Amblyopia

Amblyopia is poor vision in an eye due to failure of development of normal sight during childhood. It is sometimes referred to as lazy eye, but this is not a good term because lazy eye has been used for a number of ophthalmologic conditions. It is estimated that amblyopia is found in 4% of children.

Anything that interferes with normal use of the eyes in childhood can cause amblyopia. The most common reason for amblyopia is strabismus, or misalignment of the eyes. The brain will “turn off” an eye in a child if it is misdirected, in order to avoid double vision. Amblyopia can also be found if either eye has a significant refractive error, or is out of focus. In this circumstance, both eyes look normal; therefore, this type of amblyopia may be missed. The third most common cause of amblyopia is blockage of the visual axis by a problem in the eye or eyelid. For example, a droopy lid or cloudy lens can cause amblyopia.

Amblyopia is diagnosed by finding a difference in vision between the two eyes after refractive error is corrected. This difference can be detected in infants as well as older children.

Amblyopia is treated by forcing the child to use the weaker eye. Usually this is done by patching the stronger eye throughout the day. If glasses are needed, they must also be worn full time. Occasionally an eye drop can be prescribed to help with the treatment of amblyopia. The sooner amblyopia is detected, the easier it is to treat. After age nine, treatment of amblyopia is generally not effective. If amblyopia is caused by a defect in the eye or eyelid, these abnormalities must be corrected.

If the amblyopia is not treated, normal vision will not develop. Good results after strabismus surgery often cannot be maintained if amblyopia is not treated.

As a rule, children do not like their better eye to be patched. Unfortunately, we have little choice when dealing with amblyopia; without treatment, good vision will not develop. It is up to you to make sure that this very important treatment is carried out. Consult with your doctor if you have difficulties with this treatment.