Amblyopia in the context of Astigmatism

Far-sightedness, also known as long-sightedness, hypermetropia, and hyperopia, is a condition of the eye where distant objects are seen clearly but near objects appear blurred. This blur is due to incoming light being focused behind, instead of on, the retina due to insufficient accommodation by the lens. Minor hypermetropia in young patients is usually corrected by their accommodation, without any defects in vision. But, due to this accommodative effort for distant vision, people may complain of eye strain during prolonged reading. If the hypermetropia is high, there will be defective vision for both distance and near. People may also experience accommodative dysfunction, binocular dysfunction, amblyopia, and strabismus. Newborns are almost invariably hypermetropic, but it gradually decreases as the newborn gets older.

There are many causes for this condition. It may occur when the axial length of eyeball is too short or if the lens or cornea is flatter than normal. Changes in refractive index of lens, alterations in position of the lens or absence of lens are the other main causes. Risk factors include a family history of the condition, diabetes, certain medications, and tumors around the eye. It is a type of refractive error. Diagnosis is based on an eye exam.

Astigmatism is a type of refractive error due to rotational asymmetry in the eye's refractive power. The lens and cornea of an eye without astigmatism are nearly spherical, with only a single radius of curvature, and any refractive errors present can be corrected with simple glasses. In an eye with astigmatism, either the lens or the cornea is slightly egg-shaped, with higher curvature in one direction than the other. This gives distorted or blurred vision at any distance and requires corrective lenses that apply different optical powers at different rotational angles. Astigmatism can lead to symptoms that include eyestrain, headaches, and trouble driving at night. Astigmatism often is present at birth, but can change or develop later in life. If it occurs in early life and is left untreated, it may result in amblyopia.

The cause of astigmatism is unclear, although it is believed to be partly related to genetic factors. The underlying mechanism involves an irregular curvature of the cornea and protective reaction changes in the lens of the eye, called lens astigmatism, that has the same mechanism as spasm of accommodation. Diagnosis is by an eye examination called autorefractor keratometry (objective, allows to see lens and cornea components of astigmatism) and subjective refraction.

A monocular is a compact refracting telescope used to magnify images of distant objects, typically using an optical prism to ensure an erect image, instead of using relay lenses like most telescopic sights. The volume and weight of a monocular are typically less than half of a pair of binoculars with similar optical properties, making it more portable and also less expensive. This is because binoculars are essentially a pair of monoculars packed together — one for each eye. As a result, monoculars only produce two-dimensional images, while binoculars can use two parallaxed images (each for one eye) to produce binocular vision, which allows stereopsis and depth perception.

Monoculars are ideally suited to those applications where three-dimensional perception is not needed, or where compactness and low weight are important (e.g. hiking). Monoculars are also sometimes preferred where difficulties occur using both eyes through binoculars due to significant eyesight variation (e.g. strabismus, anisometropia or astigmatism) or unilateral visual impairment (due to amblyopia, cataract or corneal ulceration).

Blurred vision is an ocular symptom where vision becomes less precise and there is added difficulty to resolve fine details.

Temporary blurred vision may involve dry eyes, eye infections, alcohol poisoning, hypoglycemia, or low blood pressure. Other medical conditions may include refractive errors such as myopia, high hypermetropia, and astigmatism, amblyopia, presbyopia, pseudomyopia, diabetes, cataract, pernicious anemia, vitamin B₁₂ deficiency, thiamine deficiency, glaucoma, retinopathy, hypervitaminosis A, migraine, sjögren's syndrome, floater, macular degeneration, and can be a sign of stroke or brain tumor.

Strabismus is an eye disorder in which the eyes do not properly align with each other when looking at an object. The eye that is pointed at an object can alternate. The condition may be present occasionally or constantly. If present during a large part of childhood, it may result in amblyopia ("lazy eyes") and loss of depth perception. If onset is during adulthood, it is more likely to result in double vision.

Strabismus can occur out of muscle dysfunction (e.g., myasthenia gravis), farsightedness, problems in the brain, trauma, or infections. Risk factors include premature birth, cerebral palsy, and a family history of the condition. Types include esotropia, where the eyes are crossed ("cross eyed"); exotropia, where the eyes diverge ("lazy eyed" or "wall eyed"); and hypertropia or hypotropia, where they are vertically misaligned. They can also be classified by whether the problem is present in all directions a person looks (comitant) or varies by direction (incomitant). Another condition that produces similar symptoms is a cranial nerve disease. Diagnosis may be made by observing the light reflecting from the person's eyes and finding that it is not centered on the pupil. This is known as the Hirschberg reflex test.

Orthoptics is a profession allied to the eye care profession. Orthoptists are the experts in diagnosing and treating defects in eye movements and problems with how the eyes work together, called binocular vision. These can be caused by issues with the muscles around the eyes or defects in the nerves enabling the brain to communicate with the eyes. Orthoptists are responsible for the diagnosis and non-surgical management of strabismus (cross-eyed), amblyopia (lazy eye) and eye movement disorders. The word orthoptics comes from the Greek words ὀρθός orthos, "straight" and ὀπτικός optikοs, "relating to sight" and much of the practice of orthoptists concerns disorders of binocular vision and defects of eye movement. Orthoptists are trained professionals who specialize in orthoptic treatment, such as eye patches, eye exercises, prisms or glasses. They commonly work with paediatric patients and also adult patients with neurological conditions such as stroke, brain tumours or multiple sclerosis. With specific training, in some countries orthoptists may be involved in monitoring of some forms of eye disease, such as glaucoma, cataract screening and diabetic retinopathy.

Atropine is a tropane alkaloid and anticholinergic medication used to treat certain types of nerve agent and pesticide poisonings as well as some types of slow heart rate, and to decrease saliva production during surgery. It is typically given intravenously or by injection into a muscle. Eye drops are also available which are used to treat uveitis and early amblyopia. The intravenous solution usually begins working within a minute and lasts half an hour to an hour. Large doses may be required to treat some poisonings.

Common side effects include dry mouth, abnormally large pupils, urinary retention, constipation, and a fast heart rate. It should generally not be used in people with closed-angle glaucoma. While there is no evidence that its use during pregnancy causes birth defects, this has not been well studied so sound clinical judgment should be used. It is likely safe during breastfeeding. It is an antimuscarinic (a type of anticholinergic) that works by inhibiting the parasympathetic nervous system.

Anisometropia is a condition in which a person's eyes have substantially differing refractive power. Generally, a difference in power of one diopter (1D) is the threshold for diagnosis of the condition. Patients may have up to 3 diopters of anisometropia before the condition becomes clinically significant due to headache, eye strain, double vision or photophobia.

In certain types of anisometropia, the visual cortex of the brain cannot process images from both eyes simultaneously (binocular summation), but will instead suppress the central vision of one of the eyes. If this occurs too often during the first 10 years of life, while the visual cortex is developing, it can result in amblyopia, a condition where, even when correcting the refractive error properly, the person's vision in the affected eye may still not be fully correctable to 20/20.

An eyepatch is a small patch that is worn in front of one eye. It may be a cloth patch attached around the head by an elastic band or by a string, an adhesive bandage, or a plastic device which is clipped to a pair of glasses. It is often worn by people to cover a lost, infected, or injured eye, but it also has a therapeutic use in children for the treatment of amblyopia. Eyepatches used to block light while sleeping are referred to as a sleep mask.

An eyepad or eye pad is a soft medical dressing that can be applied over an eye to protect it. It is not necessarily the same as an eyepatch.

Esotropia (aka ET) (from Greek eso 'inward' and trope 'a turning') is a form of strabismus in which one or both eyes turn inward. The condition can be constantly present, or occur intermittently, and can give the affected individual a "cross-eyed" appearance. It is the opposite of exotropia and usually involves more severe axis deviation than esophoria. Esotropia is sometimes erroneously called "lazy eye", which describes the condition of amblyopia; a reduction in vision of one or both eyes that is not the result of any pathology of the eye and cannot be resolved by the use of corrective lenses. Amblyopia can, however, arise as a result of esotropia occurring in childhood: In order to relieve symptoms of diplopia or double vision, the child's brain will ignore or "suppress" the image from the esotropic eye, which when allowed to continue untreated will lead to the development of amblyopia. Treatment options for esotropia include glasses to correct refractive errors (see accommodative esotropia below), the use of prisms, orthoptic exercises, or eye muscle surgery.