Editing Amblyopia (section)

==Treatment==
Treatment of strabismic or anisometropic amblyopia consists of correcting the optical deficit (wearing the necessary spectacle prescription) and often forcing use of the amblyopic eye, by patching the good eye, or instilling [[topical]] [[atropine]] in the good eye, or both.<ref name=handbook/>{{rp|130}}<ref>Coats DK and Paysse EA.  Overview of amblyopia UpToDate.  Last updated: 25 Sep 2014</ref> Atropine appears to result in similar outcomes to patching.<ref>{{Cite journal |date=2019-12-05 |title=A patch or eye drops are similarly effective for the treatment of "lazy eye" in children |url=https://evidence.nihr.ac.uk/alert/a-patch-or-eye-drops-are-similarly-effective-for-the-treatment-of-lazy-eye-in-children |journal=NIHR Evidence |type=Plain English summary |publisher=National Institute for Health and Care Research |doi=10.3310/signal-000849|s2cid=243130859 |url-access=subscription }}</ref><ref>{{cite journal | vauthors = Li T, Qureshi R, Taylor K| title = Conventional occlusion versus pharmacologic penalization for amblyopia | journal = Cochrane Database Syst Rev | volume = 8 | issue = 8 | pages = CD006460 | date = 2019 | pmid = 31461545 | pmc = 6713317 | doi = 10.1002/14651858.CD006460.pub3 }}</ref> If there is overpatching or overpenalizing the good eye when treating amblyopia, "reverse amblyopia" can result.<ref name="Holmes" /><ref name=NEI>[http://www.nei.nih.gov/health/amblyopia/index.asp Amblyopia NEI Health Information] {{webarchive |url=https://web.archive.org/web/20050911041610/http://www.nei.nih.gov/health/amblyopia/index.asp |date=11 September 2005 }}</ref> Eye patching is usually done on a part-time schedule of about 4–6 hours a day. Treatment is continued as long as vision improves. It is not worthwhile continuing to patch for more than 6 months if no improvement continues.<ref name=vaughan>{{cite book| first1 = Emmett T. | last1 = Cunningham | first2 = Paul | last2 = Riordan-Eva | name-list-style = vanc |title=Vaughan & Asbury's general ophthalmology.|publisher=McGraw-Hill Medical|isbn=978-0071634205|edition=18th| date = 2011-05-17 }}</ref>

Deprivation amblyopia is treated by removing the opacity as soon as possible followed by patching or penalizing the good eye to encourage the use of the amblyopic eye.<ref name="Holmes" /> The earlier the treatment is initiated, the easier and faster the treatment is and the less psychologically damaging. Also, the chance of achieving 20/20 vision is greater if treatment is initiated early.<ref>{{cite journal | vauthors = Williams C, Northstone K, Harrad RA, Sparrow JM, Harvey I | title = Amblyopia treatment outcomes after screening before or at age 3 years: follow up from randomised trial | journal = BMJ | volume = 324 | issue = 7353 | page = 1549 | date = June 2002 | pmid = 12089090 | pmc = 116606 | doi = 10.1136/bmj.324.7353.1549 }}</ref>

One of the [[Healthcare in Germany#Public insurance|German public health insurance]] providers, Barmer, has changed its policy to cover, as of 1 April 2014, the cost of software for amblyopic children whose condition did not improve through patching. The app offers dedicated eye exercises that the patient performs while wearing an eyepatch.<ref>{{cite news|url=http://www.aerztezeitung.de/praxis_wirtschaft/telemedizin/article/857948/app-rezept-barmer-bezahlt-internetbasierte-behandlung.html|title=App auf Rezept: Barmer bezahlt internetbasierte Behandlung|trans-title=Prescription app: Barmer pays for internet-based treatment|website=aerztezeitung.de|date=28 March 2014|access-date=29 March 2014|language=de|url-status = live|archive-url=https://web.archive.org/web/20140329174210/http://www.aerztezeitung.de/praxis_wirtschaft/telemedizin/article/857948/app-rezept-barmer-bezahlt-internetbasierte-behandlung.html|archive-date=29 March 2014}}</ref>

