Amblyopia (Lazy Eye)

What is amblyopia?
Amblyopia, also known as “lazy eye,” is reduced vision in an eye that has not received adequate use due to lack of proper eyesight during early childhood.

What causes amblyopia?
All babies are born with poor eyesight. As babies grow, their eyesight gets better. Good eyesight needs a clear, focused image that is the same in both eyes. If the image isn’t clear in one eye, or if the image isn’t the same in both eyes, the vision pathways won’t develop right. In fact, the pathways may actually get worse.

Anything that happens to blur the vision or cause the eyes to be crossed during childhood may cause amblyopia. For example, the image might be different in both eyes if the child has strabismus. Strabismus (also called “crossed eyes”) causes the eyes to not focus the same. Children who need glasses to see better, or have cataracts, a droopy eyelid, or crossed or wandering eyes may also get amblyopia. About 5% of children have amblyopia.

Can anything be done to treat amblyopia and prevent vision loss?
With early diagnosis and treatment, the sight in the “lazy eye” can be restored.

Because there are several causes of amblyopia, the treatment must match the problem. Glasses or contact lenses fix some problems. Surgery may be needed for cataracts, droopy eyelids or crossed eyes. After the cause of the amblyopia is found, the child will need to use the weaker eye most of the time, so it will get stronger. To make the child use the weaker eye, a patch can be put over the stronger eye. Sometimes, eye drops or special glasses are used to blur the vision in the stronger eye. This makes the weaker eye become stronger. Patches may be used all day or part of the day, depending on the child’s age and vision.

The treatment usually lasts until vision is normal, or until vision stops getting better. For most children, this takes several weeks. A few children need to use eye patches until they are 8 to 10 years old.

When should treatment for amblyopia begin?
The earlier the treatment, the better the opportunity to reverse the vision loss.

Why is early treatment important?
The first few years of life are the most important for the development of eyesight. After a child is 8 to 10, the brain’s vision system is complete. It can’t develop anymore. If the amblyopia hasn’t been treated by this age, the child will have poor vision for life. It may be difficult to fix it with glasses, patching or any other treatment.

There’s a small chance that using an eye patch for too long can hurt the strong eye. For this reason, children who are wearing eye patches should see their doctor often during the treatment.

What happens if amblyopia goes untreated?
If not treated early enough, an amblyopic eye may never develop good vision and may even become functionally blind.

How do I know whether my child has amblyopia (Lazy eye) or not
The best way to be sure is to have a complete eye examination of the child twice every year. To do a complete examination, the doctor may ask you to put some eye drops or ointment which usually blurs the vision for a few hours in adults and older children or a few days in younger children. Hence the best time to do this is during the summer and winter vacations.

How soon can I start this process if my child is very young?
An eye specialist can examine and assess the visual status of a child even at the age of a few days after birth. You don’t have to wait for the child to learn alphabets to be examined. In fact the first three years of life are the most important for development of vision and should be monitored carefully.

What if my child is older than 10 years and I suspect a Lazy eye condition?
Although older children have been demonstrated to be less responsive to amblyopia treatment, those treated still have a better vision than those not treated.


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