Amblyopia

Amblyopia the loss of the ability to see clearly through one eye. It is also called "lazy eye." It is the most common cause of vision problems in children.

Alternative Names

Lazy eye

Causes

Amblyopia occurs when the nerve pathway from one eye to the brain does not develop during childhood. This happens because the abnormal eye sends a blurred image or the wrong image to the brain.

This confuses the brain, and the brain may learn to ignore the image from the weaker eye.

Strabismus (crossed eyes) is the most common cause of amblyopia. There is often a family history of this condition.

The term "lazy eye" refers to amblyopia, which often occurs along with strabismus. However, amblyopia can occur without strabismus. Also, people can have strabismus without amblyopia.

Other causes include:

Childhood cataracts
Farsightedness, nearsightedness, or astigmatism, especially if it is greater in one eye

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Symptoms

Symptoms of the condition include:

Eyes that turn in or out
Eyes that do not appear to work together
Inability to judge depth correctly
Poor vision in one eye

Exams and Tests

In most cases, amblyopia can be detected with a complete eye exam. Special tests are not often needed.

Treatment

The first step will be correct any eye condition that is causing poor vision in the amblyopic eye (such as cataracts).

Children with a refractive error (nearsightedness, farsightedness, or astigmatism) will need glasses.

Next, a patch is placed on the normal eye. This forces the brain to recognize the image from the eye with amblyopia. Sometimes, drops are used to blur the vision of the normal eye instead of putting a patch on it.

Children whose vision will not fully recover, and those with only one good eye due to any disorder should wear shatter- and scratch-resistant glasses.

Outlook (Prognosis)

Children who get treated before age 5 almost always recover vision that is close to normal. However, they may continue to have problems with depth perception.

Permanent vision problems may result if treatment is delayed. Children treated after age 10 can expect vision to recover only partially.

Possible Complications

Complications may include:

Eye muscle problems that may require several surgeries
Permanent vision loss in the affected eye

When to Contact a Medical Professional

Call your health care provider or ophthalmologist if you suspect a vision problem in a young child.

Prevention

Identifying and treating the problem early prevents children from having permanent visual loss. All children should have a complete eye exam at least once between ages 3 and 5.

Special methods are used to measure vision in a child who is too young to speak. Most eye care professionals can perform these techniques.

References

Olitsky SE, Coats DK. Amblyopia and its management. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology 2013. Philadelphia, PA: Lippincott Williams & Wilkins; 2012:vol 1, chap 10.

Olitsky SE, Hug D, Plummer LS, Stass-Isern M. Disorders of eye movement and alignment. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 615.