Lazy eye (amblyopia)

A lazy eye, also known as amblyopia, is a condition in which vision in one eye does not develop normally during childhood. This can occur because one eye is stronger than the other, or because of a squint that causes one eye to be used less. As a result, the brain ignores the information from the weaker eye and focuses primarily on the stronger eye. There is nothing physically wrong with the eye itself. Glasses do not help solve the problem.

A lazy eye can have various causes:

• Strabismus: If the eyes do not work together properly and one eye deviates, this can lead to a lazy eye.
• Refractive errors: A significant difference in prescription between the two eyes can cause the brain to use the weaker eye less.
• Eyelid abnormalities: For example, a lazy eye caused by a congenital eyelid abnormality.
• Eye diseases: such as a drooping eyelid, a cloudy lens or cornea, or abnormalities of the retina or vitreous humor.

A lazy eye usually occurs in children under the age of eight. The sooner treatment begins, the better the visual acuity can recover.

Diagnosing a lazy eye is no easy task. Children themselves often do not notice that one eye sees better than the other because they are used to it. If the child does not cross their eyes, parents are also unlikely to realize that their child has a lazy eye. Lazy eye is often detected during a visit to the well-child clinic or Youth and Family Center. The child is then referred to an ophthalmologist or orthoptist, who will diagnose the lazy eye.

Determining a child’s visual acuity is difficult. For young children, this is done by having them follow a small light or object with one eye while the other eye is covered. For preschoolers, a picture card is used, and for older children, a card with letters or symbols. If one of the eyes performs less well, a follow-up examination by an orthoptist is necessary.

During the follow-up examination, eye drops are administered. This dilates the pupils and prevents the child from affecting the measurement by focusing (accommodating). This allows the correct prescription for the eyes to be determined. In addition, the examination looks for any abnormalities in the eye that may have led to the lazy eye.

What a child with a lazy eye might notice:

• Reduced vision in one eye.
• Difficulty perceiving depth.
• Problems with reading and writing.

Treatment for a lazy eye is most effective when started early, before the age of 7.

Treatment may include:

• Eye patches: The stronger eye is covered to stimulate the weaker eye.
• Prescription Eyeglasses: Eyeglasses can help improve vision.
• Eye drops: Sometimes eye drops are used to temporarily blur vision in the stronger eye, so that the weaker eye is stimulated.

If amblyopia goes untreated, you may experience the following problems:

• Reduced visual acuity: The lazy eye has lower visual acuity, which can make daily activities more difficult. It can cause additional headaches and fatigue.
• Loss of vision in one eye.
• Problems with depth perception: Amblyopia causes you to have reduced depth perception, which can lead to bumping into things, for example.
• Self-confidence: In cases of amblyopia, the eye may appear squinted. This can cause people to feel insecure about their appearance.

In adults, an untreated lazy eye can be treated with a combination of vision therapy and video game therapy. Depending on the severity of the problem, corrective lenses may also be prescribed.

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