Amblyopia or commonly known as lazy eyes, is a visual disorder that could develop right from infancy. The child’s vision is affected because there is reduced coordination between the brain’s visual processing function and the eye. Some children may not even notice the problems making diagnosis even more difficult. And if left unchecked, prolonged lazy eye disorder can permanently damage vision. With early diagnosis and prompt treatment, it is possible to manage the condition.

Common risk factors

Children who are born prematurely or experience developmental problems during their early years are at a high risk of developing a lazy eye. Further, a family history of close members having amblyopia increases the risk for the next generation. Other known causes include –

Conditions that obstruct vision

Developing a cataract that results in a cloudy lens, corneal scars, and droopy eyes are all vision obstructers. In such cases, people develop deprivation amblyopia due to the lack of proper visual activity. If diagnosed during infancy, immediate treatment should be done to avoid permanent loss of vision in one eye.

Changes in sharpness of vision

Children who experience nearsightedness, farsightedness, or may have an uneven surface curvature of the lens are at risk of developing refractive amblyopia. This is mainly caused due to a significant refractive error in one of the eyes. As the brain becomes more dependent on the good retina for vision, chances of developing lazy eyes become high for the other eye.

Misalignment or muscle imbalance

Sometimes, a minor imbalance in the muscle position is enough to trigger lazy eyes. This is one of the most common causes of strabismus amblyopia. To prevent double vision due to the eye-crossing in or turning out, the brain focuses on visual input from the other good eye.

One of the major complications linked to the lazy eye is permanent vision loss. Therefore, it becomes absolutely necessary to have a complete eye exam done for children between the ages of 3 and 5. This exam will be done on the basis of the following noticeable symptoms.

Common signs of a developing lazy eye

• Wandering eye problem that is noticeable either moving inward or outward
• Lack of coordination between both eyes is noticeable while focusing on objects
• Lowered ability to perceive depth
• An increasing problem with perceiving depth or double vision
• Repeatedly closing and squinting with one eye
• Persistent shaking of the eyes that indicates lack of muscle control

Diagnosing lazy eye

Eye exams should be done regularly for children between the ages of 6 months and three years old. This is the time period where the risk is high. Further, routine eye exams are recommended every two years between the ages of 6 to 18. It is necessary for children with a high risk due to family history or current vision problems.

A typical eye exam starts with identifying letters of different sizes on a chart. The ophthalmologist will also assess the eye’s ability to follow the light and will examine the same with a magnifying device. All these tests will be done to assess vision clarity, ability to focus, and muscle strength for diagnosis of amblyopia.

Treatment for lazy eyes

Amblyopia treatment varies depending on the severity of the symptoms. For some people, it could involve the use of a simple vision correction device. However, others may have to get surgery to address linked complications.

Vision correction

Doctors recommend the use of corrective glasses or contact lenses for addressing refractive amblyopia. These correction devices address nearsightedness, farsightedness, and astigmatism.

Using an eye patch

The brain draws visual input from the dominant eye when there are problems in the other eye. So, doctors place an eye patch over the good eye to refocus attention on the weaker visual cortex. This promotes better visual development as the brain adapts to see from the weaker eye and makes adjustments to focus and muscle control accordingly.

Eye drops

Doctors suggest the use of atropine eye drops that temporarily weaken vision in the good eye for those who don’t prefer to wear a patch. Similar to the eye patch, this action prompts the brain to collect visual data from the weaker eye and help improve visual reception. However, the treatment is mainly reserved for those with farsightedness (not being able to view distant objects).

Surgery for severe amblyopia

Surgery is a better option for patients who have poor eye muscle control leading to strabismus amblyopia. This is mainly done to address the problem of droopy eyelids. Some children with deprivation amblyopia can also consider surgical treatment. Surgery helps realign the eyes and improve focus in the long run. Post-surgery, there are multiple visual enhancement therapies that must be done for further recovery.