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Amblyopia (Lazy Eye)

Amblyopia is the medical term for lazy eye. We define amblyopia (lazy eye) as the lack of development of clear vision in one or both eyes. It occurs for reasons other than an eye health problem that cannot be improved with glasses alone.

The term lazy eye is typically used when one eye is affected and is derived from the fact that one eye sees more clearly than the other. This clearer-seeing eye is thought to perform the bulk of seeing, which makes us consider the other eye lazy.

What Causes Amblyopia (Lazy Eye)?

In cases where the image of one eye is affected, the brain cannot effectively combine the two images and it suppresses, or turns off one of them. The constant suppression of an image from one eye can lead to the development of amblyopia in that eye.

In cases where the images of both eyes are affected, the brain never develops the ability to see clearly with both of the eyes.

There can be several reasons why the vision is affected:

Constant eye turn (strabismus) in one eye

Anisometropia (large differences in vision/prescriptions between the two eyes)
Ametropia (large prescription in both eyes)
Reduced vision in one eye due to physical problems in the eye (e.g. corneal opacity, cataract)
The visual system is designed to use both eyes to explore visual space. When both eyes see similarly and the brain can easily combine the images, it is called binocular vision. An amblyope has binocular vision; they are just not very good at it. They are binocular peripherally and suppress centrally.

Amblyopia most commonly affects one eye, but may occur in both eyes as well.
Types of Amblyopia (Lazy Eye)

Refractive Amblyopia

Large differences in vision/prescriptions between the two eyes

Strabismic Amblyopia

Constant eye turn in one eye

Deprivation Amblyopia

Reduced vision in one eye due to physical problems in the eye (e.g. corneal opacity, cataract)

Amblyopia (Lazy Eye) Symptoms

Amblyopia is difficult to detect by simple observation. The most common indicator is an obvious difficulty with depth perception. A person who has trouble catching and throwing objects, or is clumsy and always bumping into things may have amblyopia.

Amblyopia can be detected at a school screening, but not always. One of the reasons it is important for children to be seen for an eye exam from the first year of life and on is because outwardly amblyopia is not obvious. Some kids will go for years before their parents notice there is a problem.

Children figure out how to function even with amblyopia. In some cases, the brain suppresses the image from the eye, so there isn’t any double vision. The child never realizes the brain is doing this because the eye is being suppressed.

Amblyopia (Lazy Eye) in Adults and Older Children

If you’ve been told that your child has amblyopia, or lazy eye, then you may have also been told there is no effective treatment for lazy eye in children older than the age of eight. That’s simply not true. Adults with amblyopia can be treated.

The notion that older children and adults can’t be treated is based on a long-held, but incorrect, belief concerning the critical period, which was thought to end at age seven.

Since it is rare for amblyopia to develop in a child over the age of eight, many doctors over the years have assumed that the brain’s ability to change with respect to visual acuity is limited beyond this age.

However, recent research, as well as years of proven success among vision therapy patients, has proven that assumption wrong.

Amblyopia (Lazy Eye) Treatment for Adults and Children

It’s great to see clinical research backing what clinicians in the optometric vision therapy field have known for years. So what are these traditional treatments for amblyopia that are mentioned in the study?

Traditional treatment typically involves prescribing glasses and then patching the stronger eye with an eye patch or using eye drops to blur the better-seeing eye while doing daily activities. This is the common approach taken by many medical practitioners for amblyopia and the duration of the patching can vary from two to six hours per day depending on the severity of the amblyopia.

Traditionally, patching and/or prescribing glasses have been used to treat amblyopia, often for children at a younger age.

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