Columnists

What Is Lazy-Eye?

Issue 36.15

Of all the different conditions that come up in clinic with patients, lazy-eye is probably one that generates the most confusion.  I would like to briefly discuss the definition of lazy-eye, and how it can be diagnosed, and treated at an early age.  While amblyopia can occur to adults, pediatric amblyopia will be discussed in this article.

Amblyopia is a condition that affects roughly 3 percent of the population, and typically begins early in life.  By definition, amblyopia is decreased vision due to impaired visual development in the brain.  This may occur for many reasons. The two most common reasons are either an eye that is misaligned, called strabismus, or an eye that is sufficiently out of focus, called anisometropia.  Other common reasons may include congenital cataract or childhood injury.  In any of these scenarios the visual cortex in the brain is deprived of normal vision from an eye and thus poor vision is learned.  Once the child is of sufficient age, approximately 6-8 years old, this becomes permanent.

A child can be examined with the aid of friendly visual cues, and dilating drops in the office.  With the aid of special instruments and lights, the alignment and focusing power of the eye can be determined and the structures of the eye can be seen, even on infants.  No verbal cues or questions are needed in these cases.  As the child reaches 2-3 years of age, more subjective tests can be done.  Treatment may include glasses to bring the eyes into proper focus, and/or patching of the better eye to force the brain to utilize the underused eye in meaningful ways.  Over time and with diligence, the vision in the amblyopic eye will improve.

The key to preventing and treating amblyopia is early detection.  A child’s ocular health should be screened at the newborn stage, and at subsequent visits to the pediatrician.  Any sign of irregularity, or the inability to obtain reliable results, should result in a referral to an optometrist or ophthalmologist.  The American Optometric Association recommends a comprehensive eye exam with an eye care professional at 6 months of age.  It is very important to catch potential amblyopia well before two years old.  This is the time that 3-d vision, or stereopsis, forms.  The best stereopsis can only occur when both eyes are coordinating and clear.

As a parent of 6 kids, it breaks my heart to see children receive their first eye exam well into their school age years, and discover amblyopia.  By this time, it is often too late for meaningful treatment.  If you have concerns about your child’s or grandchild’s vision, please schedule a comprehensive eye exam with an eye care professional.

Dr. Gibb can be contacted at Richens Eye Center, 435-986-2020.

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