Amblyopia (Lazy Eye)

Amblyopia is an eye condition that affects your child’s ability to see clearly out of both eyes. It usually develops when they’re an infant or very young. It can get worse over time if it’s not treated.

If your child has amblyopia, one of their eyes has blurry vision, and the other has clear vision. Eventually, their brain will start ignoring the blurry eye. It will only use the eye with clear vision to see. As your child’s brain relies more on the stronger eye, the weaker eye’s vision will get even worse over time. Amblyopia is a serious medical issue. But it responds very well to treatment.

People sometimes refer to amblyopia as lazy eye or lazy vision. Even though these names are common, they’re not accurate. If a child has amblyopia, they’re not lazy, and neither are their eyes. They aren’t choosing to have blurry vision, and it’s not caused by anything they did.

Symptoms of lazy eye

It’s not always easy to tell if your child has amblyopia. Most kids aren’t diagnosed until an eye doctor or their pediatrician gives them an eye exam.

If you do notice symptoms in your child, you’ll probably see changes in how they interact with objects and space around themselves. A child with amblyopia may:

• Favor one side of their body
• Bump into objects, especially on one side of their body
• Shut one eye or squint a lot
• Frequently tilt their head to one side
• Have crossed eyes
• Have a droopy eyelid

You might not be able to see anything physically different in your child’s eyes. But one of their eyes may look off-center or like it’s drifting in a direction that doesn’t match where your child is looking.

Amblyopia causes

Amblyopia happens when something creates a difference between your child’s eyes and how they focus on objects. The most common causes of amblyopia include:

• Refractive errors: Your child may develop amblyopia if they have an untreated refractive error. These are common vision issues, like nearsightedness, farsightedness or astigmatism.
• Strabismus: If one of your child’s eyes moves without matching the other, their brain may start relying on one eye over the other.
• Other eye issues: Any condition that affects how your child’s eyes function can lead to amblyopia. Cataracts, droopy eyelids or issues with their corneas can all cause it.

Risk factors

Any child can develop amblyopia. Some factors make kids more likely to, including:

• Having a biological family history of eye and vision problems
• Developmental delays
• Preterm birth (being born before 37 weeks of pregnancy)
• Low birth weight (being born weighing fewer than 5 pounds, 8 ounces or 2,500 grams)

How doctors diagnose this condition

An eye doctor will diagnose amblyopia. Healthcare providers screen all kids for it during regular check-ups. They’ll perform an eye exam to check your child’s eyes. Your child’s provider will test how well your child can see. They’ll also look for anything that might be affecting how well your child’s eyes work.

Usually, a healthcare provider will diagnose amblyopia before you notice any symptoms at home. Most kids are diagnosed when they’re too young to tell you their vision is worse or changing. Tell your provider or eye doctor if you’ve noticed any changes in how your child holds their head or interacts with objects around them.

Amblyopia treatment

Your eye doctor will treat amblyopia by making your child’s brain use their weaker eye to see. This will repair and strengthen the connection between your child’s brain and both their eyes. Eventually, it will correct the amblyopia.

The most common treatments include:

• Wearing an eye patch: It’s a common misconception that wearing an eye patch helps a child’s damaged eye heal. In fact, the opposite is true. Your child will wear a patch that covers their stronger eye for at least a few hours per day. Blocking vision from the stronger eye forces the brain to use images from their weaker eye to see. It also strengthens their weaker eye.
• Eyeglasses: Wearing glasses can correct refraction errors that cause amblyopia. Once your child’s vision improves, their brain might return to using both eyes to see. Your child might need glasses and other treatments at the same time.
• Medicated eye drops: Your eye doctor might put medicated eye drops (usually atropine) into your child’s strong eye. The medicine temporarily makes that eye blurry, which makes their brain use the weaker eye to see. The drops are safe. They won’t permanently affect the vision in your child’s strong eye.
• Dichoptic treatment: This is a newer kind of treatment. Your child will wear a headset or special glasses with screens on them. The screens will show different information to the stronger or weaker eye. Kids usually watch a show or play a video game while they wear the headset. This can strengthen the weaker eye over time.
• Surgery: It’s rare to need surgery to correct amblyopia. But your child might if they have cataracts or another issue that nonsurgical treatments can’t fix. Your child’s eye doctor will tell you what to expect.

Most kids need amblyopia treatment for at least a few months. Make sure to encourage them to stick with it as long as your eye doctor recommends.

It can be tough for kids to get used to changes in their eyes and vision. That’s especially true when they need amblyopia treatments. Remind your child why it’s important to wear their eye patch and glasses or to use their eye drops. Reward them for sticking with their treatment and encourage them to use their weaker eye as often as they should. And it’s OK if your child feels discouraged sometimes. The important thing is that you’re working together to improve their vision.

When should my child see a healthcare provider?

Visit a healthcare provider or eye doctor as soon as you notice any changes in your child’s behavior, especially if it seems like they might not be able to see well. Talk to your provider if your child starts favoring one side of their body more than the other, or if they seem less confident when they’re moving around.

What can I expect if my child has amblyopia?

Amblyopia is very treatable if it’s diagnosed early. Children who start treatment early in life are much more likely to have improved vision and fewer long-term effects.

Amblyopia can cause permanent vision problems if it’s not treated when your child is young. It’s possible to treat amblyopia in teens, but it takes longer and is usually less effective.