A lazy eye, also known as amblyopia is a condition where the vision is reduced (not correctable to 20/20) even with the help of glasses or contact lenses and is not due to an eye disease. It usually only affects one eye, but in more rare cases, can affect both. Early detection is crucial for successful treatment. The term "lazy eye" is very misleading. Amblyopia is actually a problem with the brain, not the eye itself. Early in life, during the critical period, if the brain does not get stimulated to have 20/20 vision, then that area of the brain does not develop properly. The critical period is from birth to 6 years of age.
Causes of Amblyopia
- Strabismus amblyopia, also known as an eye turn can cause amblyopia. When one eye either turns in or out, the images displayed from both eyes do not become one image in the brain. The child's brain adapts by suppressing one of the images, thus never stimulating that portion of the brain to have clear vision.
- Refractive or anisometropic amblyopia: Anisometropia is a condition when the two eyes have unequal refractive error. The better seeing eye will dominate the vision, where as the portion of the brain responsible for the non-dominant eye will develop abnormally.
- Occlusion amblyopia occurs when something is blocking the vision, such as congenital cataracts or corneal scarring from forceps injury during birth.
Diagnosis of Amblyopia
Because amblyopia usually occurs in one eye, parents often do not realize their child is having trouble with their vision. It isn’t until they have a vision screening at school, while checking their visual acuity one eye at a time, does anyone find out that the child actually has significantly reduced vision in one eye. However, by the time the child is in school, they are already past or close to passing the critical period. It is important for parents to take their infants or toddlers to see an eye care professional for a comprehensive eye exam to detect if there are any signs of strabismus, anisometropia and/or something occluding their vision. Early detection is crucial for successful treatment.
Treatment of Amblyopia
Treatment usually requires all or a combination of the following:
-Prescribing the appropriate glasses to correct for any refractive error in order to allow the brain to be stimulated with the best vision possible.
-Patching the good eye to force the lazy eye to be used and thus stimulating that portion of the brain to function.
-Vision therapy to reinforce visual function. It is important to remember that there is a greater chance of success when treatment is initiated as early as possible.
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