Lazy Eye – Diagnosis and Treatment
Diagnosis
An eye doctor or ophthalmologist performs a detailed vision exam to diagnose amblyopia, also called lazy eye.
A vision screening checks for symptoms like reduced vision in one or both eyes, a wandering eye, or differences in how the eyes work.
Eye doctors may use dilating eye drops to widen pupils for a better look at eye health. These drops can cause blurry vision for a few hours.
Methods for Vision Testing:
| Age Group | Diagnostic Method |
|---|---|
| Preverbal Children | Lighted magnifier to spot cataracts; tracking objects to check gaze |
| Age 3 and Older | Picture or letter charts; covering each eye to compare vision |
Doctors look for signs of muscle imbalance, ptosis (droopy eyelid), or anisometropia (unequal vision between eyes). Early diagnosis helps prevent permanent vision loss, especially if there is a family history or other risk factors for poor visual development.
Ways to Manage Lazy Eye
Treating lazy eye early gives the best results while a child’s vision is still developing. The chosen method depends on the cause, such as refractive error, strabismus, or cataracts, and the level of vision loss.
Vision Correction
Many children wear glasses or contact lenses to fix nearsightedness, farsightedness, or astigmatism. Correcting the refractive error helps improve focus and can sometimes fix lazy eye.
If the eyes are not straight (strabismus), glasses can also help align them.
Encouraging the Use of the Weaker Eye
- Eye Patching: Placing an eye patch over the stronger eye makes the weaker eye work harder and get stronger. Children usually wear the patch for 2 to 6 hours a day, but the doctor may adjust this time.
- Bangerter Filter: Placing a special filter on the lens of the stronger eye’s glasses partially blurs vision and encourages use of the weaker eye.
- Atropine Eye Drops: Using atropine drops in the stronger eye blurs its vision, usually once a day or on weekends. This helps the brain use the weaker eye more. These drops are helpful for children who struggle with wearing a patch. Side effects may include light sensitivity and mild irritation.
Surgical and Other Medical Options
Sometimes, doctors perform surgery. They may remove a congenital cataract or fix a droopy eyelid that blocks vision (deprivation amblyopia).
Doctors may also perform eye muscle surgery to correct strabismus if glasses do not work.
Supporting Activities
Some doctors suggest vision exercises or activities like coloring, drawing, puzzles, or computer games as extra therapy. Researchers are still studying the benefits of these activities, and doctors usually add them to main treatments like patching or drops.
Follow-up Care
Regular visits with an optometrist or eye specialist help monitor progress. Treatment can last from six months to two years. Vision may improve in weeks or months, but lazy eye can return.
Regular eye exams help catch any symptoms early so treatment can begin again if needed.
| Treatment Type | Examples | Purpose |
|---|---|---|
| Glasses/Contacts | Eyeglasses, Contact lenses | Correct refractive errors |
| Eye Patch/Filter | Eye patch, Bangerter filter | Strengthen weak eye |
| Eye Drops | Atropine | Blur vision in stronger eye |
| Surgery | Cataract, eyelid, muscle | Address physical causes |
| Activities | Puzzles, computer games | Support therapy, not proven yet |
Getting Ready for Your Visit
Steps to Take Before the Visit
Prepare notes before the appointment. Write down any symptoms your child has, even those that do not seem related to vision. Include when the symptoms started.
Keep a list of all medicines, vitamins, and supplements your child takes, along with the dose and frequency. Add any other health issues or allergies your child has.
Knowing your family’s history with vision conditions like lazy eye, cataracts, or glaucoma can help. Add this information to your notes.
Create a list of questions to ask the doctor. Some examples are:
- What could be causing my child’s vision problem?
- Are there other possible explanations?
- What treatments are available, and which ones work best?
- How much can we expect my child’s vision to improve?
- Are there risks for more problems in the future?
- Will my child need more appointments after treatment?
You can use a table like this to organize your notes:
| Item | Details |
|---|---|
| Symptoms | |
| Medications & Doses | |
| Other Conditions/Allergies | |
| Family Eye Health History | |
| Questions for the Doctor |
Questions Your Doctor Might Ask You
The doctor may ask some of the following:
Does your child struggle to see things?
Do their eyes cross or wander?
Do they squint or hold things very close to their face?
Have you seen anything else different about their sight?
Has your child ever injured their eyes?
