Lazy eye; Vision loss - amblyopia
Amblyopia is the loss of the ability to see clearly through one eye. It is also called "lazy eye." It is the most common cause of vision problems in children.
Amblyopia occurs when the nerve pathway from one eye to the brain does not develop during childhood. This problem develops because the abnormal eye sends a blurred image or the wrong image to the brain.
This confuses the brain, and the brain may learn to ignore the image from the weaker eye.
Strabismus (crossed eyes) is the most common cause of amblyopia. There is often a family history of this condition.
The term "lazy eye" refers to amblyopia, which often occurs along with strabismus. However, amblyopia can occur without strabismus. Also, people can have strabismus without amblyopia.
Other causes include:
Symptoms of the condition include:
- Eyes that turn in or out
- Eyes that do not appear to work together
- Inability to judge depth correctly
- Poor vision in one eye
Exams and Tests
In most cases, amblyopia can be detected with a complete eye exam. Special tests are not often needed.
The first step will be to correct any eye condition that is causing poor vision in the amblyopic eye (such as cataracts).
Children with a refractive error (nearsightedness, farsightedness, or astigmatism) will need glasses.
Next, a patch is placed on the normal eye. This forces the brain to recognize the image from the eye with amblyopia. Sometimes, drops are used to blur the vision of the normal eye instead of putting a patch on it. Newer techniques use computer technology, to show a slightly different image to each eye. Over time, the vision between the eyes becomes equalized.
Children whose vision will not fully recover, and those with only one good eye due to any disorder should wear glasses. These glasses should be shatter- and scratch-resistant.
Children who get treated before age 5 almost always recover vision that is close to normal. However, they may continue to have problems with depth perception.
Permanent vision problems may result if treatment is delayed. Children treated after age 10 can expect vision to recover only partially.
Complications may include:
- Eye muscle problems that may require several surgeries
- Permanent vision loss in the affected eye
When to Contact a Medical Professional
Call your health care provider or ophthalmologist if you suspect a vision problem in a young child.
Identifying and treating the problem early prevents children from having permanent visual loss. All children should have a complete eye exam at least once between ages 3 and 5.
Special methods are used to measure vision in a child who is too young to speak. Most eye care professionals can perform these techniques.
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Kraus CL, Culican SM. New advances in amblyopia therapy I: binocular therapies and pharmacologic augmentation. B J Ophthalmol. 2018 [Epub ahead of print] PMID: 29777043 www.ncbi.nlm.nih.gov/pubmed/29777043.
Olitsky SE, Hug D, Plummer LS, Stahl ED, Ariss MM, Lindquist TP. Disorders of eye movement and alignment. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 623.
Repka MX. Amblyopia: basics, questions, and practical management. In: Lambert SR, Lyons CJ, eds. Taylor & Hoyt's Pediatric Ophthalmology and Strabismus. 5th ed. Philadelphia, PA: Elsevier; 2017:chap 73.