Amblyopia, commonly known as lazy eye, is the eye condition noted by reduced vision not correctable by glasses or contact lenses and is not due to any eye disease. The brain, for some reason, does not fully acknowledge the images seen by the amblyopic eye. This almost always affects only one eye but may manifest with reduction of vision in both eyes. It is estimated that three percent of children under six have some form of amblyopia.
The brain needs stimulation of sharp pictured from the eyes to develop fully during childhood. Anything that causes blurred images in the eye will result in the respective part of the brain used for seeing to remain undeveloped. This eye will not see well because to see clearly, one needs an eye that can form sharp pictured as well as a developed portion of the brain that is able to read these pictures. Even if the eye’s condition is fully corrected later in life, vision will not recover because the brain only develops in early childhood.
What Causes Lazy Eye?
Both eyes must receive clear images during the critical period. Anything that interferes with clear vision in either eye during the critical period (birth to 8 years of age) can result in amblyopia.
The most common causes are:
– A reduction in vision not corrected by glasses
– Constant strabismus (constant turn of one eye)
– Anisometropia (large differences in degrees between both eyes)
– Blockage of an eye due to trauma, lid droop, etc
Does My Child Have a Lazy Eye?
Lazy eye is usually unnoticed by parents if only one eye is affected as the child will appear to have good eyesight. The only way to detect lazy eye early is to have a sight test as early as possible. Their eyes should ideally be checked at birth, at 6 months and annually till 7 or 8 years age.
Why Is Early Treatment Important?
Lazy eye can only be successfully treated in younger children. In lazy eye, a part of the brain is undeveloped. This can be reversed with treatment, but as the child ages, the brain gradually loses its ability to grow and respond to treatment. Therefore lazy eye should be detected and treated as early as possible. The earlier the treatment, the better the opportunity to reverse the vision loss. All young children should undergo regular eye tests.
Treatment of Lazy Eye
The condition that caused the lazy eye must be treated. This means spectacles or refractive errors, and surgery for cataracts, drooping eyelids and squints.
The lazy eye itself is most effectively treated by occlusion therapy (patching of the good eye) or by instilling topical atropine in the eye with better vision. This forces the child to use the weak eye. The patch can be held on the eye using a disposable adhesive patch or with an elastic band like a pirate. Alternatively, the spectacles can be covered with opaque tape or made with frosted plastic. The more complete the blockage of light from the eye, the more effective the treatment.
Patching can be enforced full-time during all waking hours in more severe cases of lazy eye or only part of the time so that the child does not have to wear the patch to school in milder cases. Patching can cause lazy eye in the good eye, but this is almost always reversible. Because of this possibility, patching should always be done under supervision of an eye specialist. Patching may be needed from a few months to several years as the lazy eye may return if patching is stopped. Patching is usually not effective after the age of 10.
The main difficulty with patching is that no child likes to have his good eye patched. Parents must closely supervise and enforce the continuous wearing of patches and spectacles and use all means to persuade the child to cooperate.
Summary
Lazy eye is a common condition developing in childhood that often goes unrecognized. Early detection is important as it can only be treated in early childhood. As children should have regular eye tests from birth to detect lazy eye. Treatment is effective but depends on the parent’s ability to ensure that the spectacles and patches are worn constantly.
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