With this condition, since the brain relies on one eye more heavily, it causes the other eye’s visual pathway through the brain not to develop properly. This affects around 3 out of 100 kids and is the most common cause of vision loss in children. Amblyopia also can cause problems or even visual impairment in adults if something happens to the better eye.
The risk associated with leaving amblyopia untreated include:
Problems with depth perceptionPotential for visual impairment in the lazy eyeChance of visual impairment if the stronger eye is injured
Fortunately, if caught early enough in age, there are treatments available to help. The idea is to first correct for any refractive issues such as nearsightedness, farsightedness, or astigmatism, which will require glasses-wearing or fixing anything that blocks light from getting into the eye, such as removing a congenital cataract or lifting a ptosis (lid droop).
After correcting vision as much as possible, current options for treating amblyopia include:
Patching the eye with better visionUsing special drops to blur vision in the stronger eye
Eye Patches or Drops
With eye drops, each morning parents can put a drop of the drug atropine in the child’s stronger eye. This medication temporarily interferes with the eyes’ near-focusing ability, forcing the brain to look for information from the lazy eye instead.
Many parents prefer this approach to simple patching since it avoids the possibility that the child may inadvertently interfere with treatment by pulling off the patch by themselves.
Research indicates that daily use of atropine is as helpful as traditional patching for many people. If patching is used, this can be done for as little as two hours per day. This was actually found to be as effective as wearing the patch for up to six hours. However, always follow your eye doctor’s prescribed directions.
Another study has shown that at least six months of treatment for those younger than age 7 with either patching for a minimum of six hours a day, or once-a-day use of atropine had similar outcomes.
It was then up to the investigators whether to continue the same treatment or to switch or to combine these. By age 15, most still retained good vision, with only mild amblyopia no matter which treatment was first tried.
Glasses
It’s not always clear why amblyopia occurs, but if one eye isn’t seeing as well as the other, this can be the reason. A condition such as nearsightedness with difficulty seeing things faraway or farsightedness with problems seeing up close, or even astigmatism, which causes blurry vision, can be the culprit here if this primarily affects one eye.
Blurry visionSensitivity to light
Meanwhile, with patching in addition to inconvenience there is more likely to be skin and lid irritation, as well as sensitivity of the white part of the eye.
If this is not picked up early in a child’s life, the brain will begin to look to the “good eye” for its visual information instead, weakening the other. Fortunately, use of prescription glasses can bring things into focus. But if the eye has already become “lazy,” the brain may still need to be retrained to begin to rely on these signals again.
Eye Surgery
While nonsurgical interventions tend to be the approaches most commonly used for treating amblyopia, there can be a role for some surgery as well. Surgical procedures can prevent lazy eye from developing in the first place and if caught early enough may reverse amblyopia, particularly in children under age 6. Surgical approaches include:
These approaches temporarily force the brain to rely on the weaker eye and giving this a chance to develop.
Eye muscle surgery: This can be done for strabismus in which one or both of the eyes wander due to uneven eye muscles. These muscles can be tightened or loosened to help realign the eyes. Cataract removal: If one of the eyes has a clouded lens, this can be removed and replaced with a clear one, offering vision that’s just as sharp as in the other eye. Otherwise, the eye is not able to supply the brain with the needed visual information and the proper connection does not develop here. Surgery to relieve eye pressure: Reducing a buildup of fluid in the brain that can cause eye muscle misalignment can also enable the eyes to work better together.
Eye Exercises
Eye training, also known as vision therapy, can also be used to strengthen the weaker eye. This can take the form of a visual therapy program in which a doctor uses special equipment such as lenses, prisms, filters, or blocking one eye to help force the “lazy eye” to do its share of the visual work.
Blurry visionNight vision issuesDry scratchy eyesGlare or problems with halos or starbursts around lightsSensitivity to lightPainRed spots in the white of the eyes
For young children exercises may include activities such as specialized coloring, making dot-to-dot pictures, or even building with blocks.
These days, the world of technology is also offering answers. By playing action video games, preferably with the better-seeing eye patched, vision in the lazy eye can be improved. After 20-hours of playing such games the amount of improvement is actually comparable to 100 hours of passive patching.
A Word From Verywell
There are several options for treating lazy eye, and parents should seek treatment for their children as soon as a problem is noted. But it is still possible to make improvements in a lazy eye despite age and to ultimately enjoy improvements in vision.
