Amblyopia

Amblyopia, also known as a “lazy eye”, is described as reduced vision in one eye compared to the other. There are some rare forms of amblyopia that involve both eyes. Amblyopia is the most common cause of partial or total blindness in one eye in children.

The term lazy eye is misleading because the eye is not actually lazy. In fact, it is a developmental problem in the nerve connecting the eye to the brain, affecting the brain’s ability to use both eyes together. It is not a problem in the eye itself, but in the brain which actively ignores the visual input from the eye, leading to amblyopia in that eye.

In addition to poor visual acuity, people with amblyopia are more prone to having difficulties with depth perception, eye movements related to reading, and visual decision making while driving.
 

What Are The Causes of Amblyopia?

Amblyopia develops in childhood due to:

• Significant differences in the prescription (refractive) status between the two eyes due to nearsightedness, farsightedness or astigmatism;

• Constantly misaligned eyes or crossed eyes (strabismus);

• An obstruction of vision in early childhood i.e. cataract, ptosis (droopy eyelid)
   

It is important to note that, because amblyopia is typically a problem of infant vision development, symptoms of the condition can be difficult to detect. Symptoms may include noticeably favoring one eye over the other, an eye turn (either upward-downward outward or inward) or a tendency to bump into objects on one side.

The best way to identify children who are at risk for, or already have, amblyopia is by performing comprehensive eye examinations.
 

How Is Amblyopia Treated?

Amblyopia can be treatable at any age, although the earlier the problem is found and treated, the more successful the outcomes tend to be.

Many children who have anisometropia, or unequal vision, do not know they have an eye problem because the stronger eye and the brain compensate for that shortage. Over time, the weaker eye gets progressively worse, and amblyopia develops.
 

Treatment may include

Glasses

To correct nearsightedness, farsightedness, or astigmatism. Glasses may also correct an eye turn. If amblyopia is present, corrective lenses alone will not resolve the condition. However, they are often an important part of treatment. 
 

Cataract surgery

If a cataract is the cause of amblyopia, it can be removed surgically under either local or general anesthesia.
 

Correcting droopy eyelids

In some cases, amblyopia is caused by an eyelid that is blocking the vision to the weaker eye, in such cases, the usual treatment is surgery to lift the eyelid. Once the vision is corrected and any underlying medical issues are treated, then there are several other ways to help improve vision and getting the lazy eye to work,
 

Using an eye patch

Use of an eye patch to encourage the brain to use the weaker eye is an old, outdated treatment. While it may improve vision in the weaker eye, the patch does not solve the underlying problem; the brain will continue to ignore that eye once the patch is removed. The brain must be trained to use both eyes as a team rather than relying on only one or the other.
 

Vision Therapy

Vision therapy is a doctor-supervised program of exercises that strengthen the connections between the amblyopic eye and the brain. Vision therapy uses filters, lenses, prisms, and other special tools to strengthen the eye-brain connection and improve how both eyes work together. When amblyopia is present, typically other visual skills are deficient, such as tracking. Vision therapy is a holistic treatment program that addresses all defective visual skills, thus improving vision and quality of life.  

Revital Vision

Revital Vision is a new, FDA-approved treatment for amblyopia. This computer-based, doctor-supervised program works by improving the brain's ability to process visual input from the amblyopic eye. Treatment typically lasts two months and studies have found that the resulting visual improvement lasts at least 5 years. Include the following link as a hyperlink on Revital Vision. https://www.revitalvision.com/

When should children be checked for amblyopia?

Amblyopia often starts before there are any obvious signs that something is wrong. This is why babies and young children should have their eyes regularly checked. According to research, children should have eye examinations at the following times:

• Between 6 months and 1 year of age

• At 3 years of age

• At 5 years of age
   

If there are any concerns that the child may be suffering from or developing a “lazy eye,” have him/her examined right away. Children with a family history of amblyopia are at a higher risk for developing it themselves.

Early diagnosis and treatment increases the chance for a complete recovery. Amblyopia will not go away on its own. If not diagnosed until the preteen, teen or adult years, treatment will take longer. The sooner the treatment begins, the better.