What Is Amblyopia or Lazy Eye?

Amblyopia, or lazy eye, affects around 2% of Australian children of pre-school age, but it can cause a permanent change in children of any age, teens, and adults too. It occurs when the brain doesn’t fully recognise the images it’s receiving from one eye, so becomes more reliant on the other eye. Amblyopia can be fully corrected under the age of 7 although there are older children that improve after the crucial age of 7 especially if they haven’t had any treatment done earlier in their life.

Signs to watch out for

Symptoms of lazy eye vary. It will usually be noticeable from someone’s behaviour showing they’re having trouble seeing. Common symptoms include:

• Squinting
• Struggling to see how far away something is (depth perception)
• Shutting 1 eye to see better

There’s usually no physical way to tell apart from watching how your child behaves or them saying they have trouble seeing. Often you won’t realise children have amblyopia until it’s diagnosed by a paediatric eye specialist.

What causes Lazy Eye?

While the cause of lazy eye isn’t always clear, it is often a side effect of other eye conditions. There are 3 types of eye conditions that can most commonly lead to amblyopia.

Strabismic Amblyopia

Strabismus/Squint occurs when the eyes aren’t fully lined up or aren’t moving as a pair. When this happens, over time the brain will ignore the image from the eye that isn’t aligned.

Sensory Deprivation Amblyopia

Any obstruction to light entering the eye such as cataracts or corneal problems, can block vision in one eye. One eye is literally deprived of sight, leading the brain to rely on the other one.

Refractive Amblyopia

If both eyes aren’t as equally sharp as each other, for example, if one is longsighted or shortsighted, the brain will favour the eye with clearer vision. It will start to ignore the images from the less clear eye.

Risk factors

Amblyopia can affect anyone but some factors show an increased risk including:

• Below average size at birth
• Being born prematurely
• Family history of lazy eye, cataracts or other eye conditions
• Other disabilities

Diagnosing Amblyopia

Your doctor will be able to test for amblyopia. The most common methods of diagnosing lazy eye are:

• Testing the eyes’ ability to follow a moving object and any preference to one eye over the other
• Checking the patient’s vision in each eye by reading letters or numbers with one eye covered
• Checking for any squint or other eye conditions commonly causing amblyopia

Treatment for Lazy Eye

Glasses Or Contact Lenses

Corrective eyewear can help restore equal vision in both eyes by correcting the image from whichever eye is less clear. This is especially helpful if the lazy eye is caused by refractive amblyopia.

Eyepatches
By blocking the vision from the stronger or clearer eye, the brain is forced to rely on the weaker eye, strengthening its connection with that eye. Eyepatches won’t be needed all day and usually between 2 and 6 hours a day is enough. This is needed and very helpful in all types of amblyopia.

Eyedrops
A medication called Isopto Atropine is used to blur the vision in the stronger eye temporarily, forcing the weaker eye to be used more. This is a more discrete alternative to an eye patch.

Surgery
In more severe cases where other treatments aren’t effective, such as with cataracts, a doctor may recommend surgery to correct the issue.Surgery can also be used to correct eye alignment but is preferably done only after the amblyopia is treated.

Act quickly

The earlier amblyopia is treated, the easier it is to treat and the lower the risk of long-term eyesight complications. If you’d like to make an appointment to discuss the most appropriate lazy eye treatment options for your circumstances, get in touch.

Dr. Swati Sinkar

Dr. Swati Sinkar is a dedicated and experienced General Ophthalmologist with a special interest in cataract surgery, Pterygium surgery, eyelid malpositions, glaucoma treatment, Macular degeneration treatment, and paediatric ophthalmic conditions. She has been extensively trained in Australia and overseas and was awarded a Fellowship from RANZCO in 2015. Passionate about preventing paediatric blindness, she established neonatal screening for Retinopathy of Prematurity in Northern Adelaide at Lyell McEwin Hospital. Dr. Sinkar mentors trainees, teaches internationally, and values evidence-based medicine, with numerous publications in peer-reviewed journals. Outside work, she enjoys cooking, travel, cricket, and badminton.