There are three keys to controlling the risk of amblyopia in premature infants: tracking ROP before 1 year old, the first vision examination at 3 years old, and the golden period of amblyopia treatment between 3 and 6 years old.
According to the demographic data of the Ministry of Interior, there were 135,571 newborns in 2023, a new low, but the proportion of premature babies is on the rise. Taiwan Health Promotion Administration data shows that 1 in every 10 newborns in Taiwan is Premature infants; In addition, the prevalence rate of amblyopia among kindergarten children in Taiwan is 5.33%, which means that at least 5 out of 100 children have amblyopia. With reference to the above data, how to detect and treat amblyopia in premature infants early is an issue that parents must pay special attention to.
Premature infants have a higher rate of developing retinopathy, and the rates of amblyopia, strabismus and refractive error are slightly higher than those of ordinary children. In order to prevent the vision condition from affecting the child’s life, neonatologists will ask an ophthalmologist to take care of premature babies whose gestation weeks are less than 32 weeks and whose birth weight is less than 1500 grams. They will usually follow up until 1 year old to take care of the child’s soul as early as possible. Window. In addition, ophthalmologists remind parents that children must see an ophthalmologist for their first vision examination when they are 3 years old. If amblyopia is found, the golden treatment period between 3 and 6 years old can effectively treat children’s amblyopia.
Chen Yixin, director of Xingxing Parent-Child Ophthalmology Clinic, pointed out that although premature babies are not equated with amblyopia, they are slightly more likely to have amblyopia than ordinary children. Because premature babies are born before their development is fully developed, they often face retinopathy of prematurity (Retinopathy of Prematurity). , referred to as ROP), if not treated in time, it may evolve into amblyopia or other eye abnormalities.
Causes and treatments of amblyopia
Amblyopia is the main cause of vision loss in children. It is often caused by the inability of the retina to receive clear images, resulting in the optic nerve being unable to receive appropriate stimulation to continue development. Amblyopia can be divided into the following 3 types:
Strabismic amblyopia: commonly known as “out of the window” or “cross-eyed”, it can be detected from the appearance. Strabismus may cause amblyopia. Once parents discover that their children have misaligned eyes, they should take them to an ophthalmologist for diagnosis as soon as possible. If the ophthalmologist can promptly treat the child with surgery or surgery, correction can generally be completed.
Refractive amblyopia: congenital “high hyperopia”, “high astigmatism” or “high myopia”. These eye structure abnormalities cause children’s vision to fail to develop normally and become amblyopia; “excessive parallax” can also lead to over-reliance on vision. If one eye is good, only one side develops and the other eye becomes amblyopic. This kind of monocular amblyopia is difficult to detect. Refractive amblyopia is the most common cause of amblyopia. The treatment principle is to grasp the golden treatment period of 3-6 years old for refractive correction. The ophthalmologist will give the patient appropriate glasses to promote the stimulation and development of the optic nerve to achieve the effect of correcting vision. . Doctors emphasize that as long as the golden treatment period is grasped, continued wearing glasses, cooperating with tracking, and partially combined with eye patching treatment, most people can restore their vision to the same as that of ordinary children.
Other types of amblyopia: caused by neurological diseases of the eye. Although it is more difficult to treat, the incidence rate is relatively low.
Dr. Chen Yixin pointed out that amblyopia often runs in families, especially amblyopia caused by high farsightedness, high myopia and high astigmatism. If a child in the family has amblyopia, parents are reminded to bring other children to the eye examination.
What should I do if my child has amblyopia? Eye care for premature infants before 1 year old is key
For newborns whose gestation weeks are less than 32 weeks and whose birth weight is less than 1,500 grams, the neonatology department, in conjunction with ophthalmologists, can mostly receive proper care. Chen Yixin pointed out that neonatal retinopathy is generally discovered at birth and can be treated through cryotherapy, laser surgery and other methods.
Do newborns with ROP detected have a higher chance of amblyopia? The answer is “not necessarily.” Chen Yixin said that retinopathy of prematurity must be treated as early as possible. If not properly treated, it may cause vision problems in the future. The answer is not necessarily whether children without ROP will have vision problems in the future.
Chen Yixin pointed out that the signs of amblyopia are not easy to detect in life, and parents do not need to worry too much. Generally speaking, premature babies will be followed up by the ophthalmology department until they are 1 year old. If there are no other problems, parents will go to the ophthalmology department for the first time when the child is 3 years old. A single vision test is enough.
To check for amblyopia, do the first vision examination at the age of 3
The American Academy of Ophthalmology recommends that children have their first vision exam at age 3. Why “3 years old”? Because children’s vision has developed to a certain level by the age of 3, and their cognition has also reached a certain level, the vision test is more meaningful.
Chen Yixin explained that the visual acuity of children only reaches about 0.6 when they are 3 years old. The identification rate of visual acuity test at such a young age is low and may not be meaningful. In addition, 3 to 6 years old is a period of rapid vision development for children, and it is also the golden period for treatment. If problems are discovered at this stage, most of them can be cured if appropriate treatment is provided.
Amblyopia can be cured and the golden period of treatment is mastered between 3 and 6 years old
Many parents have myths and believe that wearing glasses at a young age is not good-looking. They hope to use acupuncture, massage or inter-vision energy therapy to try to improve amblyopia, or they hope to wait until they grow up to see if they can directly undergo surgery. …Chen Yixin pointed out that amblyopia is a problem of optic nerve development. In addition to costing money, folk treatments are also afraid of delaying the golden period of treatment, leading to irreparable regrets.
Chen Yixin also emphasized that amblyopia will not heal on its own as children grow up. Even if they want to wear contact lenses, plastic surgery, or laser myopia surgery in the future, the prerequisite must be that they do not have amblyopia. He emphasized that once amblyopia is discovered, first Don’t think about whether you can stop wearing glasses, but worry about delaying it until you can wear glasses. “The treatment of amblyopia is a race against time and is time-sensitive. If it is delayed until the golden period is missed, it will be difficult to treat.” Therefore, let the professional help as soon as possible. Doctors can check and track vision conditions so that children can protect the windows of their souls and lead a healthier life.
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