia a problem with the connections between the eye and brain and this happens during the times when the hardwiring to the brain in happening (less than 8-9 years old). amblyopia is separated by cause (refractive, strabismic, sensory). You treat amblyopia by patching the good eye and forcing the patient to use the bad eye - re-wiring the pathways. patching works well in young patients when there is more plasticity and does not to work well after 10 years old.

All fields of pedatrics is hard because kids are fussy. the exam is harder and you have to do things quickly. a lot of the exam is done while pt is unaware and just talking to the parents. like anything, if you have an interest or a passion, that will motivate you to get good at ti.

That's a great review of amblyopia. I would agree with OP in that pediatric ophthalmology is a bit more complex in terms of understanding some of the concepts, particularly sensory testing, neuroanatomy, ocular motility etc. Whereas the pathology in cornea or retina or general ophtho can often be more directly visualized, this is not always the case in pedi. Clinically, it is also a bit tougher (for some) given the difficulty of examining children. Can be very rewarding and I admire those that have a knack for it. All subspecialties have their complexities though.