LAZY EYE (AMBLYOPIA) IN CHILDREN

A lazy eye is a childhood condition that occurs when the vision in one eye does not develop properly. This means that the child can see less clearly out of one eye and relies more on the ‘good’ eye.

The medical term for lazy eye is amblyopia.

The eyes work like a camera. An image made up of light comes through the lens of each eye and is beamed on to a light-sensitive layer of tissue called the retina. The retina translates the image into nerve signals that are sent to the brain. The brain then combines the signals from each eye into a three-dimensional image.

In cases of lazy eye, something, such as a squint(where the eye turns out if its normal position) or being short-sighted, affects the quality of the image being sent from the eye to the brain so that it appears blurry and out of focus. As the child grows older the brain begins to ignore the poorer quality image and relies on the stronger eye for vision.

Left untreated this can lead to a permanent loss of vision in the affected eye.

A lazy eye is an uncommon but certainly not rare condition. It is estimated that 1 in 50 children will get one. Children are usually diagnosed with a lazy eye around the age of four.

Children with a lazy eye usually have problems accurately judging the distance between themselves and objects, which can make tasks such as catching a ball more difficult. In some cases you may notice that one eye looks different to the other (this could be due to a squint).

Younger children are often unaware that there is anything wrong with their vision and if they are, they are usually unable to explain what is wrong. So most times the only noticeable symptoms may be related to an underlying condition such as:

• A squint – where the weaker eye looks inwards, outwards, upwards or downwards, while the other eye looks forwards
• Childhood cataracts – which are cloudy patches that develop at the front of the eye (the lens)
• Ptosis – which is where the upper eyelid drops over the eye, impairing vision

Another sign is your child having problems with their depth perception. Due to the mismatch between each eye, children with lazy eyes have difficulty judging how far away objects are.

Signs to look out for include:

• being unusually clumsy for their age, such as running into furniture or falling over a lot
• problems catching a ball
• poor performance in sports

Older children may complain that their vision is better in one eye and that they have problems with reading, writing and drawing

One way to check your child’s eyes is to cover each eye, one at a time, with your hand. If they try to push your hand away from one eye, but not the other, it may be a sign they can see better out of one eye.

When to seek medical advice

Many cases of lazy eye are diagnosed during routine eye tests before parents realise that there is a problem. Children should have an eye test before they start school and then further tests at least every two years.

However, you should see your GP if you are concerned about your child’s eyesight as they can refer your child for further testing by an eye specialist (ophthalmologist).

Treating a lazy eye

The majority of cases of lazy eye can be treated, usually in two stages.

Firstly, the underlying problem is corrected, for example using glasses to correct a squint.

The child is then encouraged to use the affected eye again. This can be done with eye patches to cover the stronger eye or using eye drops to temporarily impair the vision in the strong eye.

Treatment is effective, but it's a gradual process, taking many months to work.

Outlook

Providing the condition is properly diagnosed and treated at an early age (ideally around two), then the outlook for children with a lazy eye is usually good.

The weaker eye will not normally return to perfect vision, but there is usually enough vision to avoid problems later in life.

It's more difficult to treat if the eyesight has finished developing (usually around the age of seven), although it is still possible to significantly improve the vision in the weaker eye.

NHS UK
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