What is Lazy Eye or Amblyopia?

Lazy eye, medically known as amblyopia, is a common vision disorder that affects both children and adults. It occurs when one eye becomes weaker than the other, causing the brain to rely more on the stronger eye. Despite its prevalence, many people are unfamiliar with the condition and its implications for vision.

In this blog post, we will explore what lazy eye is, its causes, signs and symptoms, how to diagnose it, and what are available treatments. Additionally, we’ll also take a look at adults with lazy eye and their treatment options.

What is Lazy Eye?

Lazy eye, also known as amblyopia, is a vision disorder, which is a result of inappropriate vision development during the early years. It is a condition where the brain and one or both eyes fail to work together. Consequently, the brain is incapable of recognizing sight from one eye. Consequently, the brain becomes increasingly reliant on the other, stronger eye. Over time, vision in the weaker eye deteriorates. Simply put, when one eye is less developed than the other, the brain starts to rely on a healthy eye more. 

Your brain will learn to disregard the image from the weaker eye if you do not receive an appropriate therapy. If not treated, lazy eye can cause long-term vision problems, as the brain learns to ignore the weaker eye. This can affect depth perception and coordination.

Visual pathway and connection between the brain and eyes

What Does a Lazy Eye Look Like?

Lazy eye can often be visually identified by several characteristics:

1. Misaligned Eyes: One eye may wander inward or outward while the other eye focuses straight ahead.

2. Weaker Vision: The affected eye has significantly reduced vision, making it appear less responsive.

3. Frequent Squinting or Closing of One Eye: The person might squint or shut one eye to improve focus, especially when trying to read or concentrate.

4. Poor Depth Perception: Difficulty in accurately judging distances or depth can be evident.

5. Uneven Eye Movement: The lazy eye may not track movement as smoothly or consistently as the stronger eye, leading to noticeable differences when focusing on objects.

Difference Between Strabismus and Amblyopia

While lazy eye (amblyopia) and crossed (strabismus) are related, they are different conditions. Strabismus refers to eye misalignment, where the eyes point in different directions. In contrast, lazy eye is a result of the brain favoring one eye over the other, leading to reduced vision in the weaker eye.

  • Lazy Eye: A neurological issue where the brain ignores one eye’s input.
  • Strabismus: A physical misalignment of the eyes that may cause lazy eye.
Amblyopia Strabismus
Nature of the conditionAmblyopia is primarily a vision-related neurological development disorder resulting from the brain favouring one eye over the other.Strabismus is a misalignment of the eyes, leading to a lack of coordination between them.
SymptomsReduced vision, poor depth perception, and difficulties with binocular activities.Visible eye misalignment, double vision, and eye strain.
Treatment FocusAmblyopia treatment focuses on promoting the use of the weaker eye through corrective measures like glasses and vision therapy.Strabismus treatment aims to correct the misalignment, often through glasses, vision therapy, or surgery.

How Common is Lazy Eye?

While it may sound like a very niche problem, up to 5% of children suffer from lazy eye. In other words, more than 130 million worldwide. It is the most common cause of visual impairment in children.

However, epidemiological data on the prevalence of amblyopia varies greatly among countries and time periods. Nonetheless, it remains a substantial global vision problem, and public health initiatives of early screening, treatment, and management are critical. However, there is good news: amblyopia can be successfully fixed with regular exercises and treatment.

“As long as amblyopia is treated early in its course, it is indeed one of the easiest and most effectively treated conditions we can treat.”

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Causes of Lazy Eye

A wide range of factors have an effect on the nerve connections in the brain that are in charge of processing sight function properly. Conditions that can lead to lazy eye are strabismus, genetics, different levels of vision in each of your eyes, damage to one of your eyes from trauma, drooping of one of your eyelids, vitamin A deficiency, corneal ulcer or scar, eye surgery, vision impairment and glaucoma.

