What causes a lazy eye?
A lazy eye (amblyopia) can develop in a child because one eye does not see an object as well as the other eye. The nerve pathways between the back of the eye, the retina, to the brain does not receive as many visual signals via the optic nerve. The brain, therefore, suppresses or ignores what it is seeing from the weaker eye and does not develop the eye’s supporting visual centre brain function. If there is a lazy eye there is often nothing wrong physically with the eye when we do an eye examination. There may not be an associated squint (strabismus), the eyes can appear externally to be the same.
A child’s lazy eye
A lazy eye (amblyopia) in a child is assessed our speciialist optometrist. If there is a lazy eye, there will be abnormal results on the vision screening tests. Unfortunately, a lazy eye is not evident without an eye examination being done. In other words, a squint is not always present. A child might just have double vision, or they may constantly tilt their head to try and get a better vision. A Binocular vision examination is needed to diagnose this accurately.
If you think your child has an eye that is wandering in or out at any time, particularly in the first four years of life, it is important to get a vision check by a qualified clinical practitioner experienced in looking after children, and have your child seen by a paediatric specialist at Woodford eye clinic. A vision check is particularly important if there is a family history of eye conditions, squint, lazy eye, or cataracts.
A lazy eye can interfere with school work and your child’s general development and can make the child timid if they cannot see well from one eye. Sports will also be difficult if it requires binocular (using two eyes) vision. Furthermore, Certain professions will be closed to them as adults if one eye is lazy.
How is my child’s lazy eye treated?
The treatment of your child’s lazy eye is going to depend entirely on the cause of it and how much the lazy eye is affecting their vision.
Firstly, the consultant may recommend that your child wears glasses. This is most commonly done for farsightedness or long-sightedness (hypermetropia) when the child is anything between the age of two and five years old. Corrective eyewear such as glasses in younger children or contact lenses as they get older can correct farsightedness, near-sightedness (myopia, short-sightedness) or astigmatism. Sometimes correcting the farsightedness also corrects any squint that is present and surgery is not required for the squint. This is called an accommodative squint (strabismus).
Eye patches can also be used to stimulate the vision in the weaker eye, and your child may have to wear an eye patch over their stronger eye for about two hours a day in order to help them develop their vision.
Another form of patching can be done with a Bangerter filter, which is a special filter put on the eyeglass of a stronger eye to blur the vision like an eye patch. It will work to stimulate the vision in the weaker eye, which then has to concentrate on seeing.
Our Optometrist will encourage children to wear their glasses at the same time as they have their patching and to concentrate on doing activities such as reading or playing with their Lego, in other words, activities that require concentrated eye work.
In some special cases, Atropine eyedrops are used in order to temporarily blur the vision of the stronger eye and again encourage your child to use the weaker eye. This can be offered as an alternative to eye patching in some children. The Atropine eyedrops are put in the stronger eye twice a week, which encourages the child to use their weaker eye. However, in certain situations the dilated pupil of the better eye can experience light sensitivity which is why this is only used in certain situations.
Conclusion
Glasses maybe required for several years, and eye patching maybe required for six months to two years. During that time, the eyes will have constant monitoring to ensure that the vision is developing well and is maintained. However, if this fails, it may recommend that surgery is the best option for your child’s eyes if they are wandering out or crossing in (exotropia or esotropia).
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