Amblyopia (Lazy Eye): Causes, Symptoms, and Treatment

 What is Amblyopia?

Amblyopia, commonly known as lazy eye, occurs when the visual capacity fails to develop properly in one or both eyes due to insufficient use during the visual learning phase. This condition begins in infancy, and if not diagnosed and treated promptly, it can persist into adulthood. Amblyopia is the most common cause of vision loss among children and young people in developed countries, affecting 3-4% of school-aged children.

When we are born, our sense of sight is not fully developed. Vision develops and is acquired over the first years of life, culminating around the age of 8-9 years, with the most significant progress occurring in the first 4 years.



Symptoms of Amblyopia

In many cases, amblyopia does not present any symptoms, as the child does not know "what it is to see properly" and adapts to their existing vision. This is especially true when only one eye is affected, as the child can see well with the other eye, leading to no apparent warning signs. Therefore, it is crucial for parents, teachers, relatives, and pediatricians to be aware of any signs that might indicate a problem with the child’s eyesight, such as moving in close to objects, not paying attention, or being "clumsy." Often, the issue lies in the child's inability to see properly.

For optimal visual learning, both eyes must receive a clear image to send to the brain, allowing for the development of visual acuity. If a child has a problem that impairs the image received by the brain, the brain will "cancel" the development of the affected eye, causing it to become "lazy."

Causes of Amblyopia

  1. Strabismus: One or both eyes deviate, leading the brain to cancel the vision of the deviated eye to avoid seeing double, thus impeding its normal development.

  2. Optical Defects (Astigmatism, Hypermetropia, or Myopia): Refractive errors cause blurry images, and the brain settles for the clearer image, hindering the learning curve of the affected eye.

  3. Anisometropia: A significant difference in prescription between the eyes causes the brain to favor the eye with better vision.

  4. Natural Causes: Obstacles like congenital cataracts, corneal opacity, ptosis (droopy eyelid), or retinal diseases interfere with proper image projection to the brain, leading to amblyopia.

Symptoms to Watch For

Most children with amblyopia are asymptomatic and develop normally. However, signs like tilting their head, constant blinking, a droopy eyelid, not paying attention, or frequent falls should alert parents and teachers to seek an ophthalmologist specializing in pediatric vision. Regardless of the child's age, the problem can be examined and assessed.

Importance of Early Diagnosis and Treatment

Early diagnosis and treatment of amblyopia can restore normal visual acuity in children. It is vital for all children, regardless of symptoms or family history, to have a check-up with a pediatric ophthalmologist at the age of 2-3 years to assess ocular motility, eyelids, the back and front of their eyes, and check for refractive errors. Subsequent check-ups will depend on initial findings. We recommend that healthy children have yearly check-ups until the age of 9, when visual learning ends, to detect and treat any changes.

Treatment of Amblyopia

To treat amblyopia, the first step is identifying and correcting the cause. This may involve correcting refractive errors with glasses or contact lenses, or performing surgery for conditions like cataracts or ptosis. Once the cause is addressed, the most effective treatment is occlusion of the healthy eye with a patch, forcing the amblyopic eye to work. The schedule and duration of occlusion depend on the severity of amblyopia, the cause, and the child's age.

Alternatives to occlusion include penalization, which involves blurring the vision of the healthy eye through optical or pharmacological means, forcing the amblyopic eye to work. These methods are secondary options, used when patching is ineffective.

Conclusion

Achieving good visual acuity as an adult depends on early diagnosis and treatment of amblyopia. It’s never too early to have a child’s eyes checked, but delaying can lead to permanent vision impairment.

At Drishti Eye Centre, we emphasize the importance of early eye examinations and provide expert care to ensure your child's vision develops correctly. Schedule a check-up today to safeguard your child's vision for the future.




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