What is Amblyopia (lazy eye)?

Amblyopia, commonly known as lazy eye, is an eye condition defined by an unexplained reduction of vision in one eye, unrelated to any obvious eye disease. The vision is not usually correctable by glasses or contact lenses. Amblyopia occurs when the vision in one eye does not develop properly during early childhood. If not treated on time; it can lead to a permanent visual impairment. Although it mostly affects one eye, both eyes can also have decreased vision due to amblyopia.

Why does amblyopia occur?

Babies are able to see when they are born, but they gradually learn how to use their eyes. Our visual development occurs up to the age of 9 years, which is most critical from birth to 6 years of age. Anything that interferes with a normal image formation on retina in either eye during this period, leads to amblyopia. Both eyes must receive clear images during this critical period. If the image is not clear, the brain shuts off the image which is out of focus and the child depends only on the better eye to see. The good eye and brain will inhibit (block, suppress, ignore) the eye with the blur. Thus, amblyopia is a neurologically active process. The inhibition process (suppression) can result in a permanent decrease in the vision in that eye that can not be corrected with glasses, lenses, or lasik surgery

The most common causes of amblyopia are strabismus (an imbalance in the positioning of two eyes) and anisometropia (when one eye has a high plus or minus number) .Strabismus or squint can cause the eye to turn in (esotropia) or turnout (exotropia).An eye disease like cataract or ptosis (drooping of eyelid) that stops a clear image from being focused inside the eye can also cause amblyopia.

How to know if your child has Amblyopia?

You may not be able to tell that your child has lazy eye. While a deviating eye may be easily spotted by the layman, amblyopia is usually difficult to diagnose, as many children with this condition look absolutely normal and carry out their activities with the normal eye. Only an eye doctor can confirm the diagnosis. That is why early infant and preschool eye examinations are so necessary. Still there are some signs which can help you in detecting if your child has amblypia or not :

• If your child’s eye is turned in,out,or up
• If he/she closes one eye (especially in bright light)
• If a small child/infant resists covering of a particular eye.

These are warning signs enough to raise a suspicion of amblyopia.

Doctor’s Role

Amblyopia is best treated by an ophthalmologist. The most important diagnostic tools are the special visual acuity tests other than the standard 20/20 letter charts currently used by schools, pediatricians and eye doctors. Treatment may involve use of spectacles to correct blurred vision or help straighten the eyes and use of eye patches on the better eye to enable the weaker eye to see by eliminating competition from the better eye. Surgery may be required to mechanically realign the eyes

Treatment of Amblyopia
Amblyopia can be treated up to the age of 17(in selected cases),but it is most effective when done early in child’s life usually before the age of 7 years. . Every amblyopic patient deserves an attempt at treatment .The aim of the treatment is to force the child to use the eye with less vision by obstructing vision in better eye.The most commonly used treatment modalities are: Patching and Atropinisation

Parent’s Role

Parents play a vital role in making sure that their child does not have this disability .

First, it is important to recognize any signs of a problem.

Second, you should never wait for a problem to be corrected on its own. Once suspicion is raised, contact an ophthalmologist as soon as possible.You play an important role in making sure that your child has a lifetime of good eyesight.

Far too many parents fail to take their infants and toddlers for an early comprehensive vision examination and many children go undiagnosed until they have their eyes examined at a much older age. Amblyopia is best treated at an early age and becomes less amenable to treatment as the child grows up. Good vision in both eyes is essential to allow good depth perception and for fine, near activities. Any trauma to the better eye may leave the person severely visually handicapped if the other eye has amblyopia.

Amblyopia is one of the most common causes of visual impairment which can be completely reversed if diagnosed early and treatment initiated on time. Unless it is successfully treated during early childhood, it usually persists into adulthood.