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Amblyopia, or Lazy Eye, is the most common cause of visual impairment in one eye in children. The conventional treatment is an eye patch over the good eye. Children hate this. An eye care reference book suggests several ways to prevent a young child from pulling the patch off: put mittens on the child, cover his/her hands with tube socks that extend past the elbows, or tape a rolled-up newspaper around the elbows so the child can't bend his/her arms enough to reach the patch. Is this really the best way?
Amblyopia is thought to be a developmental problem of the neural circuits in the brain that process visual information. Newborn babies with healthy eyes are able to transmit visual information to the brain, but their brains have to learn how to interpret this information. Young children spend years exploring the world with both touch and sight, to learn the connection between what something looks like and how it feels. A child with amblyopia has trouble with this learning process for one eye.
When the eyes do not point in the same direction, the child has double vision and may learn to ignore the image from one eye. The misalignment condition is called strabismus. Some children with strabismus learn to switch from one eye to the other, but others learn to process visual information from one eye exclusively. If one eye is much more nearsighted or farsighted than the other, with or without strabismus, the child may not learn to use the eye with poor refracting power.
Early treatment for amblyopia is very important. When the good eye is covered with a patch, the child can generally develop the full potential of the lazy eye. But children hate eye patches. They may develop great creativity in peeking around the patch unless the parent goes to great lengths to keep the patch on.
There are alternatives. Atropine eye drops in the good eye can blur vision enough that the child prefers to use the lazy eye. If both eyes are nearsighted, the child can wear eyeglasses that correct vision for the lazy eye but not the good eye.
It is essential for the parent to follow the doctor's instructions precisely. Some parents apply the patch or the eye drops more than recommended, thinking “more is better”. This can produce amblyopia in the good eye. Too much or too little treatment will leave the child with poor vision in one eye for life.
Check with your eye doctor to see that your children reach their best potential for eye health.
References:
Melvin L. Rubin, MD, et al, “Taking Care of Your Eyes”, Triad Publishing Co., 2003.
Pediatric Eye Disease Investigator Group, “Pharmacologic plus optical penalization treatment for amblyopia: Results of a randomized trial”, Arch Opthalmol. 2009 January; 127(1): 22-30.
Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.
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