Amblyopia (lazy eye)

Your child may be more likely to have amblyopia if they:

• Were born early or small
• Have a parent, brother or sister who had amblyopia, an eye turn or a strong glasses prescription
• Have a large glasses prescription, or a big difference between the two eyes
• Have an eye turn
• Were born with a cataract or a droopy eyelid
• Have a developmental delay

Amblyopia is found by checking each eye on its own. A vision screening at school or at the pediatrician’s office can catch some problems, but it can miss others. A comprehensive eye exam gives the full picture.

Your eye doctor will:

• Check how well each eye sees. For young children, this may use pictures, shapes or matching games instead of letters.
• Check how the eyes line up and move together.
• Measure your child’s prescription. Eye drops are often used to relax your child’s focusing for a short time, so the true prescription can be measured. The drops can make vision blurry and eyes sensitive to light for several hours, sometimes until the next day.
• Look at the health of each eye, inside and out, to rule out other causes of poor vision.

Children don’t need to know their letters, and they don’t need to sit still for long, to have their eyes checked.

Treatment works best when it starts early, while the parts of the brain used for vision are still developing. Older children and teens can often still improve, so it is worth treating at any age. Your eye doctor will talk with you about what is likely to help your child.

Treatment usually has two parts.

1. Give the weaker eye a clear picture

The first step is to fix whatever is blurring or blocking the weaker eye. For many children, this means glasses or contact lenses worn all day. Glasses alone can improve amblyopia a great deal, and this can take a few months. If a cataract or a droopy eyelid is blocking vision, your child may need surgery first.

2. Get the brain to use the weaker eye

If glasses alone are not enough, your eye doctor may suggest a way to make the brain use the weaker eye more:

• Patching. An eye patch is worn over the stronger eye for part of the day. Your eye doctor will tell you how many hours.
• Atropine eye drops. A drop in the stronger eye blurs its near vision for a while, so the brain uses the weaker eye instead.
• Binocular treatment. Some children use special games or videos, watched with special glasses, that train both eyes to work together.

Vision often improves within weeks to months. Some children need treatment for a year or longer. Amblyopia can come back after treatment stops, so your eye doctor will keep checking your child’s vision for a while.

Treatment takes patience, and your help makes a big difference.

• Make it routine. Put the patch on or give the drops at the same time each day.
• Keep it fun. Pair patching with a favorite activity, like drawing, puzzles, building toys or a video.
• Praise effort. Sticker charts and small rewards help many younger children.
• Talk to teachers. Let your child’s school know about glasses or patching so they can help.
• Keep the glasses on. Glasses usually need to be worn all day, even after vision gets better.
• Keep every visit. Regular checks let your eye doctor adjust treatment and catch any slide back.

If patching or drops are a daily struggle, tell your eye doctor. There are often other ways to reach the same goal.