Tests and diagnosis:
The ophthalmologist will look for a wandering eye, as well as a difference in vision between the eyes or poor vision in both eyes. Depending on the child’s age, tests may include the following:
* Newborns: Red reflex test to look for cataracts, using a lighted magnifying device (ophthalmoscope)
* Infants: Test for ability to fixate their gaze and follow a moving object, as well as check for strabismus
* Toddlers: Red reflex test, photo screening or remote auto refraction
* Preschoolers and older children: Testing using pictures or letters. Each eye is patched in turn to test the other
The doctor may also check for inflammation, tumors and other inner eye problems.
Common causes of the condition
Muscle imbalance (Squint): The most common cause of lazy eye is an imbalance in the muscles that position the eyes. This imbalance can cause the eyes to cross in or turn out, and prevents them from tracking together in a coordinated way.
Difference in sharpness of vision between the eyes (refractive anisometropia): A significant difference between the prescriptions in each eye can result in lazy eye. Glasses or contact lenses are typically used to correct these refractive problems.
Deprivation of sight: Any problem with one eye — such as a cloudy area in the lens (cataract) — can deprive a child of clear vision in that eye. Deprivation amblyopia in infancy requires urgent treatment to prevent permanent vision loss. Deprivation amblyopia often results in the most severe amblyopia.
Treatment options depend on the cause of lazy eye and on how much the condition is affecting the child’s vision.
Corrective eyewear: Glasses or contact lenses can correct problems such as nearsightedness, farsightedness or astigmatism that result in lazy eye.
Eye patches: To stimulate the weaker eye, your child may wear an eye patch over the stronger eye. The patch is generally worn for two to six hours a day.
Eyedrops: A twice-weekly eyedrop of a medication called atropine (Isopto Atropine) can temporarily blur vision in the stronger eye. This will encourage your child to use the weaker eye, and offers an alternative to wearing a patch. Side effects include sensitivity to light.
Surgery: If the child’s eyes cross or wander apart, the doctor may recommend surgical repair for the eye muscles. The child may also need surgery if he or she has droopy eyelids or cataracts.