Amblyopia (Lazy Eye)

Amblyopia (commonly called lazy eye) is a condition that occurs when a child’s brain favors one eye over the other due to vision loss in the weaker eye. Over time, the brain is trained to ignore the visual signals from the lazy eye and stops communicating with the eye even if vision is corrected.

Amblyopia affects an estimated 6–10 million Americans and accounts for more vision loss in children than all other eye conditions combined.

Amblyopia is a degenerative condition that begins at birth because of inherited developmental problems. The earlier it is diagnosed, the better the child’s prognosis. In the past, optometrists didn’t think that amblyopia could be successfully treated in children over about eight years old. Recent studies, however, show signs of vision improvement from treatment in teens and even adults as well.

There are three main causes of lazy eye amongst our patients. Amblyopia’s effects remain the same regardless of the cause; however, each cause is considered its own distinct type of the condition.

• Strabismic amblyopia: This type of lazy eye is caused by a condition called strabismus, which occurs when the eyes are out of alignment. Typically, one eye is normal while the other turns in, out, up or down. Since the eyes can’t work together to send signals to your brain, the brain learns to ignore the transmissions from the abnormal eye.
• Deprivation amblyopia: Some conditions such as cataracts can deprive children from seeing well or at all. This can occur in one or both eyes. Without early detection, deprivation amblyopia often results in permanent severely or profoundly impaired vision.
• Refractive amblyopia: Substantial vision loss in one or both of an infant’s eyes can result in refractive amblyopia without early diagnosis. This type of lazy eye is the hardest to detect in young children because there are rarely outward signs. The effectiveness of treatment depends largely on when refractive amblyopia is diagnosed.

Along with these types of amblyopia, your condition can be described as unilateral (affecting one eye) or bilateral (affecting both eyes). Unilateral lazy eye is much more common.

Diagnosing and Treating Amblyopia

Parents should be aware of the signs and symptoms of lazy eye as well as the methods of diagnosing and treating the condition. Here are some key facts you need to know:

• Signs and symptoms of amblyopia include misaligned eyes, frustration when one eye is covered up and poor depth perception. Some forms of amblyopia don’t cause any detectable signs and symptoms and can only be discovered through a complete eye exam.
• All children should have their vision examined when they’re 3­–5 years old. If there are any problems with your child’s vision, it’s vital to identify them as soon as possible. After this point, a toddler’s lazy eye may not fully respond to treatment.
• Tests performed to detect amblyopia in young children include a red reflex test for cataracts, eye movement tests, photo screening and remote autorefraction.
• Refractive lazy eye can be treated with prescription glasses or contacts if the condition is mild or detected early.
• Amblyopia is usually treated by patching the “good eye” during waking hours for an extended period of time. This forces the bad eye to see and retrains the brain to accept its signals.
• Eye drops that temporarily impair vision in the good eye can be used for situations in which you don’t want to or can’t wear an eyepatch.
• In certain cases, you may have to undergo surgery for lazy eye. This occurs most often in cases of strabismic amblyopia when the eye’s muscles can’t keep the eye aligned. Surgery can also be used in cases of deprivation lazy eye if the condition is the result of malformed eyelids or cataracts.