Amblyopia

[Anali]

I don't know quite if I would classify this as a question or a comment but it is something that makes me angry.  For the most part, do most doctors assume we are something akin to blind in our Amblyopic eye?

In the first place, why is the big E on that chart 20 feet away considered the only criteria about how well we can see?  There are thousands of things in my world besides the eye chart I can see with my Amblyopic eye.  A few weeks ago, some woman at the Social Security office told me I don't qualify as having a visual impairment disability if I could still see her sitting across from me.  Well, I could see her even with my bad Amblyopic eye, so according to her, I would not be visually impaired enough even if my vision were limited to how I see in my bad eye.

Okay, I have digressed from the real issue at hand.  I was at least about 59 to 60 when I got my last pair of glasses.  This is the Optometrist who hardly even realized I had cataracts, so he surely would not have realized how I need my glasses made if I hadn't brought this issue to his attention:

I was one day using my Amblyopic eye to see through the lens for my good eye on my last pair of glasses.  I realized that as bad as my "bad" eye might be, this STILL improved my Amblyopic Vision, I would say, at least maybe a whole diopter more if not better!  So I asked to have both of my lenses made equally!

Investigating this whole issue further, I discovered, probably for the whole of my life, that the doctors were opting out of truly figuring out my vision for my Amblyopic eye and giving me what they call a 'BALANCE LENS."  The implication here is that my left eye is totally useless so what I apparently need is a fake lens!!!

I guess this would be my question:  Do doctors and optometrists assume something akin to near-blindness in Amblyopic eyes to the extent they just think you need a fake lens for cosmetic reasons?

Here is the scary thing:  Extending this phenomenon to the reality of cataract surgeries -- could we Amblyopics end up with that balance lens mentality even into our cataract surgery?  Mfaybe not if we bother to say something, but STILL I should hope that this gets more attention than it does for the way glasses are made -- and especially for cataract surgeries!!!  What do you all think, Dr. Hagan and everybody?

[John C Hagan III, MD, FACS, FAAO]

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[Emma879]

Thank you for getting back to me and I too hope that the vision gets stronger for you.

And agreed what vision we do have is a blessing compared to others.

It is interesting to know the Amblyopic eye can improve if the good eye is lost.

I do not have an eye disease but am closely monitored but I do have an amblyopic eye and at only 31 I started to worry a bit more.

Thanks again
Emma

[berrywoo]

Hi Emma,

I don't mind your questions, but bear with me, this will probably be a lengthy answer as my situation is a bit complex. The answer to your questions is that the vision in my left eye, or what was once the "good" eye, significantly deteriorated due to complex retinal detachment. The right eye (before it too started suffering problems) was within a short period, able to see better.



October 2006 refraction: BCVA (best corrected visual acuity): O.D. (right eye) 20/200, O.S. (left eye) 20/50

Feb. 2007 (inital diagnosis of rhegmatogenous retinal detachment, O.S.): BCVA  O.D. 20/100, O.S. hand motion

Oct. 2007: BCVA O.D. 20/80 +2 on the 20/70 line, O.S. same as feb. 07

Now, my vision in the right eye hovers around 20/80 - 20/70. Although, it may seem unchanged since Oct. 2007, my vision now is NOT the same as two years ago, it is quite different, as there has been a loss in contrast sensitivity and peripheral vision. However, I know that if it were not for repeated surgeries on the eye it would have improved even more, because for a brief time between surgery number 2 and 3 the vision was correctable to 20/60. My current doctor hopes that the vision in the right eye will continue to improve and strength. I too hope it will improve, but after so many surgeries, I'm just grateful for any vision I've got.

Again, sorry for the long post and if you want the full story check out my old posts as it's buried somewhere in these message boards.

Take Care.

[Emma879]

Hi,

I was very interested to read this post - sorry to hear you lost your sight in your good eye but amazing how the bad eye improved so much thats good news for you.

I too have an amblyopic eye which is 20/100 my left eye and worry if I was left with only this vision how I would cope but you give me hope.

If you dont mind me asking how did you lose your sight in your good eye and how long was it before your bad eye got better?

Thanks
Emma

[John C Hagan III, MD, FACS, FAAO]

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[berrywoo]

Good doctors would not assume that an amblyopic eye is legally blind, b/c in some cases it may not be. That is in part why each eye is refracted separately. Also, there are low vision eye charts that can be used to measure visual acuity if the standard Snellen chart isn't adequate. Although if the big E cannot be read w/ correction most doctors just go to counting fingers at certain distances, or if that fails hand motion, and lastly light perception (this is b/c many doctors offices don't have a readily available low vision chart).

I was never given "balance" lenses. When I was younger, you could definitely see the big difference in refractive error as lens thickness varied greatly between the eyes. This difference was less apparent when I started wearing glasses w/ polycarbonate lenses.  
Although now, in my current visual state, it may not be such a bad idea to have "balanced lenses". When the time comes for me to get a real refraction, this is something I plan on discussing with my doctor.

Something you might find interesting, is that if you should lose your "good" eye the vision in your "bad" eye may improve significantly b/c it is actually being used. I found this to be the case much to my own surprise. My previously "bad' eye was 20/200, but after the loss of the "good eye" the vision improved to 20/70 with no change in rx. (Currently, working on trying to get that level of vision back)

[John C Hagan III, MD, FACS, FAAO]

I can't begin to answer that question.
JCH MD