Lazy eye or medically known as 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. Furthermore, your brain will learn to disregard the image from the weaker eye if you do not receive an appropriate therapy. It’s possible that this will result in long-term visual issues.
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How common is Lazy Eye or Amblyopia?
Amblyopia is the most common cause of visual impairment in children. The worldwide prevalence of amblyopia accounts for 1-5%. However, epidemiological data on the prevalence of amblyopia varies greatly among countries and time periods. Furthermore, the findings show that the prevalence of amblyopia differs between boys and girls, but not by geographical area, publication year, age, sample size, or socioeconomic level.
Nonetheless, it remains a substantial global vision problem, and public health initiatives of early screening, treatment, and management are critical.
Symptoms of Lazy Eye
There are few symptoms of lazy eye. The most common symptoms of lazy eye are:
1. Reduced Vision: The primary symptom of lazy eye is reduced vision in one eye, which cannot be corrected with glasses or contact lenses. 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, leading to problems with tracking moving objects or difficulty with activities that require both eyes to work together, such as 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: 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.
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: 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.
Diagnosis
When an issue occurs, parents and children often do not recognize the condition. Diagnoses can be made through a regular eye examination, between the ages of 6 and 12 months when children should get his or her first eye checkup. General eye issues are also frequently screened by pediatricians. 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.
Amblyopia, commonly known as lazy eye, is typically diagnosed through a comprehensive eye examination performed by an eye care professional, such as an ophthalmologist or optometrist. 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.
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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.
Lazy Eye Treatment
Various possibilities are known for treatment of lazy eye.
1. Corrective Eyewear: Glasses and lenses can help if you have amblyopia due to nearsightedness or farsightedness, or if you have astigmatism in one eye. Glasses can also help realign a squint and, in rare situations, even correct amblyopia without the need for additional therapy.
2. Eye Patching: Furthermore, occlusion 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, forcing 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.
3. 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.
4. Vision Therapy: Vision therapy involves a series of exercises and activities that are designed to improve the 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.
AmblyoPlay
AmblyoPlay is a vision therapy performed with a combination of anaglyph (red and green filter) glasses. In the last decades, active lazy eye training methods are gaining ground. Using different exercises and activities, we can improve the lazy eye and train the visual system to develop a healthy vision.
Vision therapy is performed through playing therapeutic games and exercises on your tablet or computer. 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 and a blue filter is placed over the left eye, the right eye sees only red targets and the left eye sees only blue targets, allowing 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 games are very engaging, a greater compliance is achieved. Therapy programs with a high degree of compliance have relatively large treatment effects.
5. Surgery: 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, which can have a positive impact on visual function.
Adults
Although treatment of lazy eye might be more effective in children, adults can also be treated for such eye impairment. 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.
Frequently Asked Questions
Lazy eye or medically known as 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.
Some signs and symptoms that may indicate the presence of lazy eye are poor depth perception, reduced vision in one eye, squinting or closing one eye, head tilting, and difficulty with fine motor skills. However, if you suspect you or someone you know may have lazy eye, it is essential to consult an optometrist or ophthalmologist for a comprehensive eye examination.
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.
Yes, the treatment of lazy eye includes corrective eyewear (glasses or contact lenses), eye patching, atropine drops, and vision therapy.
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.
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.
