Can You Fix Lazy Eye?

Treating Children and Adults Who Have a Lazy Eye

Lazy eye, also known as amblyopia, is a condition in which the brain doesn’t recognize sight from one eye. With this condition, since the brain relies on one eye more, it causes the other eye not to develop properly. This affects around 3 out of 100 kids and is the most common cause of vision loss in children. It can, however, also affect adults.

The risk associated with leaving amblyopia untreated include:

  • Problems with depth perception
  • Potential for permanent blindness in the lazy eye
  • Chance of total blindness if the stronger eye is injured

Fortunately, there are treatments available to help. The idea is to first correct any issues such as nearsightedness or farsightedness, or remove any cataracts that may be causing the brain to have to ignore messages here in favor of the stronger eye.

After correcting vision as much as possible in the lazy eye, current approaches to treating amblyopia include:

  • Patching the eye with better vision
  • Using special drops to blur vision in the stronger eye
Baby wearing glasses with one lens covered. Eye patching is one way to treat lazy eye
Viktoriia Lykhonosova / iStock / Getty Images 

Eye Patches or Drops

These approaches temporarily force the brain to rely on the weaker eye and giving this a chance to develop.

With eye drops, each morning parents can put a drop of the drug atropine in the child’s stronger eye. This medication temporarily interferes with near vision, forcing the brain to look for information from the lazy eye instead.

Many parents prefer this approach to simple patching since it avoids the possibility that the child may inadvertently interfere with treatment by pulling off the patch by themselves.

Research indicates that daily use of atropine is as helpful as traditional patching for many people. If patching is used this should be done for two hours per day. This was actually found to be as effective as wearing the patch for up to six hours.

Another study has shown that at least six months of treatment for those younger than age 7 with either patching for a minimum of six hours a day, or once-a-day use of atropine had similar outcomes.

It was then up to the investigators whether to continue the same treatment or to switch or to combine these. By age 15, most still retained good vision, with only mild amblyopia no matter which treatment was first tried.

Downsides for Drops or Patches

While use of drops tends to be more convenient, there can also be a downside as well. Problems with this can include:

  • Blurry vision
  • Sensitivity to light

Meanwhile, with patching in addition to inconvenience there is more likely to be skin and lid irritation, as well as sensitivity of the white part of the eye.

Glasses

It’s not always clear why amblyopia occurs, but if one eye isn’t seeing as well as the other, this can be the reason. A condition such as nearsightedness with difficulty seeing things faraway or farsightedness with problems seeing up close, or even astigmatism, which causes blurry vision, can be the culprit here if this primarily affects one eye.

If this is not picked up by an eye doctor, the brain will begin to look to the “good eye” for its visual information instead, weakening the other. Fortunately, use of prescription glasses can bring things into focus. But if the eye has already become “lazy” the brain may still need to be retrained to begin to rely on these signals again.

Eye Surgery

While nonsurgical interventions tend to be the approaches most commonly used for treating amblyopia, there can be a role for some surgery as well. Surgically improving vision can prevent lazy eye from developing in the first place and if caught early enough may reverse amblyopia, particularly in children under age 6. Surgical approaches include:

  • Eye muscle surgery: This can be done for strabismus in which one or both of the eyes wander due to uneven eye muscles. These muscles can be tightened or loosened to help realign the eyes.
  • Laser correction: Instead of relying on glasses, refractive surgery can correct vision problems caused by nearsightedness, farsightedness or, astigmatism. This can correct the weaker eye the same way that glasses can, but on the eye itself.
  • Cataract removal: If one of the eyes has a clouded lens this can be removed and replaced with a clear one, offering vision that’s just as sharp as in the other eye. Otherwise, the eye is not able to supply the brain with the needed visual information and the proper connection does not develop here.
  • Surgery to relieve eye pressure: Reducing a buildup of fluid in the brain that can cause eye muscle misalignment can also enable the eyes to work better together.

Laser Surgery

Refractive surgery such as LASIK (laser in situ keratomileusis) or PRK (photorefractive keratectomy) may be useful for some with amblyopia. By reshaping the surface, this may improve the vision in the weakened eye in some cases, especially if glasses are also used to make up for any lingering refraction issues.

The younger you are when the surgery is done the better but even in some adult patients laser surgery can still be effective.

Complications of Surgery

Keep in mind that while laser refractive surgery is generally safe there can of course be complications. These usually temporary complications can include:

  • Blurry vision
  • Night vision issues
  • Dry scratchy eyes
  • Glare or problems with halos or starbursts around lights
  • Sensitivity to light
  • Pain
  • Red spots in the white of the eyes

Eye Exercises

Eye training, also known as vision therapy, can also be used to strengthen the weaker eye. This can take the form of a visual therapy program in which a doctor uses special equipment such as lenses, prisms, filters, or blocking one eye to help force the “lazy eye” to do its share of the visual work.

For young children exercises may include activities such as specialized coloring, making dot-to-dot pictures, or even building with blocks.

These days, the world of technology is also offering answers. By playing action video games, preferably with the better-seeing eye patched, vision in the lazy eye can be improved. After 20-hours of playing such games the amount of improvement is actually comparable to 100 hours of passive patching.

Early Diagnosis

Whatever the approach used, treatment for amblyopia works best the sooner this is caught and the lazy eye retrained. Treatment before age 6 is optimal.

A Word From Verywell

There are several options for treating lazy eye, and parents should seek treatment for their children as soon as a problem is noted. But it is still possible to make improvements in a lazy eye despite age and to ultimately enjoy improvements in vision.

 

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  1. National Eye Institute. Amblyopia (lazy eye). Updated July 2, 2019.

  2. McConaghy JR, McGuirk R. Amblyopia: Detection and treatment. Am Fam Physician. 2019;100(12):745-750. PMID: 31845774.

  3. Repka MX, Kraker RT, Holmes JM, et al. Atropine vs patching for treatment of moderate amblyopia: Follow-up at 15 years of age of a randomized clinical trial. JAMA Ophthalmol. 2014;132(7):799–805. doi:10.1001/jamaophthalmol.2014.392

  4. Li T, Qureshi R, Taylor K. Conventional occlusion versus pharmacologic penalization for amblyopia. Cochrane Database of Systematic Reviews. 2019;8:CD006460. doi:10.1002/14651858.CD006460.pub3

  5. Simborg M. Lazy eye surgery facts. American Academy of Ophthalmology. March 4, 2017.

  6. Altintas O, Etus V, Etus H. et al. Risk of strabismus and ambylopia in children with hydrocephalus. Graefe's Arch Clin Exp Ophthalmo 2005;243,1213–1217. doi:10.1007/s00417-005-0001-z

  7. Liu X, Schallhorn SC, Hannan SJ, Teenan D, Schallhorn JM. Three-month outcomes of laser vision correction for myopia and hyperopia in adults with amblyopiaJ Refract Surg. 2020;36(8):511-519. doi:10.3928/1081597X-20200612-02

  8. Gudgel DT. Facts about LASIK complications. American Academy of Ophthalmology. December 20, 2018.

  9. Gambacorta C, Nahum M, Vedamurthy I, Bayliss J, Jordan J, Bavelier D, Levi DM. An action video game for the treatment of amblyopia in children: A feasibility study. Vision Res. 2018;148:1-14. doi:10.1016/j.visres.2018.04.005

  10. Optometrists Network, How is lazy eye treated.