Amblyopia
Amblyopia, sometimes called “lazy eye”, represents reduced vision in a healthy eye even when the best glasses or contact lenses are in place. Today we understand Amblyopia as the brain shutting off the vision signal from the eye. While it can be easily corrected if found early, as children get older it becomes harder to reverse, and eventually becomes a permanent vision loss. There are two proven treatments for amblyopia: 1) patching the good eye, or 2) blurring the good eye with daily dilation drops. Glasses may be needed with either method to insure the best possible focus is present. The treatments work by forcing the brain to begin using the image from the “weak eye”, and need careful medical monitoring.
The most common type of amblyopia is that caused by strabismus (misalignment of the eyes). Just straightening the eyes will not cure the amblyopia. The best long-term results are felt to occur when amblyopia is treated to make the vision in the eyes equal, before surgical alignment. Because strabismus is noticeable to the family, this type of amblyopia is usually found early enough to treat fully.
The second most common type of amblyopia is caused by severe blur, usually in just one eye, but occasionally in both. Since there is no outward sign, and young children rarely know to complain, diagnosis may be delayed. Early vision screening or testing in the child's doctors office are good ways to pick it up. If caught early enough only glasses or contact lenses may be needed, but often a course of patching or eye drops is needed in addition, to bring the vision up to normal.
Less commonly, cloudiness in the normally clear tissues of the eye (such as cataract, clouded cornea) can prevent the development of vision (called deprivation amblyopia). Surgical clearing of the clouded tissues must be done to allow amblyopia treatment with patching, drops and lenses. This type of amblyopia can be the most severe and difficult to treat.
Age is important, and finding the vision loss of amblyopia early is necessary to get full vision recovery. Once vision is recovered we recommend a checkup every six months until age eight or nine years old, because it can come back. After vision development is complete amblyopia is not thought to return, but is also unlikely to respond at all to treatment.