Blind World


Amblyopia.
Optical workout improves girl's vision.





March 31, 2004.

By Mary Le Arneal,
Tribune Correspondent.




Jeff and Rochelle Meyer thought they had the perfect child in Mackenzie.


Healthy, bright and bubbly, everything seemed to be perfect.


But at her kindergarten physical a problem arose - not earth shattering - but a problem that the Meyers had not foreseen. It changed their outlook and made them appreciate their health. Mackenzie was diagnosed with amblyopia, an underdevelopment in her right eye without structural change in the eye.


The Fremont family had seen no indication that their daughter had any vision problems.


"Her eyes never wandered," Rochelle said. "In pictures both eyes appeared to look straight ahead. But in thinking back, we realized that if she ever had to do something with one eye, say look in a camera, she always used her left eye."


The Meyers ended up at the office of Dr. Sebastian Troia, a pediatric ophthalmologist in Omaha, where they were educated on amblyopia and its treatment for their daughter.


"When we started treatment, she was 20/200 in her right eye," Rochelle said, "which means she was blind in that eye."


Mackenzie wore a patch over her left eye forcing her to use, and strengthen her right eye, from May 8 until July 16 last summer. The patch fit over her glasses and was worn for all except two of her waking hours.


It is important that parents protect their children's vision by being aware of amblyopia and having their vision checked at an early age.


Two to three percent of children under age 6 have some form of amblyopia. In amblyopia, the image delivered to the back of the retina is different with each eye. One eye sends a sharp picture, the other eye, the amblyopic eye, sends a blurred image to the brain. The images produced by the two eyes are different enough that the brain is not able to fuse the images as it would in properly developed eyes for a sharp picture. Instead of seeing two images, double vision, the brain suppresses the blurred image. This leads to amblyopia, with the eye sending the blurry image growing weak from not being used, not "doing its job," hence the common term "lazy eye."


There can be a number of causes of amblyopia. Strabismus or crossed-eye is a common cause, and one that is visible as the eyes are looking in two directions. Anisometropia, or unequal refractive states between the two eyes, meaning one eye may be nearsighted and the other farsighted, is another cause. Cataracts, drooping eyelids, nutrition and heredity also may play a part in a child being amblyopic. For Mackenzie, anisometropia resulted in her amblyopia.


Troia showed the Meyers in a special test that a light shining into Mackenzie's right eye hit the back of the eye. Meyer said that in the right eye, it was like the light hit a wall; it didn't seem to penetrate the eye at all.


"That test showed us that the vision is going all the way through to the brain in her good eye, and in the amblyopic eye, the light was going no where," she said.


With the patching of her left eye, Mackenzie was forced to use her right eye. Her mother said the Band-Aid patch irritated her skin. With the dark lens on the glasses, Mackenzie would look over and around the lens. They found cloth patches that fit over the front and side of her glasses. Looking on the Internet, Meyer found a mother in Iowa who made these patches (www.PatchPals) with special decorations for young amblyopic patient.


"The first month it was really hard for her," Meyer said. "My baby sitter, Phyllis Holt, did a tremendous job working with Mackenzie, too. A lot of the credit goes to her."


Mackenzie would misjudge distance and had a hard time watching television. At first, her spirits dampened, but eventually Mackenzie even was able to teach herself to ride her bicycle during her "patching" time.


Then there were the comments of other children.


"One time we were walking into a store," Meyer remembers, "and this little boy said 'Look at her! She has a stupid looking patch on.' I just flared. But I looked at Mackenzie and thought she either didn't hear him or was blowing him off. I thought 'I'll do the same!'"


The Meyers went to visit Dr. Troia at five-week intervals. At her second visit in June, her right eye already was improved to 20/50 with her glasses; in July it registered 20/30 with 20/20 being perfect vision.


"Dr. Troia said he had not seen someone bounce back that fast from doing the patch," Meyer said. "He thought we'd have the patch on for five to six months."


Once the Linden School kindergartner got the eye working, she obtained 20/30 vision with her glasses.


"She will always have to wear glasses," Meyer said. "When she gets older, she may be able to see with just one contact in the right eye."


The Meyers do not know what caused Mackenzie's amblyopic eye, though both parents had vision problems when they were young.


If the Meyers had waited until Mackenzie was older, they might not have been able to correct her vision. If she had ever been injured in her left eye - her good eye - and had to rely on her right eye, Mackenzie would have been blind. The Meyers already have decided that they will get Mackenzie goggles if she decides to be active in sports.


"We are real fortunate that we caught it early," Meyer said. "We're proud of Mackenzie that she is 20/30."



Copyright 2004 Fremont Tribune




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