• Is there any method of treatment for my son who has amblyopia, esotropia, and an inactive peripheral chorioretinal scar?


    Question:

    My son is three years old and was diagnosed with amblyopia and esotropia in his right eye, secondary to an inactive peripheral chorioretinal scar. The scar blocked the vision and my son was left with limited vision in his right eye. Is there any method of treatment and can improve the vision of this eye?


    Answer:

    Amblyopia is defined as decreased vision in an eye which is due to abnormal development of vision in infancy or childhood. It is also called "lazy eye." The most common causes of amblyopia are eye misalignment (when eyes are not straight and working together) and asymmetric prescription problems (different prescription powers in each eye). In infancy or early childhood, the eye is not stimulated visually because it is not straight or because it has a high uncorrected prescription problem. The brain turns off the eye, or suppresses the eye, and gradually the vision drops, and even with the proper eyeglasses correction the eye still cannot see normally. For your son, the eye crossing (or esotropia) is likely the cause of his amblyopia, and not the peripheral chorioretinal scar.

    A chorioretinal scar could lead to poor vision if the scar was in the center of the retina, in an area called the macula. However, your son’s scar is in the peripheral retina, and that should not lead to central vision loss. It would lead to some peripheral vision loss, but not central vision loss, and it should not lead to amblyopia. (Some peripheral scars will stretch the central retina and cause a fold in the central retina, and this situation could lead to permanent vision impairment).

    From the information I have, I feel it is likely that your son’s vision would improve with patching of the good eye, to make the brain stimulate the vision in the poorly sighted eye.

    The crossing of the eye, the esotropia, may need to be repaired surgically. This would not improve the vision, just the alignment. A pediatric ophthalmologist should be able to manage the situation for your son.


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