Amblyopia in children
You might have heard of lazy boy or lazy girl, but ever heard of lazy eye? Yes, some children may have lazy eye. It does not mean that the eye does not want to work. Lazy eye is a medical condition where there is incoordination between the eyes.
Amblyopia refers to reduced vision in one eye or both eyes in children. It cannot be corrected by glasses or contact lenses, and is not due any eye disease. It is also called as lazy eye. If left untreated the loss of vision may become severe.
In children with ambylopia, for unknown reasons, the brain tends to take signals from the unaffected eye and ignores the affected eye. This happens when nerve pathways between eye and brain are not stimulated properly. As a result, the weaker eye shows the wandering movement and is known as the ‘lazy’ eye. If this problem is not fixed when the child is young, the brain will tend to block signals or images from the weaker eye always.
The eyes may seem to wander or move inward and outward, and the movements of the eyes may not be coordinated. The child with ambylopia may squint, tilt the head to one side, or close one eye to see properly. In addition, the child may complain of headaches, blurry vision, and have drooping eyelids. The child may lack depth perception.
Amblyopia may be caused due to strabismus, a condition with misalignment of the eyes. This causes lack of coordination in the eyes, and also causes the eyes to turn out and in. If there is an abnormal retina or a cloudy lens as in cataract, then also lazy eye can occur. Difference in size of the eye or an abnormal shape of the eye can also lead to amblyopia. Tumor of the eye is another cause for lazy eye.
Diagnosis and Treatment
For effective treatment, first the cause of amblyopia has to be diagnosed. A complete eye examination and history obtained from the parents may be helpful.
Once the cause is known then the doctor concentrates on making the weaker eye work properly. For this, the doctor may put a patch on the stronger eye. Special glasses and eye drops (atropine drops) are used for the stronger eye to blur its vision, so that it is used less and the brain concentrates on getting image signals from the weaker eye. The whole point is to make the weaker eye or lazy eye pick up images and deliver the signals to the brain properly. This way the doctor is making the ‘lazy’ eye active. In case of crossed eyes, droopy eyelids and cataract, surgery is recommended. The treatment is continued till the vision of the weaker eye becomes normal. This can take several weeks. For some children the eye patches have to be worn till they are 8 years to 10 years of age. Depending on the child’s age or vision the eye patches have to be worn throughout the day or part of the day only.
Treatment in adults
Treatment is most effective during the childhood. When the child is about 8 years to 10 years of age, the vision of the eye is developed completely. All the nerves between the eye and brain are developed by then. Scientists are still exploring the area of treating adults who have amblyopia that was not treated in childhood. However, children between 7 years of age to 17 years of age are also showing improvement after treatment which is a positive sign.
It is important for the parents to educate children regarding their eye problem. It is important for parents to tell their children about wearing eye patches as recommended by the doctor. Decorating the eye patches with stickers and designs will make children want to wear them. If the child experiences any rash due to adhesive used in eye patches, applying moisturizers or ointments on the area will help. It is important for the parents to talk to their kid’s teachers and also their classmates so that their children are comfortable in the classroom. It is important for the child having ‘lazy eye’ to wear protective glasses, face shields or eye guards to protect the eye during any sports activities.
The princess with an eye patch
Long ago there was a little princess who went to the ophthalmologist who told her that she was having a lazy eye. The princess was advised to wear an eye patch over the weak eye. The princess becomes sad and did not want to wear it at first, but then puppets make their entry and tell her all the fun things they can do with eye patching. This is the story behind the 2005 Telly award winning educational DVD story to encourage children to wear eye patches. There is an ‘Eye patch Rap’ song in the DVD as well which children can sing along. The prevent blindness America has listed this “Eye patch kids” DVD as an useful tool to make children wear eye patches.