Lazy eye is an eye disorder that arises when one eye becomes weaker than the other. Lazy eye (amblyopia) in children may result in decreased vision in the weaker eye (1). This condition affects around 3% of children and is the most common reason for vision loss (2). However, early detection and appropriate treatment could help prevent long-term complications such as vision impairment in children. Read this post to learn more about the lazy eye in children, including its signs and symptoms, diagnosis, treatment options, and management.
What Happens In Amblyopia In Children?
Amblyopia occurs when there is a malfunction in the eye-brain connection. The brain is unable to recognize vision from one eye. Eventually, the brain begins to ignore the eye with the blurred vision and relies more on the ‘stronger’ eye, worsening the vision in the weaker eye (1) (2). In some children, amblyopia is not easily noticeable. In fact, even children might be unaware that the vision of one of their eyes is affected. Therefore, it becomes critical to have regular and early eye exams in children.
Symptoms Of Lazy Eye In Children
The symptoms of lazy eye could be hardly noticeable in children. Children with amblyopia usually display the following signs and symptoms of the condition (1) (2).
Poor depth perception Difficulty in telling if the object is far or near Bump into things, particularly on one side Have a difference in nearsightedness or farsightedness between the two eyes Favor one side of the body Have crossed eyes
Have a droopy eyelid Shut one eye often Squint too much Tilt their head to one side
Can Lazy Eye Be Fixed In Children?
Yes, early diagnosis can increase the chances of a full recovery. It usually takes several weeks to months to improve the vision of the ‘lazy’ or weaker eye (3).
Causes Of Lazy Eye In Children
In most cases, doctors may not know the cause of lazy eye. However, amblyopia usually occurs when there is a difference in the focusing ability of each eye (2). Some of the eye problems that may cause amblyopia are the following (1) (2).
1. Refractive errors
These conditions affect how light passes through the eyes and include:
Nearsightedness (trouble seeing distant objects; also known as myopia) Farsightedness (trouble seeing nearer objects, also known as hyperopia) Astigmatism (blurry vision due to curved cornea)
2. Strabismus (‘Cross-eyed’)
The eyes usually move together. However, in this condition, an imbalance in the lengths of the eye muscles causes misalignment in the eyes’ position. It could cause one eye to drift in, out, up, or down. Strabismus, also called crossed eyes, may cause the brain to rely on one eye more than the other, resulting in amblyopia.
3. Structural problems (Deprevation al amblyopia)
Structural issues could lead to amblyopia. These include:
Cataracts (blurry vision due to cloudiness in the lens) Droopy eyelid A scar on the cornea Eye injury or surgery
Risk And Complications Of Lazy Eye
Some children are born with the condition, while others develop it during childhood. There is an increased risk of developing amblyopia in children who (1) (2):
Are born prematurely. Weighed smaller than average at birth. Have developmental disabilities. Have a family history of other eye conditions, amblyopia, or childhood cataracts.
If untreated, the condition can result in long-term vision problems, including vision loss in the affected eye.
When To See A Doctor?
Consult an ophthalmologist if you notice any of the symptoms of amblyopia in your child. When planning a visit, make a list of the following points.
Diagnosis Of Amblyopia In Children
The American Optometric Association recommends a thorough vision screening in children before they are six months old, and when they are three years old (4). The child’s vision should be checked at least once between the ages of three and five years. These assessments could help in the early diagnosis of the condition. During diagnostic procedures, an ophthalmologist checks the difference in the visions of both eyes. They might cover an eye or place a patch over it to determine whether the child can follow a moving object with an eye. The doctor may also shine a light on the eyes, administer eye drops to dilate the pupil, and ask the child to read letters on a chart (4). They may also observe the reaction of the child with an eye patch. For instance, if the child has a problem, they will try to look above or below the patch. Younger children may try to remove it or cry (3). These tests could help determine the underlying cause of lazy eye in children. The underlying cause could include refractive errors, strabismus, cataracts, or other eye disorders.
At What Age Is Lazy Eye Treated?
The treatment of lazy eye in children was earlier considered effective up to the age of seven years. However, a recent study suggests that amblyopia can be treated in children up to 17 years of age. The study included children between the ages of seven and 17 years. The study made the following main observations.
53% of children between the ages of seven and 12 years showed improved vision after the treatment.
47% of children between the ages of 13 and 17 years gained improved eyesight after the treatment.
Treatment For Lazy Eye In Children
The treatment for amblyopia depends on the underlying cause. The correction strategy primarily relies on making the brain use the weaker eye more effectively. The following are the various treatment options for lazy eye in children (2) (5) (6) (7).
1. Eye patches
The doctor may put a stick-on eye patch on the child’s stronger eye so that the brain uses the weaker eye for vision. It gradually strengthens the vision from the weaker eye. Some children may have to wear the eye patch for a few hours a day, while others may require it for the entire day. The treatment may last for a few weeks to years.
2. Glasses
These are commonly used in correcting refractive errors, such as nearsightedness and farsightedness. Glasses may also be used in the correction of lazy eye due to strabismus.
3. Eye drops
Special eye drops could blur the stronger eye’s vision, forcing the brain to use the weaker eye. This option can help treat lazy eye in young children who may peel off the eye patch when parents are not around.
4. Surgery
Surgical treatments might be considered if lazy eye is due to strabismus or cataracts. Certain eye disorders, such as some refractive errors, could be cured with surgery. The type of surgery can vary based on the underlying cause.
5. Vision exercises and therapy
These can be used in combination with other treatment methods for strengthening the eye muscles and improving vision development. Vision therapy treatment includes:
Spatial skills involving eye-hand coordination Accommodation for focusing Fixation (visual gaze) Saccades (eye jumps) Pursuits involving eye-tracking Binocular vision for making the eyes work together
These treatment options may improve the child’s vision in a few weeks to months, depending on the severity of the child’s amblyopia. Your child may have to continue with follow-up treatment to prevent the recurrence of lazy eye at a later age.
What Can Parents Do?
You can take the following steps to improve your child’s vision and keep their eyes healthy.
