Amblyopia, more commonly referred to as a lazy eye, is a relatively common condition. It occurs in about 3% of children and involves one eye being weaker and having poorer vision than the other eye.
Although there's some stigma surrounding the term "lazy eye," it's important to note that a lazy eye is not a reflection of character. It doesn't mean that you're lazy — it is an uncontrollable health issue with your eyes — and it can be treated with a number of methods.
Without treatment, the eye will become even weaker, which is why it's so important to fix a lazy eye. Here's what you need to know about what causes a lazy eye and how to effectively treat it.
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What is a lazy eye?
A lazy eye is when there is poor vision in one eye, and vision relies on the stronger "good" eye. It is the result of a problem with the connection between the eye and the brain. A lazy eye usually develops early in life.
When the vision in one eye is abnormal, neural connections, or brain signals, won't be properly stimulated, and the signals that are sent to the brain will create a blurred image, says Jill Rotruck, MD, an ophthalmologist and assistant professor of Ophthalmology and Visual Sciences at the Yale School of Medicine.
There are three main causes of a lazy eye, Rotruck says. They are:
- Uncorrected refractive error. This is when there is an uncorrected vision problem, such as nearsightedness, farsightedness, or astigmatism.
- Strabismus. This is when the eyes are misaligned.
- Stimulus deprivation. This is when something is blocking the vision.
Amblyopia itself doesn't result in a change in appearance to the eye, says Rotruck. If the lazy eye is caused by an uncorrected refractive error, both eyes may appear normal.
However, in the case of strabismus, the eyes may be misaligned, with one eye wandering inward or outward. Additionally, if the amblyopia is caused by something blocking the vision, this will be visible, such as a droopy eyelid, scar in front of the eye, or cloudiness of the eye's lens.
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How to fix a lazy eye
Depending on the individual's situation, there are various ways to fix a lazy eye. While the methods are very different, they mainly have the same goal, which is to address the underlying cause and force use of the weaker eye.
Some examples of treatment include:
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1. Corrective glasses
One way to correct a lazy eye is by using glasses that deliberately blur the image that the stronger eye sees. This is usually done by using an incorrect glasses prescription, known as optical penalization.
By blurring the image that the stronger eye sees, Rotruck says the brain will be forced to pay attention to the weaker eye, and strengthen the connection between the brain and the weaker eye. Contact lenses can be used in the same way, however, if the patient is a very young child, it's much more likely for glasses to be used.
According to the American Academy of Ophthalmology, corrective glasses are a very common first-line treatment for amblyopia. This method is highly effective for amblyopia. A 2006 study showed that there was a significant improvement in 77% of participants. Furthermore, the condition was fully resolved in 27% of participants.
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2. Eye patches
Rather than blur the vision in the stronger eye, an eye patch takes away the vision in the stronger eye completely, which will also strengthen the weaker lazy eye by strengthening the connection between the brain and the weaker eye. Rotruck says treatment will vary from wearing the patch for two to six hours a day, to all day in some cases.
This treatment has been shown to be effective. A 2006 study found that 2 hours of daily patching resulted in a modest improvement of moderate to severe amblyopia.
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3. Medicated eye drops
The most common form of medicated eye drops for lazy eyes is atropine drops. Rotruck says these work by preventing the stronger eye from focusing, which causes blurred vision. This involves putting the eye drops in the stronger eye, which forces the patient to use the weaker eye more, says Rotruck. These drops are typically prescribed to be used two days a week.
Two 2009 studies found that weekend atropine eye drop was effective in improving severe amblyopia over the course of 18 weeks.
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4. Bangerter filter
A Bangerter filter is another way to blur the better-seeing eye's vision. This is a special type of filter that is put on the lens of the glasses of the better eye, making the view through the lens hazy, says Rotruck.
This forces the lazy eye to be used more. The filter will be used until the patient's eye doctor determines that the treatment is no longer needed. According to the American Academy of Ophthalmology, this method is not as popular as the others.
A 2009 study found that using a Bangerter filter along with corrective lenses works more quickly than using corrective lenses alone.
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5. Surgery
In some cases, surgery is necessary for amblyopia if the cause is stimulus deprivation, meaning something getting in the way of the vision such as a droopy eyelid, cataracts, or scarring.
"Clearing the obstruction will allow clear signals to reach the brain and the brain to learn how to see normally out of each eye," says Rotruck.
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Insider's takeaway
Ultimately, the best treatment for a lazy eye will be determined by the patient's doctor. The doctor will decide which method to use and how long to use it for. Some patients will see improvement within weeks, but in other cases, it can take months or longer to fully treat amblyopia.
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Ashley Laderer is a freelance writer from New York who specializes in health and wellness. Follow her on Twitter@ashladerer
