About Amblyopia
& Lazy Eye

Amblyopia is the medical term for poor vision in one, or sometimes both eyes. Children are born with poor vision.  As they develop the eyes send the message of what they see to the brain and the visual brain cells “learn” how to interpret these images. Over time the brain learns how to fine-tune the images it is receiving and the vision improves. If the image that is being sent to the brain is blurry then the brain will never learn how to see clearly from that eye.  The important piece in this problem is that the brain cannot “learn” how to see clearly after a certain age (that age is not known for certain). We do know that the younger the patient is when he/she is treated the better the outcome will be. So, Amblyopia should be treated as early as possible.
Causes of Amblyopia
The most common forms of amblyopia are strabismic and anisometropic. Strabismic amblyopia occurs when a strabismus is present and the eyes are not aligned. The brain favors one eye over the other and the non-preferred eye is not adequately stimulated and the visual brain cells do not mature normally. Anisometropia refers to the condition when the eyes have an unequal “refractive power”. As an example, one eye may be nearsighted and the other farsighted. Because the brain cannot “balance” this difference, it picks the eye that is “easier” to use and develops a preference for this eye only. Other causes of amblyopia may include: cataracts, ptosis and trauma.
Treatment of Amblyopia
In most cases Amblyopia is treatable. However, the success of treatment is dependent upon the initial level of vision, the amount of time the vision has been poor and the age of the child. The most important factor in treating Amblyopia is compliance with the treatment protocol. Treatment requires “forcing” the brain to use the non-preferred eye. In most cases this means patching the better seeing eye for some part of the day. Glasses may also be required to “balance” an unequal refractive power between the two eyes. For some patients an eye drop can be used to blur the vision in the better seeing eye.  If a cataract is present, this may need to be removed before Amblyopia treatment can be started. The initial treatment period may be difficult for the child, as he/she is being made to use their poorer seeing eye. This usually lasts a short period of time, as their vision usually improves rapidly.
Prognosis of Children with Amblyopia
The prognosis for kids with Amblyopia is quite good- if treatment is properly performed.  It cannot be overemphasized that the major reason for failure in the treatment of Amblyopia is poor compliance with the treatment protocol. Remember, Amblyopia can be treated only when a child is young. If it is delayed until the child is older and more understanding, it may be too late!