History of amblyopia

Abstract

Abstract Purpose Review the history of amblyopia. Methods Analysis of original and secondary contributions in the history of amblyopia. Results Traditionally amblyopia has been classified into different subgroups according to the major disorder which is responsible for its occurrence; accordingly, we distinguish among strabismic amblyopia, anisometropic amblyopia, isoametropic amblyopia and deprivation amblyopia. Since strabismus is the most visible disorder leading to amblyopia, the history of strabismus diagnosis can be roughly included in the history of amblyopia in the clinical context. It is known that Hippocrates described strabismus and differentiated it into comitant and non‐comitant. Later Paulus of Aegina and Ambroise Pare not only diagnosed the disorder, but also attempted to treat it. One of the first explanations of the amblyopia mechanisms was given by de la Hire who suggested that in strabismus the most sensitive part of the retina is eccentrically displaced to an abnormal position. This idea was later supported by Johannes Muller. The first treatment of amblyopia was attempted in 1743 by George L. de Buffon, who covered the better eye and suggested the use of glasses for the weaker eye. In the 1930s orthoptic programs were introduced and in the 1950s pleoptic techniques began to be used. Finally, the experiments carried out in the 1960s and 1970s by Hubel and Weisel suggested that the neural basis for amblyopia was related to a massive reduction in the binocular neurons and a shift in the ocular dominance of neural activity towards the unaffected eye. Conclusion Although our present understanding of the underlying mechanisms of amblyopia is much greater, our treatment methods are still rooted in history.