The most common causes include:

1. Strabismus (Crossed Eyes): Strabismus is a condition in which the eyes do not align properly. One eye may turn inward (esotropia), outward (exotropia), upward (hypertropia), or downward (hypotropia). The misalignment can lead to the brain favoring one eye over the other, causing the neglected eye to become lazy.

2. Refractive Errors: Errors such as nearsightedness (myopia), farsightedness (hyperopia), or astigmatism, can cause unequal focus between the two eyes. When one eye has significantly better focus than the other, the brain may rely more on the eye with better vision, leading to amblyopia in the other eye.

3. Vision Obstruction: Any condition that obstructs or hampers clear vision in one eye can contribute to lazy eye. This could include conditions like cataracts, ptosis (drooping eyelid), or a congenital eye abnormality.

4. Childhood Eye Conditions: Certain eye conditions that occur in childhood, such as congenital cataracts, childhood glaucoma, or retinal disorders, can interfere with normal visual development and lead to amblyopia.

5. Family History: Lazy eye can run in families, suggesting a genetic component. If a close family member has or had lazy eye, there may be an increased risk for an individual to develop the condition.

Normal eye versus amblyopic eye

Symptoms of Lazy Eye

The most common symptoms include:

1. Reduced Vision: The primary symptom of lazy eye is reduced vision in one eye. The vision in the lazy eye is typically poorer than the vision in the other eye.

2. Poor Depth Perception: Lazy eye can affect depth perception, making it difficult to judge distances accurately. This can result in clumsiness or problems with activities that require good depth perception, such as playing sports or driving.

3. Squinting or Shutting One Eye: Individuals with lazy eye may squint or close one eye to try to compensate for the reduced vision in the affected eye. Thus, this can be a sign that they are struggling with their vision.

4. Poor Eye Coordination: Lazy eye can cause poor eye coordination. This might lead to problems with tracking moving objects or difficulty with activities that require both eyes to work together (reading or catching a ball).

5. Tilted or Persistent Head Turn: In some cases, individuals with lazy eye may tilt or turn their head to one side to improve their vision by using their better eye.

6. Strabismus: Lazy eye is often associated with strabismus, a condition in which the eyes do not align properly. One eye may turn inward, outward, upward, or downward, causing a misalignment of the eyes.

7. Other Symptoms of Amblyopia: A presence of persistent shaking of the eyes and atypical results of vision screening tests can also be symptoms of amblyopia. You can have a look at our blog post discussing detection of early amblyopia signs.

One of the symptoms of lazy eye or amblyopia includes eye squinting or shutting.

Diagnosing Lazy Eye

When an issue occurs, parents and children often do not recognize the condition. Diagnoses can be made through a regular eye examination. Vhildren should get their first eye check up between the ages of 6 and 12 months.

General eye issues are also frequently screened by paediatricians. Broadly speaking, an eye exam will be performed by checking for eye health, a wandering eye, a vision disparity between the eyes, or impaired vision in both eyes.

Lazy eye is typically diagnosed through a comprehensive eye examination performed by an eye care professional, such as an ophthalmologist or optometrist.

Steps For Diagnosing Lazy Eye

The diagnosis of amblyopia involves several steps, including:

1. Visual Acuity Test: The eye care professional will assess the visual acuity of each eye separately using an eye chart, typically the Snellen chart. The person being tested will be asked to read letters or identify symbols at various distances. This test helps identify any significant difference in vision between the two eyes.

2. Refraction Test: This test is performed to determine if the person has any refractive errors, such as nearsightedness, farsightedness, or astigmatism. Refractive errors can contribute to the development of amblyopia.

3. Ocular Alignment and Binocular Vision Assessment: The eye care professional will examine the alignment of the eyes to check for strabismus, which is a misalignment of the eyes. They will also assess binocular vision, which refers to the ability of both eyes to work together effectively.

4. Pupil Examination: The doctor may perform a pupil examination to check for any abnormalities that could be associated with amblyopia.

5. Additional Tests: In some cases, additional tests may be performed to evaluate the overall health of the eyes, such as a retinal examination or imaging tests.

