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Amblyopia and strabismus

Amblyopia, sometimes called "lazy eye," is defective vision or blindness in an eye. Amblyopia happens when the eyes do not work together to develop the normal vision that fuses the image from each eye into one single image for the brain.

Sometimes both eyes cannot work together because of very poor vision in one eye. In most cases, however, the eyes are not aligned or "straight" (strabismus) and see two separate images. The result is double vision. Because the images from each eye are so different from each other, the disturbing second image is ignored by the brain. When it is not used, the "lazy eye" stops learning to see. Normal depth perception does not develop. In most cases, there is some peripheral vision but the sharper central vision is impaired.

Since the development of the eye is complete by the ages of six or seven, uncoordinated eyes in children must be treated immediately to prevent loss of sight. A child's eyes should be examined carefully at birth and there are eye tests that can be performed with very young children. Early detection and treatment are essential.

Strabismus means an abnormal coordination of eye movements and is very often the cause of amblyopia. In strabismus, eyes may turn in, out, up, or down; together or separately; constantly or occasionally. Strabismus may be evident at birth or may develop in childhood or adulthood. Faulty eye muscles are often the cause but poor vision, tumors, birth defects and injuries are also causes.

infant eyes

Strabismus may be apparent in infants up to six months and even a year because of the lack of muscle coordination in very young eyes. The condition, however, should be monitored to determine the cause. Babies' eyes may also appear to be crossed because the width of the bridge of the nose obscures the white of the eye nearest the nose.

As the infant matures, the bridge narrows in proportion to the rest of the face, more white shows and the eyes "straighten." This is not true strabismus. Children do not grow out of cross-eyes and must receive proper medical attention to straighten their eyes.

Children with a family history of strabismus may be susceptible to amblyopia even though the eyes look normal. An examination by an eye doctor is the only certain means of detecting amblyopia.

Treatment for amblyopia and strabismus usually consists of forcing the lazy eye to work. Patching or blocking the vision strengthens the weaker eye. A simple surgical procedure and in some cases, medicated eye drops, can straighten the eyes by correcting muscle imbalance. Glasses can help as can orthoptics, medically supervised exercises designed to help the eyes work together. Methods of treatment are often combined.

Most strabismus is evident by the age of four. Early eye examinations for children and pre-school vision screening at three and four years are crucial in detecting abnormalities. Have your child's eyes examined early. If there is a problem, start treatment immediately and stay with it. A treatment program may be difficult for both child and adult, but good vision for a lifetime is worth it.

Eye examination ABC's These ABC's tell you that a child's eyes need examination by an eye doctor.

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