Amblyopia (Lazy Eye): Seemingly Harmless, Actually Blinding

Three out of 100 children have amblyopia, commonly known as “lazy eye.” Untreated, it can cause long-term vision problems, including legal blindness.


What Is Amblyopia (Lazy Eye)?

Amblyopia is a vision development disorder wherein an eye fails to achieve normal visual acuity. The brain favors one eye, suppressing the visual signal from the other. In consequence, the suppressed eye has reduced vision.


Causes and Risk Factors

A lazy eye generally develops during early childhood, when the eyes and brain are still learning to work together. It can occur in one or both eyes due to the following causes and risk factors:


1. Vision Development Issues

The most common causes of amblyopia involve issues with how vision develops in infants and young children. If one eye has significantly better vision than the other, the brain may favor that eye and ignore signals from the weaker one. This condition is known as strabismus or crossed eyes. Unaddressed refractive errors like astigmatism, hyperopia (farsightedness), or myopia (nearsightedness) can also lead to amblyopia.


2. Obstructed Vision

Anything blocking an infant’s vision during critical periods of development can increase the risk of amblyopia. These obstructions include congenital cataracts, ptosis (droopy eyelids), or other eye conditions present from birth.


3. Premature Birth

Babies born prematurely are more prone to developing amblyopia. Coming out too early (before 37 weeks) can interrupt normal eye development and raise risks for conditions like retinopathy of prematurity, which can lead to unusual eye movements, white pupils, and vision impairment.


4. Genetics

Amblyopia may run in families. While environment and visual experience also play a role, a 2022 study suggests a child is at greater risk if a parent or sibling has amblyopia. Having biological family members with other eye and vision problems may also be a contributing factor.

Amblyopia’s causes and risk factors stress the importance of annual eye exams for young children. Early detection and intervention prevent permanent vision loss from a seemingly harmless lazy eye.


Signs and Symptoms of Amblyopia

It can be challenging to determine whether a child has amblyopia. Most parents and guardians only find out their child has this condition after a healthcare provider or eye doctor conducts an exam.

In general, a child with amblyopia may exhibit the following:

  • Bumping into objects, particularly on one side of their body
  • Using one side of their body more frequently than the other
  • Crossed eyes
  • Droopy eyelids
  • Constantly shutting one eye or squinting
  • Always tilting their head to one side


By understanding the signs and symptoms, parents and physicians can work together to prevent further vision problems and get treatment started as soon as possible.


Treatment Options for Amblyopia in Children and Adults

Treatments for amblyopia focus on correcting vision in the weak or misaligned eye, typically by strengthening connections in the brain’s visual processing centers. Some of the most common treatments for children and adults include:


1. Orthoptic Eye Patch

Patching or covering the stronger eye forces the weaker eye to work, strengthening connections in the visual processing centers of the brain. Adhesive patches worn over the stronger eye for an hour or more a day are among the most effective treatments for amblyopia in children. Still, adults can also benefit from this affordable solution.

A 2022 study published in the Indian Journal of Ophthalmology found that diligent patching for 1 hour a day thrice a week led to significant vision acuity improvement in 3- to 12-year-olds with anisometropic amblyopia.


2. Eye Exercises

Eye exercises, also referred to as vision therapy, train the eyes to work together and strengthen visual skills. Exercises may include pencil pushup treatment (PPT), coloring within the lines, or in-office vision therapy. An eye doctor may suggest these activities in combination with patching for the most effective treatment, as no clinical evidence proves that eye exercises alone can treat or fix amblyopia.

Read Healthline’s Eight Exercises to Try to Correct a Lazy Eye for more information.


3. Medicated Eye Drops

Eye drops called atropine (Isopto Atropine) help dilate the pupil and temporarily blur vision in the stronger eye, compelling the lazy eye to work harder. These drops may be better for amblyopia than patching. “Atropine eye drops had a higher acceptance rate and better compliance by children and their parents than patching. [It] may become a new standard of treatment for some forms of amblyopia,” comments Dr. Paul Sieving from the National Eye Institute.

Treatment with atropine drops may continue for several weeks or months depending on the amblyopic eye’s severity and how long it takes vision to function normally or similarly to the dominant eye.


4. Bangerter Occlusion Foils

Doctors attach these translucent filters on the eyeglass lens of the dominant eye to encourage amblyopia treatment. The material blurs vision in the stronger eye, stimulating increased use and development of the weaker “lazy” eye. Similar to patching, which fully occludes the stronger eye, this filtering technique prompts the brain to rely more on the amblyopic eye.


5. Refractive Correction

Correcting underlying refractive errors such as nearsightedness or farsightedness is crucial for treating amblyopia. Prescription eyeglasses, contact lenses, or refractive surgery are often necessary to achieve clear vision and ensure the maximum efficacy of treatments for children and adults with amblyopia.

Related: Should You Choose LASIK Over Prescription Glasses and Contact Lenses? Call Arizona Retinal Specialists at 623-474-3937 if you are considering laser eye surgery in Sun City, AZ.


6. Surgery

Surgical intervention may be necessary if amblyopia is due to droopy eyelids or cataracts. Also, if a patient’s eyes continue to wander apart or cross with prescription glasses, a specialist might advise surgery to straighten the eyes, in addition to other treatments for lazy eyes.


Act Now if You Notice Signs of a Lazy Eye

With a solid understanding of the causes and risk factors, amblyopia does not have to limit your vision or quality of life. Early detection and treatment via patching, vision therapy, medicated eye drops, Bangerter filters, refractive correction, or surgery can improve vision and even restore binocularity in some cases.

NOTICE TO USERS is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified health provider with any questions you may have regarding any health symptom or medical condition. Never disregard professional medical advice nor delay in seeking professional advice or treatment because of something you have read on