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Diagnosed With Anisometropia Of Amblyopia. What Treatment Should Be Done?

Posted on Thu, 20 Dec 2012

Question: My 14 yr old daughter from India (who does not wear glass) has been diagonised with 6/36 (corrected to 6/12p with glass) sight in right eye and 6/6P in left eye. Her AR readings are +2.75/-4.75x10, +0.75x96 KM readings are 40.25/44.25, 4.50/42.25,
10 100 180 90
This is the first time it has been detected last week. One doctor say it is anisometropia (with chances of amblopia), another one said it is WTR astigmatism (after ruling out keratoconus after getting a reading of 37 on IVA ). I am looking for a place in India where it can be correctly diagonised and treated. Can you help?

Answered by Dr. Mihir Shah (1 hour later)

Dear,

Thanks for the query.

From what you have described, it is a case of anisometropia with amblyopia with astigmatism. Whichever way you describe it, the basic problem is that her right eye is weak and she will need to constantly wear glasses. Also occlusion therapy can be tried for the amblyopia but at this age it is very unlikely to benefit her.

Follow the treatment advised at AIIMS. Hope I have answered your query. I will be available to answer any furthur queries if you have any.

Best regards,
Dr.Mihir Shah

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mihir Shah (2 days later)

1. I am attaching scanned copy of the pentacam report which was meant to test for keratoconus. The doctor (not at AIIMS) said that though the IVA reading for right eye is 37, it is not a case of keratoconus. My request is if you too can take a look at the pentacam report and conclude.

2. She has been provided the specs today after testing. It reads as:
SPH CYL AXIS VIA
RE +2.25 -3.00* 180 6/10P
LE Plain --- --- 6/6
ADD ---- --- --- ---
* The doctor said that the actual power is minus 3.5, but she is providing glass of minus 3.00 to begin with

What is the possibility of the power in her right eye increasing further. Also, I read that certain video games can reportedly improve amblyopia. Do you have any information about them?
P.S. - She is visiting the AIIMS specialist doctor of amblyopia on 1st Dec at 9 AM. Are there any specific things I should ask him?

Answered by Dr. Mihir Shah (53 minutes later)

Thanks for writing back.

Pentacam report is not suggestive of keratoconus.

Her power is unlikely to change any furthur.

The amblyopia therapist will advise occlusion therapy (occlusion of left eye so that right eye is forced to work more) about 6 hours per day. While doing occlusion therapy, encourage her to do any kind of near work (like reading, playing video games). Again as I already mentioned, at age 14, amblyopia therapy is not going to benefit her much.

I hope I have answered your query.

Best regards,
Dr.Mihir Shah

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar