Lazy Eye (Amblyopia)

Lazy eye or amblyopia is a condition in which eyesight in one eye is reduced due to developmental problems. This condition is seen in early childhood.

In most of the cases, lazy eye affects only one eye. In some rare cases, it may affect vision in both eyes.

The brain focuses on the healthy eye and ignores the images from the lazy eye. And when the lazy eye is not stimulated enough, the visual brain cells do not mature and function properly. This may lead to partial or complete loss of vision.

Treatment includes eye patches, contact lenses, glasses, and eye drops.

The most common symptoms of lazy eye (amblyopia) are:

• Strabismus or misaligned eyes
• Poor depth perception
• Decreased vision

Lazy eye may be related to an underlying condition like squint, where the weaker eye looks at a different direction when the healthy eye looks forward.

It may also be associated with childhood cataracts. The upper eyelid may drop over the eye and affect vision.

Symptoms are usually noticed in one eye, but in some rare cases lazy eye may be present in both eyes.

Lazy eye (amblyopia) can be caused by one of a number of different underlying conditions in the eye.

In the lazy eye, one eye has a better focus than the other. This may be due to conditions like astigmatism or farsightedness in one of the eye.

Thus, one of the eyes produces blurry images, which after a period of time is ignored by the brain. As the condition progresses, vision in the affected eye deteriorates considerably.

• Strabismus -- Strabismus or misalignment of the eye also result in lazy eye. In this condition, the eyes fail to focus together resulting in double vision. The brain compensates this condition by ignoring the images from the deviated eye. This affects vision in the affected eye.
• Ocular obstruction – obstruction of the eye due to conditions like cataract, droopy eyelid, and eyelid tumor prevent the formation of a clear image at the back of the eye. Thus, one of the eyes produces a blurry image which is ignored by the brain after a period of time. This leads to deterioration of vision in the affected eye.
• Unequal refractive error – when one eye is nearsighted, farsighted or astigmatic, the images produced by the other eye becomes dominant. This affects the vision of the affected eye.

Some of the risk factors for lazy eye are:

• Family history of strabismus
• Genetic disorders that affect eyes
• Strabismus
• Cataracts of childhood
• Droopy eyelid
• Eyelid tumor

Eye examination to assess eyes or vision of both eyes is the ideal method for diagnosis of lazy eye (amblyopia). If the child is too young for any other type of test, the red reflex test is recommended.

In this test, eyes are checked using a magnifying device, called ophthalmoscope. This helps to check out for cataracts.

In case of infants, tests are conducted to check the child’s power of fixing the gaze. Their ability to follow a moving object is also assessed. For older children, pictures and letters are used in testing vision.

Treatment options are based cause of lazy eye (amblyopia) and extent of vision loss. Prescription eyeglasses are recommended to treat nearsightedness, farsightedness, or astigmatism that cause lazy eye.

Eye patches help to stimulate the weaker eye. It is usually recommended for children older than four years. The patch is worn for 3-6 hours a day.

Eye patches help to improve the vision in the affected eye. Atropine eye drops when used in the stronger eye blurs the vision and force the brain to accept the image from the weaker eye.

Surgical repair is suggested for squint, droopy eyelids, and cataract.

Preventing the major reasons for the cause of lazy eye (amblyopia) is the best way to avoid lazy eye.

Be vigilant if:

• The child prefers one eye over the other
• Hits or bumps objects on one side
• Photographic red eye saw only one eye
• Pupil is cloudy
• Child has squint

A few alternative remedies exist for managing the symptoms of lazy eye (amblyopia).

A computer that stimulates specific changes in the child’s brain is used to improve vision.

Eye exercises are also used to stimulate and improve vision.

Acupuncture is suggested to reduce vision loss in some cases.

Lifestyle modifications are necessary for your child in order to cope with lazy eye (amblyopia).

The child with lazy eye need help to adjust the treatment methods.

Keeping them engaged in interesting activities will relate the treatment with a pleasant experience and make them compliant with its use. 

Partial or complete loss of vision is the major complication associated with the lazy eye (amblyopia).