Amblyopia (Lazy Eye)

Amblyopia, also known as “lazy eye”, refers to the presence of poor vision in one eye compared to the other. This often results in poor vision and poor depth perception. If left untreated, amblyopia can cause permanent vision damage and depth perception issues. Less commonly, amblyopia can affect both eyes.

Amblyopia is the most common cause of vision impairment among children according to the National Institute of Health.

Amblyopia affects about

1 in 30 people

Amblyopia is the leading cause of one-eyed vision loss in young and middle-aged adults according to the National Institute of Health.

A child may have amblyopia if they show any of the following symptoms

Squinting
Eye rubbing
Turning head to one side
General clumsiness
Sloppy handwriting
Poor eye-hand coordination
Closing one eye to see better
Problems with balance
Slower reading and comprehension speed
Unexplained poor academic performance
Poor vision in general
Headaches
Poor vision in general

Amblyopia, also known as “lazy eye”, refers to the presence of poor vision in one eye compared to the other. This often results in poor vision and poor depth perception. If left untreated, amblyopia can cause permanent vision damage and depth perception issues. Less commonly, amblyopia can affect both eyes.

Frequently Asked Questions

Amblyopia is caused by the inability of the brain to use both eyes equally. During the first few years of life, the brain of a child with normal visual development will learn to take information from both the right and left eyes and put it together, a process called fusion. Alternatively, the brain of a child with amblyopia will start to “favor” one eye over the other eye resulting in the “favored” eye in becoming stronger in the years to come and the “unfavored” eye in becoming weaker or lazier in the years to come. The following reasons can cause the brain to favor one eye over the other:

  • Large difference between the refractive error (prescription) between the two eyes such that the eye with the higher prescription becomes amblyopic. This can be from nearsightedness, farsightedness or astigmatism. In some cases, if both eyes have a significant amount of astigmatism, they can both become amblyopic
  • An obstruction in vision in one eye such as childhood cataract
  • An outward or inward deviation of one eye (also known as “eye turn” or “crossed eyes”) can cause the deviated eye to become amblyopic

If amblyopia is due to an eye turn, the parent or teacher will likely notice this and recommend treatment. However, if amblyopia is due to any of the other causes, the child or parent may never notice this since the child is usually going to have “good vision” though they are only using one eye at all times to get that vision and their brain is suppressing the other eye. This is why amblyopia is often missed. If amblyopia is not detected timely, it will result in poor vision in the long run, poor depth perception, possible head turn, headaches and eyestrain. Altogether, it can severely impact the child’s academic performance and ability to perform day-to-day tasks such as catching a ball, riding a bike, playing sports, climbing stairs or seeing 3D movies.

It is crucial to treat amblyopia at an early age to prevent any issues with depth perception, eye tracking, eye focussing and eye teaming. If left untreated, amblyopia does not resolve on its own and will prevent a child from developing proper 3D vision/ depth perception. This can cause struggles with daily activities in childhood with reading and schoolwork and in adulthood with driving. Not having proper 3D vision/ depth perception will also poorly impact the child’s sports performance throughout their life. Although amblyopia can be successfully improved at any age, it is important to treat it as early as possible for best results. Amblyopia treatment is recommended between 3-6 years of age.

Amblyopia can be treated at any age, however, the earlier the treatment, the better the outcome. Treatment may include the following:

  • Eyeglasses or contact lenses: this option corrects the refractive error (prescription) in an attempt to equalize the load on the two eyes
  • Patching or penalization: this option involves patching or reducing the vision through eyedrops out of the better seeing eye for a certain amount of time per day to “force” the poor eye to see on its own
  • Vision Therapy: this option works at the level of the brain to teach the brain how to use both eyes equally.

Vision Therapy is often used in conjunction with eyeglasses, contact lenses and/or patching to treat the underlying dysfunction that is causing the amblyopia and provide a complete treatment for amblyopia. An individualized vision therapy program for amblyopia will include customized vision activities to eliminate suppression, enhance eye coordination, eye tracking, eye focusing and eye teaming, which will teach the brain how to use the two eyes both individually and together as an effective team. This will in turn improve overall vision, depth perception, binocular vision, reading abilities, sports performance and visual processing abilities. The skills obtained from the vision therapy program for amblyopia will be learned for life since vision therapy exercises are working at the level of the brain to teach it how to control the eyes, a skill that once learned, cannot be forgotten.

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Schedule a Vision Therapy Assessment with our board-certified developmental optometrist, Dr. Arora, for a thorough assessment of your visual skills and visual processing speed.