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What is Amblyopia or Lazy Eye?
by Dr. Jeffrey Cooper & Rachel Cooper (no relation). © 2001-2014

What is Amblyopia or Lazy Eye?

Amblyopia (Lazy Eye) and Strabismus are not the same condition.

What Causes Amblyopia or Lazy Eye?

Diagnosis of Amblyopia

Amblyopia Lazy Eye Treatments

What is Amblyopia or Lazy Eye?
Amblyopia, commonly known as lazy eye, is the eye condition noted by reduced vision not correctable by glasses or contact lenses and is not due to any eye disease. The brain, for some reason, does not fully acknowledge the images seen by the amblyopic eye. This almost always affects only one eye but may manifest with reduction of vision in both eyes. It is estimated that three percent of children under six have some form of amblyopia.

Amblyopia (Lazy Eye) and Strabismus are not the same condition.
Many people make the mistake of saying that a person who has a crossed or turned eye (strabismus) has a "lazy eye," but lazy eye (amblyopia) and strabismus are not the same condition. Some of the confusion may be due to the fact that strabismus can cause amblyopia. Amblyopia can result from a constant unilateral strabismus (i.e., either the right or left eye turns all of the time in one direction). Alternating and/or intermittent strabismus (an eye turn which turns in different directions and/or occurs only some of the time) rarely causes amblyopia.

While a large eye turn or deviation (strabismus) is easily spotted by the layman, amblyopia without strabismus or associated with a small deviation is usually not noticed by parents or pediatricians. Only an eye doctor expert in examining infants and young children can detect this type of amblyopia. This is why early infant and pre-school eye examinations by an eye care professional are so necessary. Eye exams by a pediatrician or school eye screenings are not a substitute for a comprehensive vision examination by a developmental optometrist or primary eye care doctor.

Due to misunderstanding or misuse of the terms for different visual conditions (i.e., crossed eyes vs. lazy eye), many people are inaccurately labelled as having a "lazy eye." If you think you or someone you know has lazy eye, it is recommended that you learn more at What is a Lazy Eye? - Comprehensive Patient Education and What is Strabismus?. In addition, there is a related visual condition which is common, not detected by the standard 20/20 eye test, and can be mistaken for lazy eye - see What is Convergence Insufficiency?

To complete the picture, find out about all amblyopia and strabismus treatment options.

What Causes Amblyopia or a Lazy Eye?
Both eyes must receive clear images during the critical period. Anything that interferes with clear vision in either eye during the critical period (birth to 6 years of age) can result in amblyopia (a reduction in vision not corrected by glasses or elimination of an eye turn). The most common causes of amblyopia are constant strabismus (constant turn of one eye), anisometropia (different vision/prescriptions in each eye), and/or blockage of an eye due to trauma, lid droop, etc. If one eye sees clearly and the other sees a blur, the good eye and brain will inhibit (block, suppress, ignore) the eye with the blur. Thus, amblyopia is a neurologically active process. The inhibition process (suppression) can result in a permanent decrease in the vision in that eye that can not be corrected with glasses, lenses, or lasik surgery.

Diagnosis of Amblyopia
Since amblyopia usually occurs in one eye only, many parents and children may be unaware of the condition. Far too many parents fail to take their infants and toddlers in for an early comprehensive vision examination and many children go undiagnosed until they have their eyes examined at the eye doctor's office at a later age.

The most important diagnostic tools are the special visual acuity tests other than the standard 20/20 letter charts currently used by schools, pediatricians and eye doctors. Examination with cycloplegic drops can be necessary to detect this condition in the young.

Treatment of Amblyopia
Early treatment is usually simple, employing eyeglasses, drops, Vision Therapy, and/or eye patching. While detection and correction before the age of two is considered to offer the best outcomes, recent scientific research has disproven the long held belief that children over a certain age (seven or whatever) can not be successfully treated. In fact, many scientific studies on neuroplasticity of the brain in adults are now showing that therapies can improve the vision in amblyopic or lazy eye conditions in older children AND adults. See information on recent scientific studies and research on amblyopia and lazy eye treatments.

Treatment of amblyopia after the age of 17 is not dependent upon age but requires more effort including vision therapy. Every amblyopic patient deserves an attempt at treatment.

To quote one of our members, Dr. Leonard J. Press, FAAO, FCOVD: "It's been proven that a motivated adult with strabismus and/or amblyopia who works diligently at Vision Therapy can obtain meaningful improvement in visual function. As my patients are fond of saying: "I'm not looking for perfection; I'm looking for you to help me make it better". It's important that eye doctors don't make sweeping value judgments for patients. Rather than saying "nothing can be done", the proper advice would be: "You won't have as much improvement as you would have had at a younger age; but I'll refer you to a vision specialist who can help you if you're motivated."

In conclusion, improvements are possible at any age, but early detection and treatment offer the best outcome. If not detected and treated early in life, amblyopia can cause a permanent loss of vision with associated loss of stereopsis (two eyed depth perception). Better vision screenings are needed for young children. The 20/20 eye chart screening is not adequate.

Amblyopia causes more visual loss in the under 40 group than all the injuries, and diseases combined in this age group.

What is Strabismus?
Helping Teachers and Therapists since 1996

Latest Scientific Research on Lazy Eye

Learn All About Lazy Eye Surgery

Learn about Strabismus Treatments

Two-Eyed Vision
Some vision problems can't be improved with just glasses or surgery.

Vision Therapy treats the entire visual system and changes reflexes to make a lasting cure. Learn more...

Constant? Intermittent?

What is Convergence Insufficiency?

What is Double Vision?

What is Optometric Vision Therapy?

What is Strabismus or Lazy Eye Surgery?

Patient Testimonials
Successful Lazy Eye Treatment

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