Amblyopia, or “lazy eye,” is the most common reason children can lose their vision. According to the Centers for Disease Control and Prevention (CDC), it affects nearly 3% of the U.S. population.
If caught early, amblyopia can be treated and vision improved. But without treatment, it can lead to lifelong vision impairment.
What is amblyopia?
Amblyopia affects just one eye and can interfere with depth perception. It develops when the brain and the eye don’t work together correctly. The brain struggles to recognize what the weaker eye sees because from a young age the visual pathways between the brain and the eye did not develop well. As a result, the brain relies more on the stronger eye. Over time, the brain starts ignoring signals from the weaker (“lazier”) eye, causing vision to worsen.
This eye condition typically starts at birth or in early childhood and is best treated before age 8. Without treatment it can lead to one-eye vision loss. However, early treatment (before 8 years of age) can usually prevent long-term vision problems.
What causes amblyopia?
Various eye conditions can cause amblyopia. These include:
- Strabismus (crossed eyes): Usually, your eyes move together as a pair, but when they don’t, the eye that turns can develop amblyopia. In other words, one eye might look straight ahead while the other drifts in, out, up or down. The brain ignores the eye that isn’t lined up and that causes amblyopia.
- Refractive errors: Amblyopia can happen if one eye has a refractive error or if the eyes are very different. For example, if one eye has blurry vision and the other sees clearly, the brain may rely more on the good eye, leading to amblyopia in the weaker eye. Common refractive errors include:
- Nearsightedness (when you can’t see far away)
- Farsightedness (when you can’t see up close)
- Astigmatism (when the front of the eye, the cornea, is highly curved)
- Cataracts: Some children are born with a cataract in one eye. A cataract is a cloudy spot in the eye that blocks vision. If a cataract is in one eye, it can cause amblyopia.
- Droopy eyelid: A droopy eyelid, or ptosis, can block some of the eye and cause amblyopia.
Is my child at risk of amblyopia?
In addition to eye problems, there are a few factors that can also increase the risk of a child developing amblyopia:
- A family history: Children may be at higher risk if a parent or sibling has amblyopia or other vision problems.
- Premature birth: Babies born early (before 37 weeks) are more likely to develop the eye condition, especially if they have other vision issues in the hospital.
- Low birth weight: Babies born weighing less than 5 pounds 8 ounces are at an increased risk of developing amblyopia.
- Other health conditions: Certain conditions, such as cerebral palsy or Down syndrome, can increase the risk of developing this eye condition.
How can you tell if my child has amblyopia?
Amblyopia can be hard to spot. Your child may not notice that one eye is weaker than the other, and there may not be any obvious signs of a vision problem.
If you notice symptoms, you may see changes in how they look at objects or use the space around them. Here are some signs to look for:
- Your child’s eyes are cross-eyed or don’t move with the other.
- They squint or close one eye to see better.
- Your child tilts their head to one side a lot.
- They have trouble seeing things clearly or complain of blurry vision.
- They bump or knock into objects (especially on one side of their body).
- Your child has trouble judging distance (depth perception).
If you notice these symptoms, schedule an eye exam with your child’s pediatrician or an eye care specialist.
How is amblyopia diagnosed?
Amblyopia is most often detected during a routine vision screening typically done as part of a pediatric well-check or in-school health screenings. Your child will then be referred to, and diagnosed by, an optometrist or ophthalmologist (eye care specialists).
Your child’s first vision screening should take place at around 12 months. All children ages 3 to 5 should have their vision checked at least once before they enter school.
Your child’s health care provider, pediatrician or eye care specialist will check how well each eye sees. They may also look for other problems, like crossed eyes or refractive errors.
If amblyopia is found, the eye care specialist will explain the best treatment plan for your child.
Treatment options
The goal of treatment is to make the weaker eye stronger. There are several ways to do this:
- Glasses: Wearing corrective lenses can help with nearsightedness or farsightedness. In some cases, glasses alone can fix amblyopia.
- Eye patch: Your child may need to wear a patch or cover over their stronger eye. Wearing an eye patch forces the brain to use the weaker eye. Over time, this can improve vision in the weaker eye. It is common to wear the patch 2 to 4 hours a day.
- Medicated eye drops: Special drops (usually atropine) can temporarily blur vision in the stronger eye, forcing the brain to rely on the weaker eye. The eye drops are safe and will not affect your child’s vision in their strong eye.
- Vision therapy: Special exercises and activities may help improve eye coordination and strengthen the weaker eye. The exercises focus on accommodation, fixation, saccades, eye tracking and hand-eye coordination. Vision therapy can be done at home or with a behavioral or developmental optometrist.
The length of treatment depends on your child’s age and the severity of the amblyopia. Some children may need treatment for a few months, while others may need it for a few years.
Will my child need surgery?
While not common, in some cases, your provider may recommend surgery to correct certain eye problems like crossed eyes, droopy eyelids or to remove a cataract. Surgery alone doesn’t cure amblyopia but can help the eyes work better together when combined with other treatments.
Can adults be treated for amblyopia?
The eye condition is easiest to treat in young children because their brains are still developing. However, in some cases, treatment can still help older children and adults.
Improvements may take longer and be less effective for teens and adults than children. Success will depend on the severity of the amblyopia, how early treatment starts and the specific treatment methods used. Even small improvements can make a big difference in daily life.
Ways to prevent amblyopia
You can’t prevent amblyopia or other vision issues that cause it, but there are things you can do to improve vision and avoid long-term effects. Here’s what you can do:
- Schedule an eye exam: Start regular vision screenings by age three or earlier if you have a family history of eye problems. Early checkups help catch issues before they lead to amblyopia.
- Watch for warning signs: Look out for symptoms like squinting, tilting the head or one eye that drifts. If you notice these, schedule an eye exam right away.
- Correct vision problems early: If left untreated, issues like nearsightedness, farsightedness or astigmatism can lead to amblyopia. Glasses or contact lenses can help prevent the brain from ignoring one eye.
- Treat misalignment: Crossed eyes or strabismus are a common cause of amblyopia. An eye specialist can recommend treatments such as glasses, patches, vision therapy or surgery to correct the problem.
- Treat cataracts or blockages: Cataracts or droopy eyelids can block vision in one eye. Treat these conditions early to prevent amblyopia from developing.
- Follow medical advice: If your provider prescribes glasses, a patch or other treatments, follow the plan. Consistency will prevent the eye condition from worsening.
We’re here to help
At Banner Health, we know how important your vision is. Our eye care team is here to support you every step of the way. From early diagnosis to treatment, we’ll work with you to protect your vision. Schedule an appointment with a Banner Health eye care specialist today to learn more about your eye condition and how we can help.