Treatment for Lazy Eye (Amblyopia)


If you suffer from lazy eye caused by refractive error, this can be corrected with glasses or contact lenses.  If the lazy eye is caused by cataract, it can be removed with cataract surgery.  If lazy eye is recognised in childhood, the use of the good eye can be restricted forcing the affected eye to work and its visual pathways to develop as normal.  This is known as vision therapy.  This is a very effective method of improving vision to a normal standard.  Placing a patch over the good eye in a procedure termed ‘eye patching’ usually does this.  The efficient eye then catches up because it is being forced to work.

The age of the child and the severity of amblyopia usually determine when and for how long the patch must be worn.  Once the desired result has been achieved, the patch is no longer required.  If the response to the patch disappears, there is obviously no point wearing it and therefore the treatment is discontinued. 

Following successful treatment, regular eye exams are essential to ensure that the eye is not becoming amblyopic again.  Alternatives to the eye patch are eye drops or glasses, which blur the vision in the good eye.  These may be better options, as children are often reluctant to wear an eye patch.  The eye drops used are usually atropine drops.  They have certain side effects, which should be considered.  These include eye dilation, which can make eyes sensitive to light.  There is also a risk of paralysis of the ciliary muscle after long-term atropine use.  This may affect the eye's ability to accommodate or change focus. 

To maintain the progress that has been achieved with treatment, parents may be asked to encourage their child to play visually demanding games, which require a lot of use of the affected eye. 

Another treatment strategy is to wear prosthetic contact lenses in the good eye so that its vision is distorted and the other eye is forced to work.

Alternatively, surgery may be recommended but this is very rare.  It may be advocated when there is a squint.  The surgery corrects the muscle problem, which is responsible for the squint and enables eyes to focus properly and work together. 

Treatment is more effective the younger the child.  Treatment in older children can give some improvement in vision but there are still likely to be some loss of vision.  It is crucial that the child follows the ophthalmologists or orthoptists advice and wears the eye patch or glasses or uses the drops properly.  The long term benefit of good vision is certainly worth a few weeks or months of irritation caused by treatment.

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