Amblyopia (lazy eye) in Children
(The following information is also available on our pdf page in pdf format.)
What is amblyopia?
Amblyopia is often referred to as “lazy eye”.
Amblyopia means that there is a reduction in vision of one or both eyes that persist even after any necessary glasses have been worn. This is usually as a result of an interruption in the visual development during early childhood, from birth to 7 years. It is, therefore, extremely important that any treatment for amblyopia occurs during this time.
The causes of amblyopia
Amblyopia can be caused by
• A turn in the eye, which is known as a strabismus or squint.
• A difference in the long/ short sightedness or astigmatism between the two eyes.
• An obstacle blocking visual stimulation to the eye i.e. droopy eyelid or cataract (a cloudy lens within the eye).
Treatment of amblyopia
Glasses will be ordered if there is any significant long or short sightedness or astigmatism.
The usual treatment for amblyopia is to wear a patch over the good eye that will, in turn, stimulate the poorer sighted eye. If your child wears glasses the patch is usually worn on the face with glasses on top.
Occlusion does not replace the need for glasses nor does it eliminate any squint.
The length of time the patch will need to be worn will depend upon the amount of amblyopia present. The poorer the vision the longer the patch will need to be worn. If the amblyopia is left untreated the vision will be permanently impaired.
Unfortunately, children do not always understand why they need to patch their good eye and so the treatment can sometimes be difficult. Give lots of praise when the patch is worn well and be ready to distract their attention to prevent the patch being removed.
Occasionally atropine drops/ ointment may be used in the good eye instead. This blurs the vision in the good eye and again encourages the weaker eye to work harder. This treatment is only used after patching has been tried. Glasses will still need to be worn. It is only suitable with certain levels of vision. Your orthoptist will advise you whether this is an option with your child.
You orthoptist is very experienced in dealing with children who have amblyopia and will be available to advise you about carrying out the treatment at home as effectively as possible.
Occasionally children are allergic to the patches. If the skin around the eye becomes sore you should mention it to your orthoptist who may be able to suggest other patches.
In older children there is a very small risk of them developing double vision. If this happens you should stop the patching immediately and contact the orthoptic department. The orthoptist will monitor the risk of this happening and will stop any treatment if the risk becomes too high.
Activities and patching
Doing detailed work is a good idea when your child is wearing the patch. Activities could include reading, drawing, colouring, dot-to-dots or any other activity that requires concentration. In school age children it can often be a good idea for your child to wear the patch at school, as this is when they do their most concentrated work.
It is important to remember that your child is relying on the poorer eye to see. Also, when one eye is patched the child has no 3D vision and may struggle to judge distances.
If you have any questions or concerns regarding the treatment, or have run out of patches, please do not hesitate to contact us during office hours.
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