Only the corneais being removed

Myths & Facts

Myth:

People think that when we collect eye ball from dead, the whole eye will be transplanted

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Fact:

We transplant only the black circular part of the eye (cornea) from dead to the living person

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By definition Amblyopia/lazy eye is lack/ reduction of visual potential for which no obvious structural/ anatomical cause can be detected on physical examination of the eye. Or simply we can say reduced vision in other wise structurally normal eye. Most commonly referred to as lazy eye , was first described by Hippocrates in 4 th century B.C. the word amblyopia is derived from Greek word amblys=dull ops=face.

The prevalence of lazy eye in Indian population is 1.2% to 1.7 %. Slightly more common in male population with male to female ratio is 53: 47. It can affect either one or both eyes. Most common cause for lazy eye being uncorrected refractive error. Other causes being childhood cataract, squint, post eye injuries with improper rehabilitations.

Usually unilateral lazy eye will go unnoticed as the other eye will be functioning normally hence child will never complain. But in binocular lazy eye child presents with reduction in vision, going close to the T V , or keeping books too close to the eyes, or not recognizing small objects . Usually they identify isolated letters better than letters written in groups. The contrast sensitivity might be compromised to some extent. Sometimes there may be associated abnormal eye movements. Distance vision is more affected than near.

What is Amblyopia / lazy eye?

1.2% - 1.7% of Indian Population are affected

Becomes Refractory

Can lead to other

with ageing

complications if leftuntreated

More common in males than females

AMBLYOPIA AMBLYOPIA“Lazy Eye”The The

From the BlockLOW DOSE ATROPINE FORMULATION IN MYOPIA CONTROL

DR. Manjula Jayakumar, DO; DNB; FICO Pediatric ophthalmologist and Senior consultant, Dr Agarwal’s Eye Hospital, Chennai

As the most common eye disorder in the world, myopia affects between 25 and 50% of all adults in the UnitedStates and Europe. In Asia, the disease has reached epidemic proportions with 85 to 90% of young adultsaffected. In Israel, the myopia prevalence increased from 20% in 1990 to 28% in 2002.In India the prevalence right now is around 30 % which is lower than the South East Asian countries like Singapore where the prevalence is around 90 %.We are still raising concerns because myopia is catching up fast in our children and this can cause vision threatening complications like myopic maculopathy, cataract, strabismus, glaucoma and retinal detachment. The economic burden worldwide is estimated to be around $268 billion. The concerns aregenuine and it may be difficult for a country like ours to tackle myopia related complications in adulthood due tomonetary constraints.

A meta-analysis by Huang et al in 2016 compared the efficacy of 16 interventions in controlling myopia andfound out that drugs like atropine and pirenzipine were on the top followed by orthokeratology. A low doseatropine topical formulation of .01 % is commercially available as Myatro and Myopin eyedrops. This iseconomical as well as easy to administer in children as a once daily dosage at night. Children between 5–15 years with progression of more than 0.5 dioptre per year are given this form of therapy and will be continued on treatment for up to 2 years of non progression or upto 15 years of age whichever is the earliest. Children younger than 5 years with myopia could have non axial contributory factors and children older than 15/16 years with progression could be suffering from pathological myopia that does not respond to atropine therapy. A low-dose formulation of atropine slowed the progression of myopia for a majority of treated children over a two-year period with no adverse side-effects, according to a study presented at the European Society of Ophthalmology (SOE) Congress in Barcelona. Before treatment the mean progression was around 0.75D per year compared to 0.32D a year after treatment. Importantly there were no side-effects and no patient discomfort associated with its use.The best responders seemed to be children withmyopia less than -6.0D and no family history of the disease. The most difficult children to treat were thosewith high myopia and with both parents classed as myopic. Whatever limited experience we have had forthe past 1 year we found good response in myopes less than 6 dioptres.and most patients compliant to treatment as parents were eager to find a cure for their progression. Axial length documentation and pupillary size in photopic conditions were also noted and power determined by a good cycloplegic refraction before starting atropine therapy.

While the exact mechanism of how atropine works to delay myopia remains unknown, one hypothesis is that the drug blocks muscarinic receptors in the human ciliary muscle, retina and sclera, thus inhibiting thinning or stretching of the sclera, and thereby eye growth .Apart from using drugs in combating myopia, life style changes like play, outdoor sunshine exposure and less time spent on gadgets, smartphones and books all have a positive feedback in myopia control programs.

Successful treatment of lazy eye includes:

Early detection and early initiation of treatment.

Wearing correct glass power all the time.

Patching of the better seeing eye.

Doing different activities during patching hours.

Regular follow ups.

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Treatment

Early detection and early starting of correct treatment is single most powerful indicator forsuccessful result. During early stages the density of laziness will be very less so the reversal of lazy eye is more easier faster and complete.

Wearing the correct glass power at all waking hours is very important In order to get the good and fast result. Unless kids wear glasses ( if they have glasses) all the time, reversal is very slow and may remain incomplete. Not only wearing glasses all the time is very important. But wearing the correct glass power is also very important for full recovery. To achieve that regular visit to your eye specialist is very important.

Patching is the most effective way to treat lazy eye especially when one eye is affected. Usually better seeing eye is patched and patient is forced to use the lazy eye. Patching is done using disposable stickers which will prevent the light entry in the good eye. Patching is done at a stretch, not intermittently. Patching should be done daily and duration of patching varies from kid to kid. It depends on age duration, density, and associated refractive errors. Usually the duration of patching is best understood by talking to your eye specialist. Make sure that theywear glasses during patching if they have it.

While patching it is very important to do different range of activities. Your eye specialist is the best person to guide you in this as it depends on severity of lazy eye. Activities like playing (safe) games, painting, drawing, reading, writing, e.t.c.

Regular follow up is very important as the result of patching needs to be assessed at regular intervals and duration of patching might need to be adjusted depending on the recovery of lazy eye.

FEB 2019ISSUE