AMBLYOPIA – LAZY EYE

Lazy eye or amblyopia

Have you ever heard of "lazy eye"? Well, its technical name is amblyopia , and it's a somewhat peculiar condition. One eye doesn't see as clearly as the other, and no matter how many glasses or contact lenses you put on it, your vision doesn't improve completely. It's as if that eye had fallen a little "asleep." In some cases, although it's less common, it can occur in both eyes at the same time, which is called Bilateral Amblyopia.

But be careful, the lazy eye not only sees less, it also has difficulties with other important visual skills. Its eye movements may be less precise, it has more difficulty distinguishing contrasts, its ability to focus up close may be worse, and eye-hand coordination, gaze fixation... everything may be clumsier than in the "good" eye. Because of these differences, the two eyes don't quite work together, they don't collaborate with each other!

Why does lazy eye appear? The importance of the early years!

Here's something super important. Babies aren't born with fully developed vision. It's during the first years of life that our eyes and brain learn to see well! Therefore, it's crucial that both eyes receive equal, high-quality visual input during this period. This is like giving them the same "information" so that both reach their full potential and learn to work together, developing good binocularity (the use of both eyes at the same time).

But what can cause an eye to become lazy? There are several causes!

• Strabismus: This is when one eye wanders. This is one of the most common causes. If one eye isn't properly aligned with the other, the brain may begin to ignore the image from that eye to avoid double vision, and over time, that eye can become lazy. It's as if the brain were saying, "If you're not looking in the same place, I'm not paying attention."
• Anisometropia: This unusual name simply means that one eye has a very different prescription than the other. For example, one eye may need distance glasses and the other barely needs them. The brain may begin to rely more on the better-seeing eye, and the other eye may not work as hard and either doesn't use it or shuts down.
• Poorly compensated refractive errors: If a child needs glasses to see well (whether due to myopia, hyperopia, or astigmatism) and does not wear them or they are not the correct ones, the vision in one or both eyes may not develop fully, leading to amblyopia.
• Eye diseases: Some diseases that affect the eye from birth or in the early years, such as congenital cataracts (an opacity in the lens) or ptosis (a drooping eyelid that blocks vision), can prevent light from reaching the retina correctly and cause lazy eye.
• Other causes: There are other less common reasons, but they can also contribute!

How do you detect that someone has lazy eye?

Amblyopia can sometimes go undetected, especially in young children who are unable to express their vision problems with one eye. However, parents and educators can be alert to some signs with a simple test.

Cover one eye of the child and observe how they react. Then, repeat the test by covering the other eye. If the child sees much worse with one eye (they may whine, try to pull their hand away, or seem disoriented), it could be a sign of amblyopia!

Starting at age 5, it's very important for children to have annual eye exams. The optometrist can detect amblyopia even before parents notice anything.

Can lazy eye be prevented? By taking action from a young age!

Prevention is key! We can do several things to help children's eyes develop properly:

• Don't cover one eye unnecessarily! Avoid it! Simple things like always having the baby lie on the same side in the crib, always holding the bottle in the same arm, or constantly having hair covering one eye can cause one eye to receive less stimulation than the other. Vary your positions and make sure both eyes have clear vision.
• Regular eye exams! It's essential. An optometrist can detect vision problems early and take action before amblyopia develops.
Is there a treatment for lazy eye? And does it work at any age?

In optometry, the main goal after improving the vision of the lazy eye is to get both eyes working together as a team. It's no use having one eye see better if it doesn't cooperate with the other.

Although the ideal is to treat amblyopia in childhood, there is some very positive news. Recent studies show that good results can also be achieved in adults. Even adults can improve the vision of their lazy eye, as they tend to have more interest, motivation, and consistency in treatment.

Traditional treatment usually combines occlusion (covering the "good" eye) and vision therapy (specific exercises for the lazy eye and improving binocular coordination). The disadvantage of occlusion is that, once the good eye is uncovered, the lazy eye sometimes goes "asleep" again if it hasn't been taught to work together with the other eye. This is why vision therapy is so important to strengthen the lazy eye's skills and teach it to work as a team with the good eye. This is essential for long-term success.

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Frequently Asked Questions (FAQ) about Amblyopia (Lazy Eye)

1. What is amblyopia, or "lazy eye"? Amblyopia is when one of the eyes lacks good visual acuity, and this condition is not fully corrected with glasses or contact lenses, even though the eye itself appears healthy. It's as if the eye has "turned off" a little.
2. Why is it called "lazy eye"? The term "lazy eye" means that the eye doesn't "work" efficiently. Although there may be associated eye movement problems, the main characteristic is poor visual acuity.
3. What are the most common causes of lazy eye in children? The most common causes are strabismus (eye deviation), anisometropia (different vision prescriptions between the eyes), and refractive errors (nearsightedness, farsightedness, astigmatism) that have not been adequately corrected.
4. How can I suspect my child has lazy eye? You can observe if your child frequently closes or squints one eye, tilts their head to see better, has difficulty judging distances, or reacts differently when you cover one eye compared to the other. Annual eye exams are key to detection.
5. Can lazy eye be prevented? What measures can I take? Yes, it can be prevented by ensuring that both eyes of the baby and child receive equal visual stimulation, varying their posture, avoiding constantly covering one eye, and undergoing regular eye exams to detect and correct any vision problems early.
6. What is an effective treatment for lazy eye? The main treatment is vision therapy (exercises to improve the lazy eye's visual skills and coordination between both eyes). Simply covering the good eye may not be enough if the eyes are not trained to work together.
7. Until what age can lazy eye be successfully treated? Although treatment is most effective in childhood, recent studies have shown that significant improvements in lazy eye vision can also be achieved in adults with vision therapy and occlusion. It's never too late to try!
8. What is vision therapy in the context of lazy eye? Vision therapy is a personalized exercise program designed to improve various visual abilities of lazy eye, such as visual acuity, contrast sensitivity, accommodation, and eye movements, as well as promote eye coordination.
9. Does strabismus always cause lazy eye? Not always, but it is a common cause of lazy eye. If the eye deviation is constant and occurs from an early age, the brain may suppress the image from the lazy eye, which can lead to the development of amblyopia.
10. Is it important to treat lazy eye even if the person sees well with the other eye? Yes, it is very important! Although a person with lazy eye may see well with their "good" eye, the lazy eye is not developing its full visual potential. Furthermore, if the "good" eye were to develop any problems in the future, the person would be dependent on the eye with reduced vision. Treatment aims to improve vision in both eyes and promote binocular vision.