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Amblyopia

Amblyopia is reduced vision in one eye caused by abnormal visual development early in life. The weaker — or lazy — eye can also have a turn – inwards or outwards.

Amblyopia generally develops from birth up to age 7 years. It is the leading cause of decreased vision in one eye among children. Rarely, lazy eye affects both eyes.

Early diagnosis and treatment can help prevent long-term problems with your child's vision. Lazy eye can usually be corrected with glasses and / or eye patches. Sometimes surgery is required.

Symptoms

Signs and symptoms of lazy eye include:

• An eye that wanders inward or outward
• Eyes that appear to not work together
• Poor depth perception
• Squinting or shutting an eye
• Head tilting
• Abnormal results of vision screening tests

Sometimes lazy eye is not evident without an eye exam.

Causes

Amblyopia develops because of abnormal visual experience, early in life, that changes the nerve pathways between the retina at the back of the eye and the brain. The weaker eye receives fewer visual signals. Eventually, the ability of the eyes to work together decreases, and the brain suppresses or ignores input from the weaker eye.

Anything that blurs a child's vision or causes the eyes to cross or turn out may result in lazy eye. Common causes of the condition include:

• Stabismus (Muscle imbalance) The most common cause of lazy eye is an imbalance in the muscles that position the eyes. This imbalance can cause the eyes to turn in or out and prevents them from tracking together in a coordinated way.
• Anisometropia (Different power in each eye) A significant difference between the prescriptions in each eye — which can be due to long-sightedness or short-sightedness or an imperfection on the surface of the eye called astigmatism — can result in lazy eye. In some children lazy eye is caused by a combination of strabismus and refractive problems.
• Deprivation. Any problem with one eye — such as a cloudy area in the lens (cataract) — can deprive a child of clear vision in that eye. Deprivation amblyopia in infancy requires urgent treatment to prevent permanent vision loss.

Risk factors

Factors associated with an increased risk of lazy eye include:

• Premature birth
• Small size at birth
• Family history of lazy eye
• Developmental disabilities

Complications

Untreated, lazy eye can cause permanent vision loss. Lazy eye is the cause of permanent vision loss in 2.9% of adults.

Treatment

It's important to start treatment for lazy eye as soon as possible in childhood, when the complicated connections between the eye and the brain are forming. The best results occur when treatment starts before age 7.

Treatment options depend on the cause of lazy eye and on how much the condition is affecting your child's vision. Your doctor might recommend:

• Corrective eyewear. Glasses can correct problems such as myopia, hyperopia or astigmatism that result in lazy eye.
• Eye patches. To stimulate the weaker eye, your child may wear an eye patch over the stronger eye. The patch is generally worn for two to six hours a day.
• Eye drops. A twice-weekly eye drop of a medication called atropine can temporarily blur vision in the stronger eye. This will encourage your child to use the weaker eye, and offers an alternative to wearing a patch. Side effects include sensitivity to light.
• Surgery. If your child's eyes cross or wander apart, your doctor may recommend surgical repair for the eye muscles. Your child may also need surgery if he or she has droopy eyelids or cataracts.

For most children with lazy eye, proper treatment improves vision within weeks to several months. Treatment might last from six months to two years.

It's important for your child to be monitored regularly in regards a lazy eye. They may require frequent examinations with an ophthalmologist and/or orthoptist.

If you have any concerns about your or your child’s eyes or suspect they may have a lazy eye – Please don’t hesitate to contact the clinic on 021 4341030 or bgolchin@corkeyeclinic.ie