Download 5 Simple Eye Exercises

Grow your vision with 5 simple activities you can do at your home!

Treatment Options

Various possibilities are known for lazy eye treatment. However, amblyopia treatment is usually divided into:

(a) treatment of the cause and
(b) treatment of the amblyopia itself.

Corrective Eyewear

Corrective eyewear, like glasses, can play an essential role in treating lazy eye, especially when it’s caused by refractive errors.

However, will glasses fix lazy eye on their own? In most cases, glasses improve vision clarity but need to be combined with other treatments to address the underlying visual processing issues associated with lazy eye. In rare situations, glasses even correct amblyopia without the need for additional therapy.

Glasses and lenses can help if you have amblyopia due to nearsightedness or farsightedness, or if you have astigmatism in one eye. Corrective eyewear can also help realign a squint.

Eye Patching for Lazy Eye

Furthermore, occlusion (eye patching) therapy by using an eye patch is another possible solution. This method involves covering the stronger eye with an eye patch for several hours each day. This way, we force the brain to rely more on the weaker eye. By patching, we are strengthening the weaker eye and consequently improving vision. We can simply cover the lens if the individual wears glasses.

Atropine Eye Drops

Instead of using an eye patch, atropine eye drops can be used to blur the vision in the stronger (healthy) eye, similarly promoting the use of the weaker eye. Similarly to eye patching, it encourages the weaker eye to use it more as we blur the vision in the good eye. In case of crossed eyes or eyes that are not aligned, surgery of eye muscles is an option.

Vision Therapy for Amblyopia

Vision therapy involves a series of exercises and activities designed to improve eye coordination and function of the eyes. It may include activities like focusing exercises, eye tracking exercises, and visual perception training. Vision therapy is often used in conjunction with patching or atropine eye drops.

Eye Patching is an option for the treatment of a lazy eye.

Gamified Vision Therapy for Treating Lazy Eye: AmblyoPlay

AmblyoPlay is a vision therapy performed through playing therapeutic games with a combination of anaglyph (red and green filter) glasses. In the last decades, active lazy eye exercises to fix lazy eye are gaining ground.

Using therapeutic exercises, we can improve the lazy eye and train the visual system to develop a healthy vision. Vision therapy is performed on your tablet or computer, so you don’t have to buy any additional equipment.

What is more, the use of red and green lenses allows excellent control over stimulus characteristics. When a red filter is placed over the right eye the right eye sees only green targets. When a green filter is placed over the left eye, the eye sees only red targets. This allows you to see with both eyes at the same time.

Researchers found that treatments that include fun activities have a higher percentage of compliance. As video games are very engaging, a greater compliance is achieved. Therapy programs with a high degree of compliance have relatively large treatment effects.

Get your AmblyoPlay Vision Therapy today!

AmblyoPlay Vision Therapy for the Treatment of Lazy Eye in Children: Vision Therapy Success Stories

amblyopia exercises
South Africa

Sarah: “I would absolutely recommend AmblyoPlay to others.”

We have found AmblyoPlay to be very helpful and generally manage to get our four year old daughter with lazy eye to do her two “daily training” sessions without too much of a fuss. She had thoroughly enjoyed being able to “buy” new items of clothing for her characters and is always very excited when she gets a new character. I would absolutely, without hesitation recommend AmblyoPlay to others.

lazy eye treatment
Mosta, Malta

Karl: “Highly recommended!”

We have been using Amblyoplay for the last six months and have seen a very good improvement in my son’s lazy eye. The games are fun and interactive and he enjoyed playing and collecting gems. Highly recommended!

Lazy Eye Surgery: Amblyopia Caused by Strabismus

In cases where amblyopia is caused by strabismus (misalignment of the eyes), surgery may be recommended to realign the eyes. Additionally, surgery can help improve the alignment and coordination of the eyes. This can have a positive impact on visual function.

Lazy Eye Treatment for Adults

Although treatment of lazy eye might be more effective in children, lazy eye can be treated in adults. For decades, it was believed that amblyopia could only be treated in children under the age of ten.

