- Jun 5, 2006
- 161
- 5
- 18
- School/Org
- Southern California College of Optometry
- City
- Salt Lake City
- State
- UT
“Lazy eye” is the common name for amblyopia (pronouced am-blee-OH-pee-ya), a condition in which vision is reduced in an eye that has not received use during early childhood. Most parents of children with this condition are surprised at the diagnosis. Their child showed no signs of having poor vision. Importantly, when vision is impaired, learning opportunities are missed, impacting a child's healthy development. Fortunately, amblyopia is treatable. With early diagnosis and correction, a child's educational progress vastly improves.
Consider this fairly common scenario. Before your child enters into kindergarten you have no suspicion that he has a vision problem. The child appears to be able to see well. However, during a school vision screening it's discovered that the child sees well with one eye, but the other has very poor vision! You take him to the eye doctor for glasses. After the exam, the doctor informs you that even with the glasses your child will still have poor vision in one eye. You're shocked! How did this happen?
Often blurry vision in the pediatric population goes undetected. Similar to our example, some children rely on only one eye for clear vision. Even when both eyes are blurry, there's frequently no obvious indication of a problem. A child that never has experienced clear vision supposes that everyone sees a blurry world. Therefore, a child will rarely complain of blur, no matter how severe it may be.
Most visual problems are detected later in childhood. As the child progresses through school, she is expected to perform more demanding visual tasks, like reading smaller words. She may begin complaining of headaches, falling back in school, or become disinterested in reading. The situation becomes more critical considering that approximately 80% of what we learn occurs through vision. Unfortunately, by the time the child enters the first grade, the blur might be somewhat “locked in”. This condition is known as amblyopia.
Defining Amblyopia
Interestingly, “seeing” our world is not an immediate ability we are born with. Vision is a “learned” or acquired skill. The moment a newborn opens it's eyes the brain begins forming neural connections, trying to make sense of this new sensation. In order for the visual system to fully develop, the brain needs to receive a fairly clear image from the eyes. If this image is of poor quality or nonexistent during early childhood, the brain won't know what connections to make. This linkage-forming process continues until we are about 7 to 9 years old. After that, the visual system is difficult to change or “hardwired”. Amblyopia, is simply the brain's inability to make sense of visual input despite the patient wearing the best prescription.
What Causes Amblyopia?
The answer to this question is quite simple. Anything that inhibits the brain from “seeing” a clear image during the development period of the visual system causes amblyopia. Examples of these causes may be from the rare congenital cataract (clouding of the eye in infancy) to the more common problem of the child having a large difference in image quality between the two eyes. See the sidebar for more examples. One in twenty children have amblyopia. Adults with this condition have had it since childhood. Often these adults tell their eye doctor, “I've never had good vision in that eye.”
Treating the Condition
Treatment involves eliminating the cause of the poor vision. This may include glasses, contact lenses, or, less commonly, surgery to allow a clear image to be relayed to the brain. However, remember that amblyopia is characterized by blurry vision despite having the best prescription in front of the eyes. If the treatment is initialized before about the age of five, full-time wearing of the prescription often resolves some of the amblyopia.
Residual amblyopia or late treatment may require penalization therapy. The basis behind this therapy is to put the good eye at a disadvantage to force the poor eye to work harder. This is accomplished by either patching or using an eye drop to blur the good eye. Therapy often produces excellent results. With good compliance by the patient and parent, close to 20/20 vision in the previously poor eye is commonly achieved.
Prevention
The key to successfully treating amblyopia is early detection and intervention. The American Optometric Association recommends that children be seen by an eye doctor at 6 months old, 3 years old, and again before starting kindergarten. Your pediatric eye doctor will implement various techniques to approximate your child's prescription and uncover any other amblyopia-causing factors, no matter what the child's age.
Michael S. Peterson, OD, PC
Total Vision, Optometrist
1702 S. Kimball Ave.
Caldwell, ID 83605
208-459-2641
Consider this fairly common scenario. Before your child enters into kindergarten you have no suspicion that he has a vision problem. The child appears to be able to see well. However, during a school vision screening it's discovered that the child sees well with one eye, but the other has very poor vision! You take him to the eye doctor for glasses. After the exam, the doctor informs you that even with the glasses your child will still have poor vision in one eye. You're shocked! How did this happen?
Often blurry vision in the pediatric population goes undetected. Similar to our example, some children rely on only one eye for clear vision. Even when both eyes are blurry, there's frequently no obvious indication of a problem. A child that never has experienced clear vision supposes that everyone sees a blurry world. Therefore, a child will rarely complain of blur, no matter how severe it may be.
Most visual problems are detected later in childhood. As the child progresses through school, she is expected to perform more demanding visual tasks, like reading smaller words. She may begin complaining of headaches, falling back in school, or become disinterested in reading. The situation becomes more critical considering that approximately 80% of what we learn occurs through vision. Unfortunately, by the time the child enters the first grade, the blur might be somewhat “locked in”. This condition is known as amblyopia.
Defining Amblyopia
Interestingly, “seeing” our world is not an immediate ability we are born with. Vision is a “learned” or acquired skill. The moment a newborn opens it's eyes the brain begins forming neural connections, trying to make sense of this new sensation. In order for the visual system to fully develop, the brain needs to receive a fairly clear image from the eyes. If this image is of poor quality or nonexistent during early childhood, the brain won't know what connections to make. This linkage-forming process continues until we are about 7 to 9 years old. After that, the visual system is difficult to change or “hardwired”. Amblyopia, is simply the brain's inability to make sense of visual input despite the patient wearing the best prescription.
What Causes Amblyopia?
The answer to this question is quite simple. Anything that inhibits the brain from “seeing” a clear image during the development period of the visual system causes amblyopia. Examples of these causes may be from the rare congenital cataract (clouding of the eye in infancy) to the more common problem of the child having a large difference in image quality between the two eyes. See the sidebar for more examples. One in twenty children have amblyopia. Adults with this condition have had it since childhood. Often these adults tell their eye doctor, “I've never had good vision in that eye.”
Common Causes of Amblyopia
- Eye turn (misaligned eyes)
- Droopy eyelid
- Congenital cataract
- Severe nearsightedness, farsightedness, or astigmatism
- Large difference in image quality between the two eyes
Treating the Condition
Treatment involves eliminating the cause of the poor vision. This may include glasses, contact lenses, or, less commonly, surgery to allow a clear image to be relayed to the brain. However, remember that amblyopia is characterized by blurry vision despite having the best prescription in front of the eyes. If the treatment is initialized before about the age of five, full-time wearing of the prescription often resolves some of the amblyopia.
Residual amblyopia or late treatment may require penalization therapy. The basis behind this therapy is to put the good eye at a disadvantage to force the poor eye to work harder. This is accomplished by either patching or using an eye drop to blur the good eye. Therapy often produces excellent results. With good compliance by the patient and parent, close to 20/20 vision in the previously poor eye is commonly achieved.
Prevention
The key to successfully treating amblyopia is early detection and intervention. The American Optometric Association recommends that children be seen by an eye doctor at 6 months old, 3 years old, and again before starting kindergarten. Your pediatric eye doctor will implement various techniques to approximate your child's prescription and uncover any other amblyopia-causing factors, no matter what the child's age.
Michael S. Peterson, OD, PC
Total Vision, Optometrist
1702 S. Kimball Ave.
Caldwell, ID 83605
208-459-2641
Last edited:
