抓住弱视的“病根”

 If we want to understand the true cause of amblyopia and the most effective treatment then it is essential to understand the concept of binocular competition. What does that mean? To explain it in a simple and illustrative way, allow me to use another analogy. Imagine that the two eyes are twin brothers and their mother is in the visual cortex of the brain.

要了解引起弱视的真正原因,并找到最有效的治疗方法,就必须先了解双眼竞争这个概念。双眼竞争是什么意思呢?为了简单、形象地解释双眼竞争,我用一个类比,方便大家理解。将两只眼睛,想象成双胞胎兄弟,他们的妈妈,在大脑视觉皮层。

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16. Mother and twins representing the brain and two eyes.

16 妈妈和双胞胎兄弟,代表大脑和双眼。

 

The brothers both want to talk to their mother. In a normal and well-functioning visual system, there is good communication between the three; sometimes one brother will speak while the other listens, and vice versa. When the brother work in this coordinated manner the mother has the easiest time receiving the information.

兄弟二人都想和妈妈说话。视觉系统功能正常运行时,三者之间沟通良好;当哥哥跟妈妈说话时,弟弟在一旁听,就这样轮流和妈妈说话。当兄弟两人相互配合时,妈妈很容易接收到所有信息。

 

Let’s see how the normal process of binocular competition gets distorted, thus producing an amblyopic eye. When the process gets distorted, the better seeing eye will behave like a bully and the amblyopic eye as the less assertive brother. Whenever the less assertive brother wants to talk to mom, the bully will cover the less assertive brother’s mouth preventing him from speaking to her.

然而,双眼竞争,扰乱了运行良好的视觉系统,因此导致弱视眼。当视觉处理的进程被扰乱后,较好的那只眼,就像恶霸哥哥,弱视眼就像是弱小的弟弟。每当弱小的弟弟想和妈妈说话时,霸道哥哥就会阻止弱小弟弟和妈妈说话。

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17. The bully represents the good eye and the less assertive brother represents the amblyopic eye.

17 霸道哥哥代表好眼,不够自信的弟弟代表弱视眼。

 

Over time the less assertive brother gets less and less assertive, so that eventually he loses the desire and ability to speak to the mother. After a while, the only one doing the talking is the bully. This process of abnormal binocular competition or bullying is called active suppression.

随着时间的推移,弱小的弟弟就越来越弱,最终他再不愿意和妈妈说话,甚至失去了和妈妈说话的能力。经过一段时间后,就只有霸道哥哥和妈妈说话了。这种非正常的双眼竞争过程,我们称为主动抑制

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18. The “amblyopic eye” loses the desire to speak to the mother.

18“弱视眼不愿意再和妈妈说话。

 

During treatment, if you want the less assertive brother to be able to communicate with mom, first you must put the bully in a different room so that the bully cannot cover his brother’s mouth he tries to speak.

在治疗过程中,为了让弱小的弟弟和妈妈沟通交流,首先要把霸道哥哥关在另一个房间里,这样霸道哥哥就阻止不了弟弟和妈妈说话。

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19. The “bully” being sent to a different room to reduce the binocular competition.

19 霸道哥哥被关到另一个的房间,减少双眼竞争。

 

This is effectively what happens when you put an eye patch on the good eye. What happens when the bully re-enters the room (i.e., when we remove the patch)? The bully will make use of its strength and superiority and will once again cover the mouth of his brother! This is why only patching is not the most effective treatment, and the gains made during patching are lost after the patch is removed.

眼罩遮盖好眼是有效的。当霸道哥哥回到房间后(即不遮盖的时候),会出现什么情况呢?霸道哥哥会再次欺负弱小的弟弟!所以停止遮盖后,之前遮盖取得的治疗效果也会消失。所以说单纯遮盖,不是最有效的治疗方法。