Amblyopia (Lazy Eye)
What is amblyopia?
Amblyopia, often called lazy eye or lazy vision, is a serious eye condition that affects vision. Poor sight develops in one eye during infancy or childhood and gets worse over time if not treated.
How does amblyopia affect my child?
In a child with amblyopia, one eye has blurred vision, and the other has clear vision. The brain begins to ignore the blurry eye and uses only the eye with clear vision. Eventually, the brain learns to rely on the stronger eye, allowing the weaker eye to worsen.
Who is at risk for amblyopia?
Some children may have risk factors for amblyopia, including:
- Family history of eye problems.
- Developmental disabilities.
- Born early (premature birth).
- Small at birth.
How common is amblyopia?
Amblyopia is the most common reason for vision loss in kids, affecting 2% to 4% of children through the age of 15 years . It can occur even if a child has no noticeable problems. But it can cause permanent problems if not detected and treated during childhood. Early, regular eye exams are important.
Symptoms and Causes
What causes amblyopia?
Amblyopia occurs when there is a major difference between the two eyes in their ability to focus. The most common cause of amblyopia is other vision problems. It’s important to treat these other conditions, or the brain starts relying on the eye with better vision, leading to amblyopia.
What eye conditions may lead to amblyopia?
Conditions that may lead to amblyopia include:
Refractive errors: These conditions affect how light passes through the eye. They include:
- Nearsightedness (myopia), trouble seeing far away.
- Farsightedness (hyperopia), trouble seeing up close.
- Astigmatism, a curved cornea.
Strabismus (crossed eyes): The eyes are meant to move together as a pair, but sometimes they don’t. If one drifts (in, out, up or down), the brain may rely on one eye over the other, leading to amblyopia.
Structural problems: Sometimes, the eye has a structural problem that can lead to amblyopia, including:
- Cataracts, which cause cloudiness in the lens and blurry vision.
- Droopy eyelid.
- Scar on the cornea.
What are some lazy eye symptoms?
Amblyopia is not always obvious. The condition often goes undetected until a child has an eye test. So every child should have early, regular vision screening.
You may notice symptoms. A child with amblyopia may:
- Bump into things on a particular side a lot.
- Experience a large difference in nearsightedness or farsightedness between the two eyes.
- Favor one side of the body.
- Have crossed eyes.
- Have a droopy eyelid.
- Shut one eye or squint a lot.
- Frequently tilt their head to one side.
Diagnosis and Tests
When should amblyopia be diagnosed?
Early diagnosis increases the chances of a full recovery. The American Optometric Association recommends that children have a thorough vision screening before 6 months of age and again before they’re 3 years old.
What tests can diagnose amblyopia?
A pediatrician, school vision program, optometrist or ophthalmologist can test a child’s vision for amblyopia. The screener may:
- Put drops in the eye to make the pupil bigger.
- Shine a light in each eye.
- Cover one eye at a time and test whether each eye can follow a moving object.
- Ask older children to read letters on a chart on the other side of the room.
A vision exam determines:
- Do the eyes allow light all the way through?
- Do both eyes see equally well?
- Are the eyes moving correctly? Are they moving together?
- Are the eyes properly aligned?
- Does vision differ between the two eyes?
- Does one eye drift or wander?
- Are any cataracts visible with a lighted magnifying tool?
Management and Treatment
What are the treatments for amblyopia?
Amblyopia treatment is much more effective if it starts early, while the connections between the eyes and brain are still developing. Strategies focus on making the child’s brain use the weaker eye. Options include:
- Eye patches for kids: Your child may wear a patch over the better eye for at least a few hours per day. This effective treatment can last months or even years. The patch forces the brain to use the images from the weaker eye, eventually making that eye stronger.
- Glasses: Eyeglasses are also a common lazy eye treatment. They can help amblyopia by improving nearsightedness, farsightedness and eye crossing.
- Eye drops: For mild cases, your provider may recommend eye drops (atropine) to temporarily blur vision in the better eye. The goal is the same as a patch: to force the brain to use the weaker eye.
- Surgery: An operation for amblyopia is rare. Your healthcare provider may suggest surgery to fix certain causes of amblyopia, such as cataracts.
Can I prevent amblyopia?
You can’t prevent amblyopia or the other vision problems that may cause it. But you can stop it from getting worse or causing permanent problems. The best way to prevent vision loss from amblyopia is to get regular eye exams. Make sure your child has a thorough eye exam by the age of 6 months and then again by 3 years.
Outlook / Prognosis
What’s the outlook for people with amblyopia?
With early diagnosis and treatment, children with amblyopia can significantly improve their vision. The goal of treatment is to improve sight as much as possible, though it may not lead to perfect sight, especially in severe cases.
Amblyopia does not go away on its own. If left untreated, it can cause permanent vision loss and a “wonky eye” that always looks in another direction. And lazy eye is much harder to treat in teenagers and adults. Early vision exams and treatment are essential.
Can you fix a lazy eye with exercises?
Although exercises for the eye would not hurt the amblyopia there is no good evidence that suggests they can help on their own. Combined with other proven treatments, the following exercises can be tried:
- Color in the lines.
- Hold a pencil near your nose. Move it away, then bring it close. Focus on it as it moves.
- Do puzzles while wearing a patch on the stronger eye.
- Read while wearing a patch over the stronger eye.
How can I best take care of my child with amblyopia?
You can take several steps to help your child with lazy eye:
- Eye care: Your child should have regular eye exams, one by 6 months old and another by 3 years old. And go to all follow-up eye appointments.
- Stick with treatment: Encourage your child to wear the eyeglasses or patch, even though they may not want to. Try offering rewards and explaining why it’s so important.
- Strengthen the eye: Encourage your child to actively use the lazy eye when wearing glasses or a patch. Read or do puzzles together.
What else should I ask my healthcare provider?
Consider asking your healthcare provider:
- What is causing my child’s lazy eye?
- What treatment will work best? Will my child need surgery?
- How many months or years will my child need treatment?
- How often will my child have to wear the eyeglasses or eye patch?
- Will my child’s vision return to normal after treatment?
- What can I do to encourage my child to wear the eyeglasses or eye patch?
- What can we do at home to improve my child’s vision?
A note from Cleveland Clinic
Amblyopia is a common cause of vision loss in children. Kids should have early and regular vision screening so providers can detect any vision problems. Treatments, such as a patch or glasses, can be very effective when started early before vision loss is severe. Most pediatricians and schools offer vision screening. Talk to your healthcare provider if you notice any vision or eye problems in your child.