Pediatric Amblyopia (lazy eye)

Amblyopia, often called "lazy eye" is poor sight in a normal eye. During early childhood, a child's brain actively develops its visual pathways from the eyes to the visual processing center. This process occurs from the first month of life until around 8 to 10 years of age, after which the pathways are permanently set. If development of the visual pathways is impeded, the affected eye may never develop good vision.

Some of the most common causes of amblyopia include various forms of strabismus (misalignment of the eyes), uncorrected refractive errors, newborn cataracts or ptosis ("droopy eyelid").

There may be no symptoms. Because vision problems from amblyopia affect only one eye, the child may function with one good eye and be unaware of the problem. Early detection is important.

A visual acuity test is an important screening tool. These tests are performed at schools, health fairs and primary care clinics, usually beginning around 3 or 4 years of age. If there are concerns regarding visual acuity, a full eye exam is needed.

Treatment of lazy eye at Children's National is designed to both address the underlying cause and help the brain use the eye that has been effectively ignored. Based on their extensive experience, Children's National pediatric ophthalmologists will carefully individualize each child's treatment timeline and regimen, taking into account what is most suitable for the condition, the child's age and temperament, and the family's dynamics.

Treating the underlying cause of lazy eye may involve:

• Glasses
• Surgery
• Patching

Patching

Treatment of lazy eye may involve the use of patching or atropine drops in the good eye to encourage the brain to use the affected eye more, making its visual development stronger.

Patching can be a challenge for any parent and child. Most children with lazy eye are too young to appreciate the benefits of patching and it can be an annoyance. Adhesive patches, available at most pharmacies, are the gold standard for treatment.

Some patients may be able to use atropine eye drops instead, depending on the type and severity of their lazy eye. There are rare occasions when felt patches also can be used. A Children’s National specialist will be able to tell you which options are appropriate for your child, based on a thorough evaluation.

The good news about lazy eye is that it can be a very treatable disease, leading to improved vision, if effectively addressed in a timely manner. Treatment may be needed throughout childhood to best treat the child and timely follow-up is of crucial importance. Follow-up appointment intervals may range from a few weeks to a few months, depending on the age of the child, type of lazy eye, and severity of the disease.