Commonly known as "lazy eye"

Responsible for vision loss in more children than all other causes combined

Amblyopia, or "lazy eye," is a common vision problem in children and is responsible for vision loss in more children than all other causes combined. Amblyopia affects approximately 2-5% of all children. There is often a family history of this disorder.

When we are born, our eye structures are mature, yet the area of our brain devoted to interpreting vision (the visual cortex) is not fully developed. The visual cortex develops in the first 6 years of life, and its development is dependant on good visual input.

Simply put, the eyes “teach” the visual portion of the brain to see. When one or both eyes send a blurry image to the brain in the first 6 years of a child’s life, amblyopia develops. The brain does not learn to see clearly.

Amblyopia, then, is not a problem with the eyes; it is actually a problem of the visual cortex of the brain. Therefore, glasses cannot solve the visual loss from Amblyopia if caught too late. Amblyopia may occur even when there is no observable structural abnormality of the eye. If amblyopia is not treated in a timely fashion, the vision loss may be permanent into adulthood.

How we treat amblyopia

Amblyopia develops when one or both eyes send blurry images to the brain. In order to treat this condition, we must clear up the image that the eyes see, so that the eyes will send proper information to the brain. The first six years of life are the most critical for brain development to occur. If Amblyopia is caught early, we can still “re-wire” the brain and treat the problem. After about age 6, vision loss from Amblyopia is much more permanent, and much more difficult to treat.

We can clear up the image that the eyes see by prescribing glasses. It is important that your child wear the glasses FULL TIME. The reason for this is every time the glasses are removed, the eyes see a blurry image, and this blurry image is sent to the brain. When the brain is fed blurry images, it fails to develop properly.

Sometimes, even with the proper glasses, we will also need to have your child wear a patch over the "good eye," to further stimulate the "bad eye." We will determine if patching is necessary based on your child’s level of amblyopia.

Vision therapy is the last stage in treating amblyopia. After the poor eye develops better vision through correct glasses and patching, vision therapy helps the eyes work as a team, developing 3-D or binocular vision. We will determine if vision therapy is needed based on your child’s level of binocularity.

Active patching

Patching your child’s "good eye," you are forcing the "bad eye" to see the image and forces the brain to rewire itself.

While patching, it is important that your child uses the "bad" eye actively. Passive activity (like watching TV) does NOT work.

Schedule time for your child to do ACTIVE visual activities while patched. For example, have him or her:

• Drop clothespins into a bottle, or toothpicks into a straw, beginning with larger objects into a larger opening, and increasing difficulty with smaller objects into a smaller opening.
• Pick up small objects with tweezers, beginning with larger objects and increasing difficulty by using smaller objects.
• String beads to make jewelry, beginning with large beards and increasing the difficulty by using smaller beads.
• Divide a large square into smaller sections with a ruler. Then cut out all the resulting squares.
• Complete maze drawings, beginning with easy mazes and increasing difficulty by using smaller more complicated mazes.
• Punch out letters with a hole punch from a newspaper or magazine, beginning with headlines, and increasing difficulty by punching smaller print.
• Play “tracking” computer games. Go to the Eye Can Learn website and then click on the section titled “Tracking.” The other areas on this site are good, but they will be more applicable when we are finished patching and need to reinforce binocular vision. **MOST COMPUTER TIME IS PASSIVE, SO ONLY USE THIS SITE FOR ACTIVE PATCHING THERAPY**

Vision therapy for Amblyopia

The newest clinical study through PEDIG (Pediatric Eye Disease Investigator Group) is one of a series of randomized trials to address management of amblyopia (lazy eye) in children. This study compares 2 groups:

1. effectiveness of patching combined with active vision therapy plus near activities
–versus-
2. patching combined with control vision therapy plus near acitivities for moderate amblyopes.

Initial results of this study and other studies show very cleary that vision therapy should be part of the treatment protocol for kids with amblyopia (lazy eye).