Treatment for amblyopia depends on the child’s age, severity of the vision loss and the prescribing doctor’s preference. Treatment options include, vision therapy, total or partial occlusion therapy, prescription eyeglasses or any combination. Common types of occlusion therapy include the use of eye-patches or optical blurring. Optical blurring can include the use of pharmacological agents (eye drops) or visual degradation using either power to blur the image or foils placed over the lens.<ref>{{Cite web |title=Common Kid's Eye Conditions |url=https://www.2020mag.com/article/common-kid39s-eye-conditions#:~:text=Hyperopia%E2%80%94The%20normal%20eye%20at,years%20tend%20to%20remain%20hyperopic. |access-date=2024-12-23 |website=www.2020mag.com}}</ref>

Evidence for [[vision therapy]] is unclear as of 2011.<ref>{{cite journal |last1=West |first1=S |last2=Williams |first2=C |title=Amblyopia. |journal=BMJ Clinical Evidence |date=30 June 2011 |volume=2011 |pmid=21714945|pmc=3275294 }}</ref>

===Older age===
Treatment of individuals age 9 through to adulthood is possible through applied [[perceptual learning]].<ref name="polat">{{cite journal | vauthors = Polat U, Ma-Naim T, Belkin M, Sagi D | title = Improving vision in adult amblyopia by perceptual learning | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 101 | issue = 17 | pages = 6692–7 | date = April 2004 | pmid = 15096608 | pmc = 404107 | doi = 10.1073/pnas.0401200101 | bibcode = 2004PNAS..101.6692P | doi-access = free }}</ref><ref name=zhou>{{cite journal | vauthors = Zhou Y, Huang C, Xu P, Tao L, Qiu Z, Li X, Lu ZL | title = Perceptual learning improves contrast sensitivity and visual acuity in adults with anisometropic amblyopia | journal = Vision Research | volume = 46 | issue = 5 | pages = 739–50 | date = March 2006 | pmid = 16153674 | doi = 10.1016/j.visres.2005.07.031 | s2cid = 1290214 | doi-access = free }}</ref><ref>https://pubs.covd.org/VDR/issue8-4/index.html Volume 8, Issue 4, Page 260: Neural Vision Perceptual Learning as an Effective Treatment of Amblyopia</ref><ref name="Effects of Perceptual Learning on D">{{cite journal | pmc=8999262 | date=2022 | last1=Zhong | first1=J. | last2=Wang | first2=W. | last3=Li | first3=J. | last4=Wang | first4=Y. | last5=Hu | first5=X. | last6=Feng | first6=L. | last7=Ye | first7=Q. | last8=Luo | first8=Y. | last9=Zhu | first9=Z. | last10=Li | first10=J. | last11=Yuan | first11=J. | title=Effects of Perceptual Learning on Deprivation Amblyopia in Children with Limbal Dermoid: A Randomized Controlled Trial | journal=Journal of Clinical Medicine | volume=11 | issue=7 | page=1879 | doi=10.3390/jcm11071879 | doi-access=free | pmid=35407483 }}</ref><ref>{{cite journal | pmc=3864996 | date=2013 | last1=Yalcin | first1=E. | last2=Balci | first2=O. | title=Efficacy of perceptual vision therapy in enhancing visual acuity and contrast sensitivity function in adult hypermetropic anisometropic amblyopia | journal=Clinical Ophthalmology | volume=8 | pages=49–53 | doi=10.2147/OPTH.S48300 | doi-access=free | pmid=24376340 }}</ref> Tentative evidence shows that perceptual training may be beneficial in adults.<ref>{{cite journal | vauthors = Astle AT, Webb BS, McGraw PV | title = Can perceptual learning be used to treat amblyopia beyond the critical period of visual development? | journal = Ophthalmic & Physiological Optics | volume = 31 | issue = 6 | pages = 564–73 | date = November 2011 | pmid = 21981034 | pmc = 3428831 | doi = 10.1111/j.1475-1313.2011.00873.x }}</ref><ref>{{cite journal | vauthors = Levi DM | title = Prentice award lecture 2011: removing the brakes on plasticity in the amblyopic brain | journal = Optometry and Vision Science | volume = 89 | issue = 6 | pages = 827–38 | date = June 2012 | pmid = 22581119 | pmc = 3369432 | doi = 10.1097/OPX.0b013e318257a187 }}</ref>