Lazy eye (Amblyopia)

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What is amblyopia?

Lazy eye, medically referred to as amblyopia, stands as one of the prevalent eye disorders affecting children. It emerges when the vision in one or both eyes is compromised due to an abnormal visual experience early in life between the eye and the brain. The weaker eye receives a significantly poorer visual resolution compared to the better eye.

Eventually, the eyes’ ability to work together decreases, and the brain ignores visual input from the weaker eye leading to suppression or poorer visual acuity.

It’s essential to distinguish amblyopia from strabismus, commonly known as eye misalignment, as they are two different conditions which may coexist.

What Is The Risk Of Developing Lazy Eye?

Lazy eye, also known as amblyopia, affects around 2%–4% of the population. The likelihood of developing this condition is heightened under certain circumstances, particularly in children who:

  1. Are born prematurely
  2. have a significantly different eye power in both eyes
  3. have been diagnosed with a pathological eye condition

How is lazy eye diagnosed?

Lazy eye, or amblyopia, is diagnosed during paediatric eye exams by the ophthalmologist or the optometrist.

Lazy Eye Signs and Symptoms

  1. Misalignment of the Eyes (Strabismus)
  2. Poor Depth Perception and Peripheral Vision
  3. Repeated Eye Closure or Squinting
  4. Persistent Head Turn or Head Tilt

Check out this eye screening book by NeuroTree. This eye screening book allows parents and educators to screen children from the age of 3. It can be used in schools or at home.

Alternatively, inform your preschool and elementary schools about NeuroTree’s Champions of Good Vision Award for schools as NeuroTree provides a free community eye screening for children starting from 3 years old.

A workshop is also included to share how children’s myopia gets worse and how carelessness can be caused by weak visual skills.

Lazy Eye Treatment

To counter lazy eye (amblyopia), it’s vital to stimulate the nonworking eye. Early intervention is key to prevent permanence, but studies show older children can also benefit from treatment.

Vision Therapy

Vision therapy includes activities that stimulate the weaker eye to force the brain to rely more on the amblyopic eye.

The therapy may also involve eye-tracking exercises, focusing activities, and visual-motor integration tasks to improve coordination and teamwork between the eyes.

The goal is to strengthen the neural connections between the eyes and the brain, promoting more balanced and efficient visual processing.

It is often performed in conjunction with patching, specialised glasses or contact lens that can shift the visual dominance to the amblyopic eye.

 

 

Eye patch

Traditional treatment for lazy eye involves placing an eye patch on the stronger eye, redirecting the brain’s attention to the weaker eye for improved visual development.

What Causes Lazy Eyes?

Lazy eye, or amblyopia, stems from three distinct causes, each shedding light on the intricate factors influencing visual development in children:

Strabismus-induced Amblyopia:

Strabismic amblyopia occurs when the eyes are misaligned, prompting the brain to disregard signals from the deviated eye. 

This compensatory mechanism minimises the risk of double vision during crucial developmental stages. Consequently, the neglected eye undergoes a decline in visual acuity as the brain prioritizes signals from the straightened eye.

Refractive Amblyopia:

Refractive amblyopia occurs when poor visual development arises due to a significant difference in the refractive errors between the eyes. 

Despite having proper eye alignment, a child may present with significant nearsightedness, farsightedness, or astigmatism in one eye, while the other unaffected eye has no significant refractive error. 

In this scenario, the brain leans towards reliance on the unaffected eye, leading to the neglect and subsequent amblyopia in the eye with significant refractive error.

Deprivation Amblyopia:

Deprivation amblyopia results from an obstruction in a child’s vision, impeding the proper development of visual acuity. Potential culprits include a cloudy lens (cataract), a droopy eyelid (ptosis), or a corneal scar. 

In these cases, the hindered transmission of light to the eye impedes the eye’s ability to develop optimal visual acuity.

Understanding the distinct pathways to amblyopia—whether through misalignment, refractive disparities, or obstructed vision—provides valuable insights for early detection and intervention. 

Addressing these factors can significantly contribute to the prevention and management of lazy eye, ensuring optimal visual health for children.

Corrective lenses and glasses

Wearing corrected glasses or contact lenses helps to ensure that the amblyopic eye receives a clear and focused image, providing visual stimulation to promote the development of the visual system. This encourages the brain to recognize and process visual information from the weaker eye.

Atropine Eye Drops

Similar to the patch method, this treatment involves applying eye drops to the stronger eye, temporarily weakening its vision to enhance the connection with the weaker eye. 

The constant dilation of the stronger eye may cause light sensitivity and difficulty in seeing nearby objects, making it particularly effective for farsighted prescriptions.

Surgery

Strabismic amblyopia is often treated with strabismus surgery, followed by methods like eye patching, atropine eye drops, and eye exercises. 

Deprivation amblyopia may require surgical procedures such as cataract surgery or eyelid correction to address underlying issues and restore optimal vision.