However, a recent study of the National Eye Institute found that lazy eye may be successfully treated in children as young as 17 years old, and even adults. Therefore, we can conclude it is never too late to treat lazy eye. Adults using AmblyoPlay experienced amazing positive effects of training their vision.

AmblyoPlay Treatment in Adults with Lazy Eye

treating amblyopia in adults
Ipswich, UK

Sumit: ”I highly recommend AmblyoPlay irrespective of age”

Hi, I am 30 years old. I have been using AmblyoPlay for the past 6 months. It’s a really good app. It chooses the games at random and helps you improve your vision for the lazy eye. If practiced daily, you can sense the improvement. Just maintain a good streak and you would see that your gaming performance is improving. Double vision is reducing as well. Highly recommended to anyone who wishes to treat amblyopia irrespective of age. However, it would be great to receive daily, weekly reminders so that one doesn’t skip the practice.

adults vision therapy success stories
Worcestershire, UK

Carol: ”Using AmblyoPlay as an adult has not only improved my vision but also exceeded my expectations in countless ways”

After 11 months, my optician is very impressed & has now prescribed glasses that no longer exclude the weak eye, but use it.
Best of all, as my binocular vision has improved so much reading is easier, I no longer drop as many things, and my eye & neck strain has reduced ….. AND my right eye looks straighter in the socket rather than drifting to the side. He’s now finding out more about Amblyoplay to recommend it to other patients – so hopefully a good result for the Amblyoplay team too.

THANK YOU TO THE AMBLYOPLAY TEAM FOR IMPROVING MY LIFE.

Read the full vision therapy success story.

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Frequently Asked Questions

What is lazy eye?

Lazy eye, also called amblyopia, is a condition when the connection between the brain and eyes breaks down. Consequently, the brain is incapable of recognizing sight from one eye and the brain becomes increasingly reliant on the other, stronger eye over time, while vision in the weaker eye deteriorates.

How do I know if I have lazy eye?

Common signs of lazy eye (amblyopia) include poor depth perception, reduced vision in one eye, squinting or closing one eye, head tilting, and trouble with fine motor skills. If you suspect lazy eye in yourself or someone else, schedule a full eye exam with an optometrist or ophthalmologist.

What causes lazy eye?

There are several factors that can contribute to the development of lazy eye. Those are strabismus, refractive errors, certain eye conditions (e.g., cataracts), eye obstruction or deprivation, and family history.

Is there treatment for lazy eye?

Yes. Lazy eye treatment includes corrective eyewear (glasses or contact lenses), eye patching, atropine drops, and vision therapy.

Can vision therapy treat lazy eye?

Yes, vision therapy is an effective treatment for lazy eyes. It involves a series of customized exercises and activities to improve eye coordination, depth perception, focusing ability, and enhance visual processing.

What is AmblyoPlay?

AmblyoPlay is a vision therapy solution that is performed through playing therapeutic games and exercises on your tablet or computer for 30 minutes per day. With exercises that adapt to each patient and their specific needs, it is an ideal solution for problems such as lazy eye, strabismus, convergence insufficiency, double vision, or other binocular problems.

What is the difference between astigmatism and lazy eye (amblyopia)?

Astigmatism is an optical problem caused by an irregular cornea or lens, and it often leads to blurred vision. Lazy eye (amblyopia) means one eye has reduced vision because the brain favors the other eye. Lazy eye often needs treatments like vision therapy, not just corrective lenses.

Will glasses fix lazy eye?

Glasses can correct vision problems from refractive errors, but glasses alone usually do not fix lazy eye. Lazy eye often requires a combination of treatments, including patching, atropine drops, or vision therapy, to stimulate and strengthen the weaker eye and improve the brain-eye connection. Glasses are an important part of treatment but are usually most effective when paired with other therapies.

Can you get a lazy eye from not wearing glasses?

Yes, especially in young children. If a child needs glasses and does not wear them, ongoing blur can disrupt normal visual development and lead to amblyopia (lazy eye).

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