Amblyopia

What is Amblyopia?

Amblyopia, or lazy eye, occurs when one eye becomes weaker than the other during infancy or childhood. The brain favors the better eye, allowing the weaker eye to get worse over time. Early screening is important because treatment is more effective when started on time. Treatments include eye covering or glasses.

How does amblyopia affect my child?

In a child with amblyopia, one eye has blurred vision, and the other has clear vision. The brain begins to ignore the blurry eye and uses only the eye with clear vision. Eventually, the brain learns to rely on the strongest eye, allowing the weaker eye to worsen.

Who is at risk of amblyopia?

Some children may have risk factors for amblyopia, including:

Family history of eye problems
Developmental disabilities
Born early (premature birth)
Small at birth

How common is amblyopia?

Amblyopia is the most common cause of vision loss in children, affecting 2% to 4% of children through the age of 15 years. It can occur even if a child has no noticeable problems. But it can cause permanent problems if not detected and treated during childhood. Early, regular eye examinations are important.

What causes amblyopia?

Amblyopia occurs when there is a major difference between the two eyes in their ability to focus. The most common cause of amblyopia is other vision problems. It is important to treat these other conditions, or the brain starts relying on the eye with better vision, leading to amblyopia.

What eye conditionsmay lead to amblyopia?

Conditions that may lead to amblyopia include:

Refractive errors: These situations affect how light passes through the eye.

Myopia, difficulty seeing far away.
Hypermetropia, trouble seeing up close.
Astigmatism, a curved cornea.

Strabismus (crossed eyes): The eyes are meant to move together as a pair, but sometimes they don’t; if one drifts (inside, out, up or down), the brain can rely on one eye over the other, leading to amblyopia.

Structural problems: Sometimes, the eye has a structural problem that can lead to amblyopia, including:

Cataracts, which causes cloudiness in the lens and blurry vision
Droopy eyelid
Cornea scar

What are the symptoms of amblyopia (lazy eye)?

Amblyopia is not always obvious. The condition is often not detected until a child undergoes an eye examination. So, every child should undergo an early, regular vision check-up.

You may notice symptoms. A child with amblyopia may:

Bump into things on a particular side a lot
Experience a large difference in near sightedness or far sightedness between the two eyes.
Favor one side of the body.
Have crossed eyes.
Have a droopy eyelid.
Shut one eye or squint a lot.
Frequently tilt their head to one side.

When should amblyopia be diagnosed?

Early diagnosis increases the chances of a full recovery. Athens EyeCare Clinic recommends that children undergo a thorough vision test before the age of 6 months and again before the age of 3 years.

What tests can diagnose amblyopia?

A pediatrician, school vision program, an optometrist or ophthalmologist can check a child’s vision for amblyopia.

The screener may:

Put drops in the eye to make the pupil bigger
Shine a light in each eye
Cover one eye at a time and test whether each eye can follow a moving object
Ask older children to read letters on a chart on the other side of the room

What are the treatments for amblyopia?

Amblyopia treatment is much more effective if it starts early, while the connections between the eyes and brain are still developing. Strategies focus on making the child’s brain use the weaker eye. Options include:

Eye patches for kids: Your child may wear a patch over the better eye for at least a few hours per day. This effective treatment can last months or even years. The patch forces the brain to use the images from the weaker eye, eventually making that eye stronger.
Glasses: Eye glasses are also a common lazy eye treatment. They can help amblyopia by improving near sightedness, far sightedness and eye crossing.
Eye drops: For mild cases, your provider may recommend eye drops (atropine) to temporarily blur vision in the better eye. The goal is the same as a patch: to force the brain to use the weaker eye.
Surgery: An operation for amblyopia is rare. Your paediatric Ophthalmologist may suggest surgery to fix certain causes of amblyopia, such as cataracts.

Can I prevent amblyopia?

You cannot prevent amblyopia or other vision problems that may cause it. But you can stop it from getting worse or causing permanent problems. The best way to prevent vision loss from amblyopia is to get regular eye examinations. Make sure your child has a thorough eye examination by the age of 6 months and then again by 3 years.

What is the outlook for people with amblyopia?

With early diagnosis and treatment, children with amblyopia can significantly improve their vision. The goal of treatment is to improve vision as much as possible, though it may not lead to perfect sight, especially in severe cases.

Amblyopia does not go away on its own. If left untreated, it can cause permanent loss of vision and a “wonky eye” that always looks in another direction.

How can I best take care of my child with amblyopia?

You can take several steps to help your child with lazy eye:

Eye care: Your child should have regular eye examinations, one by 6 months old and another by 3 years old. And go to all follow-up eye appointments.
Stick with treatment: Encourage your child to wear eyeglasses or patch, even though they may not want to. Try to offer rewards and explain why it is so important.
Encourage your child to actively use the lazy eye when wearing glasses or the overlay. Read or make puzzles together.

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