What is amblyopia?

A lazy eye, also known by its medical term amblyopia, is a vision condition that occurs in childhood. A lazy eye in children can develop between birth and the age of seven years old, when one eye is used less than the other. As a result, the affected eye is not able to build a strong link with the brain and will have reduced vision.

Typically, amblyopia only affects one eye, although in rare instances, both eyes may be affected due to a strong glasses prescription. It is estimated that this condition affects around 1 in 50 children.

Lazy eye symptoms

Amblyopia symptoms are not usually noticeable and young children are often unable to identify this vision condition. With young children, you can check their vision by covering one eye at a time. If they are relying on one eye more than the other, they may object to you covering this up. With older children, they may be able to tell you if they’re experiencing issues with their vision.

One eye may appear to be different to the other, but this is typically a symptom of another condition which could contribute to amblyopia in children. These can include an eye squint (strabismus), short-sightedness, long-sightedness or astigmatism.

Often, the signs of a lazy eye are not evident without an eye examination. In the UK, all newborns have their eyes checked a few days after birth and again between the ages of 2-3 months. You can then have regular eye checks at opticians from the ages of 3 years old onwards. If you are worried about any issues with your child’s eyesight, you can consult your GP for a lazy eye test and other examinations.

Lazy eye causes

A lazy eye occurs when something causes the connection between the brain and the retina in the eye to not develop properly in a child’s early years. This can be a result of other conditions, such as a squint, obstacles in the vision field such as a droopy eyelid or cataract, or differences in prescription between the eyes.

As a result of these potential amblyopia causes, the eye may receive a reduced amount of light, experience a lack of focus or see differences between images in the eyes. As the affected eye receives fewer visual signals, the vision deteriorates and the child becomes more dependent on their stronger eye. If left untreated, central vision in the affected eye may never develop properly.

There are also a number of risk factors associated with the causes of lazy eye, including a family history of amblyopia, premature birth or small size at birth, and developmental disabilities.

The different types of amblyopia

There are different amblyopia causes, with the most common being a muscle imbalance. Known as strabismic amblyopia, this is where an imbalance in the eye muscles results in them crossing and being unable to work in sync with one another.

Refractive amblyopia is where one eye has a significantly reduced sharpness of vision due to differences in prescriptions between the eyes. This is due to vision issues such as long-sightedness, short-sightedness or astigmatism.

When an issue in one eye prohibits a clear field of vision, this can cause deprivation amblyopia. This can be caused by another condition, such as a cataract, and is typically the most severe of the amblyopia types, requiring urgent treatment to prevent a permanent loss of vision in the eye.

Lazy eye treatment options

Amblyopia treatment is most successful in young children under the age of 8 years old. Attempts to treat a lazy eye after this age may be more difficult and not be as effective. Therefore, it’s important to start treatment for a lazy eye as young as possible.

As well as their age, the success of the lazy eye treatment does depend on the initial vision level in the child’s affected eye, as well as their cooperation with the treatment. It is essential that the treatment instructions of the doctor or vision consultant are followed as strictly as possible to prevent the child’s vision becoming permanently impaired.

Treatment for a lazy eye in a child will involve correcting any underlying conditions, as well as encouraging use of the affected eye to allow it to develop. For instances where short-sightedness, long-sightedness or astigmatism are contributing to a lazy eye, glasses should help to correct this issue. These should always be worn and the prescription should be checked regularly. Glasses can also help to treat squints and may resolve the lazy eye issue without any further treatment.

If a cataract is causing the issue, then lazy eye surgery may be required to remove the cataract and allow vision in the affected eye to develop properly. The operation typically takes around two hours and is performed under general anaesthetic. Surgery may also be required in some cases of squints. This will improve the appearance by strengthening or weakening the muscles in the eye to change the position of the lazy eye. While this won’t improve their vision, it will align the child’s eye and allow them to work together better.

Advice for lazy eye treatment for children

Lazy eye exercises will be used to stimulate the affected eye. A patch may be placed over their good eye to encourage use of the weaker one. The length of time the patch is worn will depend on several factors, including the child’s age, their cooperation with the treatment and the severity of their vision issues. Normally, a child will wear the patch for a few hours each day over a period of several months. If the child requires glasses, the eye patch for the lazy eye can be worn underneath the glasses.

If the child cannot wear the patch or is uncooperative, then atropine eye drops can be used to blur the vision in their good eye to encourage use of their lazy eye. Side effects of these eye drops are rare, but can include irritation of the eye, headaches and flushing of the skin. The choice between eye drops for a lazy eye or a lazy eye patch is a matter of preference.

Young children do not always understand why they require lazy eye treatment and using a patch or eye drops may be an unpleasant experience for them. That’s why it’s so important to explain the reasons for the treatment and give them a lot of praise when they are cooperative. Try to give them incentives or distract them with fun activities. Your consultant can advise you on how to successfully carry out the treatment at home.

Reasons to choose Moorfields Private for your lazy eye treatment

Moorfields Private is renowned worldwide for delivering the highest quality of care for a wide range of different eye conditions. Our experienced surgeons work at the top of their profession and all hold accredited consultant positions at the Moorfields Eye Hospital NHS Foundation Trust.

If you choose us for your treatment for a lazy eye, you will benefit from a service with complete continuity. From initial consultation to follow-up appointments, you will be seen every step of the way by your chosen consultant surgeon. This means you can enjoy complete confidence and peace of mind at each visit.