Valerie M. Kemo, RN, CCM, CMAC
What is Lazy Eye and How is it Treated?
Many people have heard the term “lazy eye”. My earliest recollection of the term was as a child in elementary school. For a fellow student that had crossed eyes, a wandering eye, or wore an eye patch, they were referred to as having a lazy eye. My knowledge of this condition was lacking, even as a nurse. That was until my grandson was diagnosed with Amblyopia (am-blee-OH-pee-uh).
What is Amblyopia?
Amblyopia is the result of poor vision in one eye, although it can rarely affect both eyes. Between birth to about age 8, the connections between the brain and eyes are developing. For amblyopia to develop, a child has one stronger eye and one weaker eye. The brain learns to depend on the vision of the stronger eye with better vision, developing the necessary connections for clear vision, while ignoring the weaker eye. The weaker eyed becomes “amblyotic”. According to the National Eye Institute, 3 out of 100 children have amblyopia.
Causes of Amblyopia
Causes of Amblyopia include:
Refractive errors. More commonly known as nearsightedness or farsightedness, or astigmatism. Refractive errors are typically corrected with prescription glasses or contact lenses.
Near sightedness: you can see clearly close-up but not at a distance.
Far sightedness: you can see at a distance but not close-up.
Astigmatism: the shape of your eye (cornea or lens) is more curved than it is supposed to be causing blurred vision.
Strabismus. Caused by muscle weakness, the eyes do not coordinate or work together resulting in a “wandering eye”, one that moves side to side or up and down.
Cataracts. Cataracts result in cloudy vision.
If these underlying vision issues are not identified and corrected, Amblyopia can result.
Children may have a higher risk for Amblyopia if they were premature, had a low birth weight or are diagnosed with developmental disabilities. Family history can also be a predictor for this condition.
Symptoms of Amblyopia
Children may learn to compensate for weak vision in one eye and Amblyopia can often go unnoticed for years. You may notice that they tilt their heads, look sideways, or squint. Strabismus may be more noticeable since one eye may be turned in or out or be crossed. Or, you may not see any outward signs at all.
Diagnosis of Amblyopia
Early diagnosis and intervention are imperative since, if left untreated, Amblyopia can result in permanent vision loss.
Eye screening is the best way to diagnose this condition. Oftentimes, routine childhood vision screening identifies the issue. It is recommended that exams should be done as early as toddler age, and all children should have an eye exam by the age of 5. The older the child is at the time of diagnosis, the more difficult it is to treat.
Treatment of Amblyopia
Treatment depends on the type of underlying vision problem. For example, if the child has a refractory issue, corrective lenses will be prescribed. For cataracts, surgery.
The brain then needs to be retrained to use the weaker eye by limiting the use of the stronger eye. Two common treatments are:
Covering the stronger eye with a patch. They offer many themes and characters familiar to the child that may help with compliance.
Eye drops (Atropine) that will temporarily blur the vision in the stronger eye. This may be a better option for children that have difficulty with wearing a patch.
By patching or blurring the vision in the stronger eye with drops, the brain is made to use the weaker eye with the goal of making that eye stronger.
Results of treatment can occur anywhere from weeks to months. The key is to start treatment early for the best possible outcome.
Available Resources
There are many resources available for information, support, and in some cases free eye patches and children’s books. Some of the resources include:
State Agencies or State sites such as the Ohio Amblyopia Registry.
Major health institutions.
Schools or educational facilities.
If you suspect your child has a vision problem, discuss it with your healthcare provider. For the most effective outcomes, early diagnosis through routine vision screenings and eye exams and referral to an eye professional for treatment can limit the possibility of permanent vision loss.
References:
National Eye Institute
Mayo Clinic
KidsHealth
American Academy of Ophthalmology
Assessed and Endorsed by the MedReport Medical Review Board