Amblyopia is the leading
cause of reduced vision in children following
cataract surgery. It may develop as a
consequence of anisometropia, strabismus or
both.
Reduced visual acuity in one eye presents a
severe obstacle to sensory fusion and in fact
may abolish the fusion mechanism altogether. The
ensuing strabismus is the direct consequence of
a primary sensory deficit, and in such cases the
term
sensory
heterotropia is used.
It is not
entirely clear why some patients become
esotropic and others exotropic when they lose
sight in one eye.
The standard treatment of amblyopia in
children following cataract surgery has
been occlusion therapy of the phakic eye with
either an adhesive patch or an occluder, this
must be combined with full correction of the
pseudophakic eye with glasses or contact lenses.
In such children if amblyopic therapy succeeds
to improve vision, lasik or IOL exchange is advised.
Current
clinical guidelines based on expert opinion
advise the initiation of amblyopia treatment
before surgical correction of strabismus.
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Retrospective
case series provide evidence for the association
of amblyopia treatment with the development of a
new angle of deviation.
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