Amblyopia (Lazy Eye): Symptoms, Diagnosis, Treatment

What is amblyopia (lazy eye)?

Amblyopia (lazy eye) is a type of poor vision that typically occurs in only one eye, but it is not uncommon for both eyes to be affected.

It occurs when there is a breakdown in how the brain and the eye work together, resulting in the brain’s inability to recognise the sight from one eye. The brain is increasingly dependent on the stronger eye over time, resulting in poorer vision in the weaker eye.

If your condition is left untreated, your brain will learn to ignore the image that comes from the weaker eye, which could lead to permanent vision problems.

What are the symptoms of lazy eye?

Lazy eye symptoms can be tough to take note of. Children with amblyopia may have decreased depth perception, which means they have difficulties identifying how near or far something is.

As parents, you may notice signs that your child is trying to see things properly as well, such as squinting, closing one eye, or tilting their head.

In many cases, parents have no idea that their child has amblyopia until a diagnosis by the doctor during an eye exam. Therefore, it is important for children between the ages of three to five years old to get their vision screened at least once.

What are the causes? 

• Refractive errors: Errors like these include common vision problems such as near-sightedness, far-sightedness, and astigmatism. These can be fixed with glasses or contacts. However, the brain may begin to depend on the eye with stronger vision if they are not treated.
• Strabismus: The eyes usually move together as a pair. However, the eyes do not line up in children with misalignment of the eyes, such as one eye turning in, out, up, or down, which can lead to amblyopia. The brain may ignore the visual input from the misaligned eye to avoid double vision.
• Structural eye conditions: Anything that obstructs vision in one eye during early childhood, such as a congenital cataract, ptosis (droopy eyelid), or other conditions, can cause amblyopia. The brain receives less visual information from the affected eye, leading to its underdevelopment.

What are the risk factors? 

Some children are born with amblyopia, while others get it later in childhood. The chances of developing amblyopia are increased in children who:

• Were born prematurely.
• Were smaller than average-sized babies at birth.
• Have a family history of amblyopia, childhood cataracts, or other eye-related issues.
• Have developmental challenges.

How is lazy eye diagnosed? 

Lazy eye, or amblyopia, is typically diagnosed through a comprehensive eye examination conducted by an ophthalmologist. 

• Visual acuity test: This measures the sharpness of vision in each eye. It often involves reading letters on a chart (Snellen chart) from a distance to determine how well the patient can see. This helps identify if one eye has significantly poorer vision than the other.
• Refraction test: This test determines the correct prescription for glasses or contact lenses. It involves looking through a series of lenses to find which ones provide the clearest vision. This can reveal differences in refractive errors between the two eyes.
• Ocular alignment and movement test: The doctor will examine how well the eyes work together and whether they are properly aligned. This involves covering one eye at a time and watching the uncovered eye for movement, which can indicate strabismus (eye misalignment).

Poor vision in one eye does not necessarily mean a child has amblyopia. Refractive errors can cause poor vision in one eye, and these issues can often be corrected with glasses or contact lenses.

How is lazy eye treated?

Treatment for lazy eye, or amblyopia, focuses on improving the vision in the weaker eye and ensuring both eyes work together properly. The most effective treatments are typically administered during early childhood when the visual system is still developing.

• Corrective eyewear:Prescription glasses or contact lenses can correct refractive errors in the amblyopic eye. For some children, wearing corrective lenses consistently can significantly improve vision in the weaker eye.
• Wearing an eye patch over the stronger eye:This encourages the brain to prioritise the weaker eye by covering up the stronger eye with a stick-on eye patch. The duration of the patching varies as some children just need to wear the patch for two hours a day, while other children may need to wear it whenever they are awake.
• Putting special eye drops in the stronger eye: The brain is forced to use the weaker eye after putting a once-a-day drop of the drug atropine that temporarily blurs near vision. This treatment is as effective as using an eye patch for some children, and some parents find this method simpler to use as young children may attempt to pull off their eye patches.

• Vision therapy: Specific exercises and activities designed to improve the coordination and focusing abilities of the eyes can be helpful. Vision therapy may involve computer-based programs, puzzles, and other activities that promote the use of the amblyopic eye.

Your child can correct his or her lazy eye by doing fun exercises such as dot-to-dot cards, colouring within lines, and binocular vision in individuals with amblyopia may be improved by performing Brock string tests.

What are the complications of untreated amblyopia?

The main complication of untreated amblyopia is a permanent and lifelong vision loss. If amblyopia is not treated during childhood, the affected eye may never develop normal visual acuity. 

Proper depth perception relies on both eyes working together to create a three-dimensional view of the world. Untreated amblyopia can impair depth perception, making it difficult to judge distances and perform tasks that require precise hand-eye coordination, such as driving, playing sports, or certain occupations.

The visual limitations caused by amblyopia can affect academic performance, career opportunities, and daily activities. This can lead to frustration, reduced self-esteem, and other emotional or psychological impacts.

How to prevent amblyopia?

Amblyopia may not be prevented but rest assured that early detection and treatment will be effective and often prevent long-term vision issues.

Make an appointment at Pantai Hospitals

Get in touch with us to book an appointment today if you have concerns or questions regarding amblyopia. A dedicated and expert team of ophthalmology specialists at Pantai Hospitals is available for consultation to provide the best care and assistance. We assure you the best possible care tailored to your specific needs.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.