When one eye gets weaker compared to the other throughout infancy or childhood, it is known as amblyopia or lazy eye. The brain needs to prioritize the stronger eye, which causes the weaker eye to deteriorate gradually. Early detection is crucial since timely treatment has a greater chance of success. An eye patch or spectacles are used as treatments for the same.

What does it mean to have a lazy eye?

Amblyopia is a type of vision impairment that typically affects only one eye but less frequently both. It occurs when the interaction between the brain and the eye breaks down, making it impossible for the brain to recognize what is being seen by only one eye. While vision in the weaker eye deteriorates over time, the brain begins to rely more and more on the other, stronger eye.

The term “lazy eye” is inaccurate because the eye is not inactive. Not a problem with the eye itself; the ailment is a developmental issue with the nerve that connects the brain to the eye. The brain essentially ignores the lazy eye concentrating on one eye more than the other. The nerve cells that control the vision due to lack of proper stimulation do not mature.

Major causes of a lazy eye

Certain vision issues typically cause amblyopia. It’s crucial to cure these issues, or your brain will learn to rely more on the eye with better vision, which might cause amblyopia. So, here we will discuss some causes of a lazy eye –

• Strabismus:

When the muscles that control eye position are out of balance, it results in strabismus, which causes the eyes to cross or turn out. Your eyes won’t align properly at this point. The muscular imbalance makes it challenging for both eyes to track objects simultaneously. Lazy eyes are most frequently caused by an imbalance in the muscles that position the eyes.

• Refractive errors:

Refractive errors occur when one eye may have a significantly stronger sense of focus than the other. One eye may be farsighted, whereas the other may be nearsighted. Or perhaps it has astigmatism (distorted or blurry vision). To fix these refractive issues, glasses or contact lenses are commonly used. A combination of strabismus and refractive issues might lead to lazy eyes in some children.

• Deprivation amblyopia:

A hazy lens inside your eye can cause things to appear fuzzy, which is a problem with one eye, like cataracts. It’s possible that the eye won’t develop its eyesight properly,. To prevent irreversible visual loss, infants with deprivation amblyopia need urgent treatment. This form of amblyopia is frequently the most severe.

Symptoms of a lazy eye

Lazy eye symptoms and signs include:

• Abnormal screening test results for vision
• Eyes that don’t seem to cooperate
• Blinking or closing one’s eye
• A poor sense of depth
• An inward- or outward-moving eye
• Tilting the head

Various types of a lazy eye treatment

The most appropriate method of lazy eye treatment is to cure underlying eye disorders. In other words, you have to support the normal development of your damaged eye. Simple early lazy eye treatment options include eyeglasses, contact lenses, eye patching for the lazy eye, eye drops, and lazy eye surgery or vision therapy.

Here we will discuss various types of lazy eye treatments:

• Corrective glasses or contact lenses:

Vision differences between the two eyes might occasionally lead to lazy eyes. For instance, one eye may be farsighted or nearsighted. If you have amblyopia due to nearsightedness, farsightedness, or astigmatism in one eye, your eye expert may recommend corrective glasses or contact lenses. Glasses can sometimes correct the lazy eye without any additional therapy, and they can also help to straighten a squint.

• Amblyopia treatment patching:

Your weaker eye can get stronger if you cover your dominant eye with an eye patch for two to six or more hours each day. It is a straightforward, affordable method of treating lazy eyes for adults and kids. It helps in weaker eye’s eyesight improvement. In this method, the weaker eye gradually becomes stronger as a result of the patch’s influence on the brain to process images from that eye.

• Eye drops:

Your ophthalmologist can suggest atropine eye drops for mild cases to temporarily blur vision in the better eye. The drops are typically prescribed for daily or weekend use, and they urge adults and children to utilize their weaker eyes. This is an alternative treatment method of patching for lazy eyes.

• Lazy eye surgery:

When a squint, droopy eyelid, or cataract is the cause of amblyopia, lazy eye correction surgery may be necessary. If you have crossed or opposing pointing eyes, you might need surgery on your eye muscles. Your doctor could advise surgery to treat some amblyopia-related conditions, like cataracts. If a cataract is the root of amblyopia, it can be surgically removed under local or general anesthesia.

• Bangerter filter:

Bangerter filters may be used by a user who cannot use an eye patch. The stronger eye’s lens is covered with this unique filter. These filters have a specific kind of opaque coating that attaches to the interior of the eyeglass lens and is used on the dominant eye.

Diagnosis of a lazy eye

During the examination, your doctor will look for any signs of eye disease, a wandering eye, different vision in each eye, or poor vision in both eyes. Typically, eyedrops are used to widen the pupils. Vision blurring brought on by the eyedrops can endure for several hours or even a day. Your eye’s ability to concentrate is assessed by your doctor. A simple eye exam is all that is necessary to identify amblyopia in the majority of cases. Basically, your age and developmental stage will determine the procedure used to test your vision.

About the author- Prof. Dr. Mahipal S Sachdev, Chairman and Medical Director, Center for Sight, New Delhi