Commonly known as lazy eye, amblyopia is a vision imbalance where eyesight in one eye is weaker. It is caused by a breakdown in eye and brain communication that occurs between birth and age seven. The brain relies more on the stronger eye, further weakening the “lazy” eye.
Amblyopia affects 2-3% of children. If doctors detect amblyopia early, it can often be entirely corrected. If not detected, it can permanently affect vision as children grow into adults.
Some young people may lack confidence because of an amblyopia diagnosis — even though it is the most common cause of vision loss in children. This lack of self-esteem can cause problems in school, social withdrawal and unnecessarily risky behavior.
As a parent, you must speak with children about amblyopia and any other insecurities. Providing education on an amblyopia diagnosis is one way to help children replace fear with knowledge. Education can also teach parents how to properly support their child after an amblyopia diagnosis.
What is amblyopia (lazy eye)?
The term “lazy eye” is not accurate, as the problem has little to do with the eye itself. Instead, the problem lies in nerve connectivity breakdowns between the eye and the brain. Over time, the brain will ignore images sent by the weaker eye. If it receives different images from both eyes, it will prioritize the stronger eye’s image over the weaker eye. This phenomenon allows amblyopia to grow worse if not immediately treated.
Untreated amblyopia can lead to vision complications and severe visual disability in one or both eyes. Over time, it can also cause complete blindness. It’s important to see a pediatric eye doctor if you suspect your child has amblyopia.
Types of amblyopia
Doctors can diagnose children and adults with more than one type of amblyopia. The type of amblyopia your child develops will depend on the way their vision is blocked or impaired.
Depending on the cause, children can develop any of the three types of amblyopia:
- Strabismic amblyopia: Develops when eyes are not parallel and do not receive the same image from the brain. One eye may tilt, flip or move the image in a different way than the other eye.
- Deprivation amblyopia: Develops when cataracts or other items impair eyesight and “deprive” children of clear vision.
- Refractive amblyopia: Develops when eyes have different levels of refractive error, leading to different levels of overall focus.
When eye doctors treat amblyopia with eye patching or atropine drops, it can also cause reverse amblyopia. This rare condition can make amblyopia symptoms worse or create new symptoms. Patients can often eliminate reverse amblyopia by properly treating the original condition.
What causes amblyopia in children?
Amblyopia originates from different visual inputs in each eye. It can be caused by any factor that prevents the eye from focusing.
From extensive research, eye doctors have compiled a list of factors that can cause amblyopia in children. It includes:
- Strabismus: Eye misalignment that affects which images are sent to each eye from the brain. Eyes with strabismus often look in different directions.
- Anisometropia: A large difference in refraction between a child’s eyes. It is one subtype of refractive amblyopia.
- Genetic history: Children with a history of amblyopia in the family can have an elevated risk of developing it themselves.
- Eye injury or infection: If untreated or improperly treated, some eye injuries or serious infections can cause amblyopia.
- Deprivation: Cataracts, droopy eyelids, or other growths can prevent light from hitting the eyes. The brain ignores the eye experiencing this lack of light, causing deprivation that can lead to amblyopia.
- Delays in child development: Children with slow development or neurological conditions might experience a higher risk of developing amblyopia.
In rarer cases, medication and eye conditions like ptosis can also cause amblyopia. Given the number of possible causes of amblyopia, it’s important for parents to understand its signs.
Signs your child may have an amblyopia
Parents should look for different signs if they suspect their child might have amblyopia. These signs can include:
- Squinting: Partially or completely closing one eye can help children focus their vision through a weaker eye.
- Head tilting: Tilting their head to one side indicates that children are compensating for misaligned eyes.
- Reduced vision: Children with amblyopia might complain about trouble seeing items, recognizing faces, or reading signs that are far away.
- Headaches: Often accompanied by other symptoms, headaches can stem from visual irritation.
- Misaligned eyes: Parents sometimes recognize unparallel eyes in their children, particularly when children attempt to make eye contact.
- Inconsistent eye tracking: A child’s eye movement might be slow or delayed when following a moving object.
Children avoiding a certain task can also indicate amblyopia. For example, children might avoid reading because it strains their vision. They might also steer clear of activities like sports, riding a bike or drawing.
The longer amblyopia goes without treatment, the more of a challenge it becomes. Schedule a visit with an eye doctor if you suspect your children might have amblyopia.
Diagnosing amblyopia
Developing a treatment plan for amblyopia can take time. The first step is to find a pediatric eye doctor that you and your child trust. Your eye doctor will answer questions and let you and your child know what to expect during the diagnosis process. Once your eye doctor provides a diagnosis, they will work with you to develop a treatment plan specific to your child’s needs.
Your eye doctor might use methods like visual acuity testing, refraction testing or visual function testing during the diagnosis process. They will examine how your child reads and processes input at different distances. They will likely test each eye individually as well.
Treatment options for children and teens with amblyopia
A treatment plan will shortly follow an amblyopia diagnosis. Your ophthalmologist will work with you and your child to develop and explain each treatment step.
Here are some of the amblyopia treatments available for babies and children with amblyopia:
- Vision therapy: Exercising one or both eyes to improve a child’s eye coordination.
- Glasses or contacts: Making vision in both eyes parallel through contact lenses or eyeglasses. Specially made contacts or glasses help correct the disparity between a child’s eyes.
- Patching: Covering a child’s better-performing eye with an adhesive patch. This strengthens the weaker eye as it is forced to provide all images to the brain.
- Atropine eye drops: Using eye drops to deliberately blur vision in one eye. Like patching, this forces the weaker eye to compensate for the lack of vision from the stronger eye.
- Surgery: Correcting uneven vision through a simple corrective lazy eye surgery. An eye doctor will start with a small incision. This allows them to remove cataracts, reposition eyelid muscles, or make other changes to improve vision.
Surgery isn’t required for every case of amblyopia. Before taking any action, eye doctors will first discuss treatment types with parents and children.