Eye Health Central

Lazy Eye or Amblyopia

What is Lazy Eye in Children or Amblyopia?

Amblyopia is a childhood vision problem that is more commonly known as having a 'lazy eye' or a 'turned' eye. According to NHS Choices, the condition is most often diagnosed around age 4 and symptoms may not always be obvious. For this reason, it's suggested that a child's vision is checked at six months old and again at three years old to ensure true binocular vision is developing properly. As treatment is often most successful in childhood and could be ineffective in adulthood, early detection is crucial.

The Causes of Amblyopia

There are several different conditions that can cause a lazy eye. A child having one or more of these conditions increases their chances of having a lazy eye, so it's important that a child's visual progress be carefully monitored. Such co-conditions include:

  • Strabismus. This is the condition that can cause the brain to ignore the weaker eye because one eye is turned in (exotropia) or turned outward (esotropia). One eye turned up is called Hypertropia, and one down is called Hypotropia.


Congenital Cataract

  • A congenital cataract. This clouding of the ocular lens isn't always obvious to the casual observer, but it can make it impossible for a child to focus clearly with the affected eye. If the cataract isn't noted and corrected, the brain may start to ignore the affected eye, resulting in a 'lazy' eye. While surgery on a child can seem scary, cataract surgery is very safe and is integral to creating normal, binocular vision in affected children.

  • Refractive issues. If your child has one eye that is close to normal vision and is very farsighted or nearsighted in the other, it's crucial to have corrective lenses fitted as soon as possible. Otherwise, the brain will learn to ignore the inferior eye, leading to amblyopia. Both glasses and contact lenses may be appropriate, depending on your child, their cooperativeness and the condition of their eyes.

Early Detection Factors

One of the best actions you can take to ensure your child doesn't develop a vision issue such as amblyopia is to ensure he or she is taken for a vision screening at six months and again at three years. This will help find any issues in their infancy, before there are life-long consequences.

You can also stay vigilant for other signs that your child is favoring one eye over the other. Watch to see if your child squints a lot, turns their head to look out of one eye frequently or is always leaning too close or too far from objects. All of these early warning signs are easy to miss, because a child's brain is very good at compensating for inferior vision. By noticing these signs and having your child evaluated early, you can have problems addressed in their earliest stages.

Possible Treatments for Amblyopia

Treatment and prevention for amblyopia are largely predicated by finding and treating the risk factors. For example, surgery to remove the clouded lens may be necessary in the case of a congenital cataract, while a refractive error may only need corrective lenses. It's also possible that vision therapy or using an eye patch can strengthen the inferior eye and ward off amblyopia, if your child has a milder case of strabismus. For more severe cases, surgery may be the best course of action. There are also eye drops available that will penalize the stronger eye temporarily, allowing the weaker eye to get stronger over time. Regardless of what issues your child is facing, you can work in tandem with your optometrist or ophthalmologist to determine the right solution for your child.

Amblyopia or 'lazy eye' is entirely treatable, and outcomes are best when treatment begins young. If you are concerned about your child's vision, it's imperative to have him or her evaluated as soon as possible. Children's brains are very good at compensating for vision problems, but no amount of compensation can take the place of therapy, corrective lenses, patching or surgery.

It is often asked by parents that if their child has glasses that corrects a squint if contact lenses would do the same? The answer is yes, it is the power of the lens in the glasses that helps to correct a squint - and this does not matter if the power is in the glass lens, or in a contact lens, the effect is the same. The squint will be corrected to the same degree.

Author: John Dreyer Optometrist Bsc(Hons), MCOPTOM, DipCLP
Created: 27 Jun 2017, Last modified: 4 Mar 2020