CONDITIONS

Amblyopia

What is amblyopia?

Amblyopia, known as “lazy eye,” is characterized by reduced vision in one eye compared to the other. It typically develops during childhood, often due to improper visual development or alignment of the eyes.

When a child has amblyopia, one of their eyes cannot see well, while the other eye can see clearly. Because of this, the brain chooses only to use the eye that sees well. As the brain gets used to using the strong eye, the weaker eye’s vision can get even worse over time. So, it is vital for a doctor to help with amblyopia to prevent the weak eye from getting worse.

What causes amblyopia?

Common causes include: 

Strabismus: Strabismus occurs when the eyes are not properly aligned, causing them to point in different directions. One eye may look straight ahead while the other turns inward, outward, upward, or downward. To prevent double vision, the child’s brain might ignore the image from the eye that is not aligned. However, this hinders eye development. 

Refractive errors: Refractive eye error means being nearsighted, farsighted, or having astigmatism (blurry or distorted vision). In some cases, a child may have a refractive error that is more severe in one eye. As a result, that eye may become “switched off,” leading to improper vision development. Detecting this condition can be challenging because the child’s vision appears normal when both eyes are functioning together.

Blockage of vision: Cloudiness can develop in the typically clear areas of the eye. Some children are born with cataracts, causing the lens of the eye to become cloudy.

Droopy Eyelids: A drooping eyelid, medically known as ptosis, can obstruct the entry of images into the eye, blocking a child’s vision and cause amblyopia.

Who is at more risk of developing amblyopia?

The chances of having amblyopia are higher in children 

  • who were born prematurely
  • with below-average birth weight.
  • Have a family history of amblyopia, childhood cataracts, or other eye conditions
  • Those with developmental disabilities

What are the symptoms of amblyopia?

Some common symptoms include:

  • Poor vision in one eye
  • An eye that wanders inward or outward
  • Poor depth perception
  • Squinting or shutting one eye
  • Head tilting

How is amblyopia diagnosed?

Ophthalmologists (eye specialists) diagnose amblyopia by:

  • Checking if vision differs between the two eyes
  • Covering one child’s eyes to see how well they can follow a moving object and watching to see how the child reacts when one eye is covered.
  • Performing a complete medical eye exam to check for other eye problems that could be affecting vision

It is important to note that poor vision in one eye does not always signify a child has amblyopia. Sometimes, wearing glasses to correct a refractive error in one eye can improve vision.

The American Optometric Association suggests that children undergo a thorough eye evaluation by six months and then again at three years of age. If there is a family history of misaligned eyes, childhood cataracts, or serious eye disease, an ophthalmologist should check the child’s eyes when they are an infant.

How is amblyopia treated?

It is important to start treatment early for amblyopia as soon as possible in childhood when the connections between the eye and the brain are forming. The treatment aims to re-train the brain to accept the signals from the amblyopic eye to improve vision in that eye. The ophthalmologist will identify the cause of the lazy eye and will suggest treatment accordingly.

Treatments include:

  • Corrective eyewear – glasses or contact lenses can correct problems such as nearsightedness, farsightedness, or astigmatism that result in lazy eye
  • Eye patches –The child wears an eye patch over the eye with better vision for two to six or more hours daily
  • Eye drops – these can temporarily blur vision in the stronger eye and encourage the child to use the weaker eye
  • Surgery – might be required if the child has droopy eyelids (ptosis) or cataracts that prevents clear formation of an image on the retina causing amblyopia or if the appropriate glasses do not stop the crossing or wandering eye.

In conclusion, amblyopia, or lazy eye, is a condition that can affect children’s vision if left untreated. Early detection and intervention are key to improving vision outcomes. The effects of amblyopia can be alleviated through comprehensive eye examinations and appropriate treatment, such as corrective lenses, eye patches, or eye drops. Regular eye check-ups are essential to monitor and manage potential vision issues effectively.

References

  1. Cleveland Clinic. Amblyopia (Lazy Eye). Available from: https://my.clevelandclinic.org/health/diseases/10707-amblyopia-lazy-eye . Accessed on 15th April 2024
  2. Amblyopia (Lazy Eye). Available from: https://www.healthdirect.gov.au/amblyopia-lazy-eye Accessed on 15th April 2024
  3. American Optometric Association. Amblyopia (Lazy Eye). Available from: https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/amblyopia?sso=y. Accessed on 15th April 2024
  4. American Academy of Ophthalmology. Amblyopia. Available from: https://www.aao.org/eye-health/diseases/amblyopia-lazy-eye Accessed on 15th April 2024

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