Due to the fact that the amblyopic eye may not look different from the normal seeing eye, parents and doctors cannot diagnose the condition just by looking at the eyes. Lazy eye is often diagnosed during routine eye examination before parents realize the problem.
The earlier it is diagnosed, the greater the chance for treatment to be successful. Therefore, it’s important for children to undergo vision screening.
The eye examinations should begin in the toddler and preschool years in order to recognize the problems before the child reaches visual maturity. Most vision screening examinations are done at the clinics or schools. If an abnormality is found, your child will be referred to an ophthalmologist for further evaluation and treatment. However, you can directly visit an optometrist or ophthalmologist if you have concerns about your child’s eyesight.
How is Amblyopia Treated?
It’s important to start treatment for lazy eye as soon as possible in childhood, when the complicated neuronal connections between the eyes and the brain are forming. It tends to be more effective the younger the child is. After the child has reached eight years old and above, the chances of successful treatment reduce significantly.
The most common treatment for amblyopia is to force the brain to start using the “bad”eye. This is done by first correcting any underlying problems in that eye and then by putting a patch over the “good”eye.
This can be done through wearing glasses, eye patches, applying eye drops, eye surgery, or a combination of these methods.
A child with myopia (short-sightedness) or hyperopia (long-sightedness) will be prescribed glasses. The child will have to wear them at the time so that the specialist can monitor how effective they are on improving amblyopia. Glasses may also treat the squint.
In some instances, wearing the glasses maybe the only treatment needed. However, more often, patching of the “good” eye is needed to force the brain to pay attention to the visual input from the amblyopic eye and enable normal vision development to occur in that eye.
A patch is placed over the good eye so that the lazy eye is forced to work. As the brain is now getting data only from that eye it won’t ignore it. The patch is worn for 2-6 hours a day while the child is awake, for duration of several months or years, depending on the severity of the condition. A child should be encouraged to do close-up activities while wearing the patch, such as reading, coloring or doing schoolwork.
3) Atropine drops
Sometimes, despite parents’ best efforts, some children refuse to wear their eye patch. In these cases, atropine drops may be used as an alternative to eye patches. A drop of atropine is placed in the good eye to dilate the pupil, to temporarily blur vision so that the child will use the eye with amblyopia, especially when focusing on near objects. Studies have shown that it works as effective as eye patching in treating mild to moderate amblyopia. However, it may have some rare side effects like irritation and stinging in the eye, skin rash or headache.
Treatment of strabismic amblyopia often involves strabismus surgery to straighten the eyes, followed by eye patching and vision therapy (orthoptics) to help both eyes working together equally as a team. If the child has cataract or droopy eyelid that blocks the light from getting into the eye, surgery is recommended followed by patching.
Lazy eye will not go away on its own. For most children with lazy eye, proper treatment is often effective but it’s a gradual process that takes many months to work. The earlier amblyopia is diagnosed and treated, the better the chances to restore vision and avoid permanent vision loss. Often there is no apparent sign of a vision problem, thus it is important for children to undergo vision screening at young age. Early diagnosis and treatment are the keys to the best visual outcome.
Dr. Wong Ching Lin is an ophthalmologist currently working in Penang General Hospital Ophthalmology Department and is registered with the National Specialist Registry of Malaysia. She obtained her medical degree from University Kebangsaan Malaysia (UKM) in 2004. Dr. Wong started her training in ophthalmology in Penang General Hospital, later in Kuala Lumpur General Hospital and UKM Medical Center. After completed her Master of surgery in Ophthalmology from UKM in 2012, she started to work as a specialist in Penang General Hospital until now. She provides treatment to a broad range of eye conditions which include cataract, eye infection and inflammation, eye injuries, paediatric eye assessment, lazy eye, general eye diseases like glaucoma, pterygium, diabetic retinopathy and other medical retinal disorders. She also involved in research projects and wrote for publications. Dr. Wong has actively taken part in the teaching of medical students, trainees and allied health personals.