Lazy eye or Amblyopia is a vision disorder that begins during infancy or early childhood. In this condition, the eye fails to achieve normal visual acuity even with the help of eyeglasses or contact lenses. Generally, only one eye is affected. However, in some cases, visual acuity can be poorly developed in both the eyes of the child. 

If this eyesight problem is detected early and treated promptly, deterioration of the vision can be avoided. If left untreated, the brain learns to ignore the image which comes from the lazy eye and only focuses on the images from the other eye. Without proper stimulation, the nerve cells responsible for the vision do not mature normally. This could result in severe visual disability in the lazy eye. 

This article takes you through the causes, symptoms and treatment options for lazy eye or amblyopia. 

What are the Causes?

To determine the proper treatment method, one needs to understand the underlying cause of this vision disorder. Amblyopia or lazy eye is categorized into three types based on the causes as described below:

  • Imbalance in Muscles – It is one of the most common factors responsible for causing a lazy eye. There is an imbalance in the muscles that are responsible for the position of the eyes. Due to this, the eyes tend to either cross in or turn out and fail to work together. The vision disorder due to this factor is known as strabismus amblyopia. 
  • The Difference in Vision Sharpness of the Two Eyes – When there is a significant difference between the prescriptions of both the eyes, it can affect the visual acuity of an eye. This difference in the sharpness of vision often occurs due to farsightedness. Only sometimes it may be caused by nearsightedness or an uneven surface curve of the eye, also known as astigmatism. This factor is responsible for causing refractive amblyopia. 
  • Deprivation – When something obstructs the light from entering and being focused on the child’s eye, like a clouded lens (cataract), it may result in deprivation amblyopia. This type of lazy eye requires immediate treatment to prevent permanent loss of vision. 

What are the Symptoms?

The symptoms of amblyopia are as follows: 

  • Blurred vision
  • Poor depth perception
  • Shutting or squinting an eye
  • An eye that wanders outwards or inwards
  • Head tilting
  • Eyes that don’t appear to work together
  • Abnormal results of vision screening tests

What are the Treatment Options?

The following are the treatment options for the lazy eye:

  • Glasses – Near-sightedness, far-sightedness or astigmatism can be corrected with the help of prescription glasses. The child has to wear them all the time so that the eye specialist can monitor their effectiveness in improving the vision problems in the lazy eye. Sometimes, glasses may also correct an eye turn. In some cases, prescription glasses can cure amblyopia. If an individual is unable to wear glasses or contact lenses safely or successfully, Lasik surgery may help correct the dissimilar refractive errors to prevent lazy eye. However, many parameters need to be considered in such cases and hence a professional consultation is required. 
  • Surgery – Although LASIK eye surgery can correct the refractive error of both your eyes, it cannot alter the brain’s incapacity to see.This means that if one of your eyes is amblyopic, it will continue to have blurred vision in comparison to your healthy eye.

Sometimes a cloudy lens (cataract) can cause a lazy eye. Cataract surgery can remove the cataract under either general or local anesthesia.

Once the vision is corrected and underlying medical issues are addressed, several treatment options can help improve the vision. These include:

  • Atropine eye drops – These are used to blur vision in the good eye. This makes the lazy eye make more effort. 
  • Vision exercises – Various exercises and games designed to improve vision are prescribed in combination with other treatments. For instance, Home-based Pencil Push-ups (HBPP). These exercises are to be performed only with a prescription and under the supervision of an eye doctor.

Certain factors put a child at an increased risk of getting amblyopia. These include premature birth, small size at birth, a family history of lazy eye, developmental disabilities, etc. Remember, the earlier amblyopia is detected, the better is the result of the treatment.