Amblyopia

Amblyopia is commonly referred to as a "lazy eye". Amblyopia is a developmental problem of reduced vision that is not correctable to 20/20 with any prescription or surgery, and is not a result of eye disease. This usually occurs because that eye did not receive proper stimulation during the first few years of a child's life while the visual system was developing.

There are two types of amblyopia (lazy eye): refractive and strabismic. Refractive amblyopia can develop when there is a large difference in the power or prescription of the eyes. For example, if one eye is much more farsighted than the other eye, it receives a blurry image compared to the stronger eye. The brain ignores the image from the blurry eye, to avoid confusion of seeing a blurry image simultaneously with a clearer image. Because of this suppression of the weaker eye, the associated visual pathway doesn't develop to the same level of sharpness as the other eye because of lack of a clear image to stimulate those nerves. Passive treatment for this type of amblyopia is patching of the eye that is stronger to force use of the "lazy" eye. Patching for amblyopia or lazy eye has to be done with a full prescription in place, and should be done only during stationary activities where there is no risk for harm or injury while using the weaker eye to see. Patching for amblyopia should only be done under an Optometrist's guidance.

The other type of amblyopia, strabismic amblyopia, results when the two eyes are not straight. The brain suppresses or ignores the image from the eye that drifts or wanders to avoid seeing double vision. Long term suppression of one eye leads to amblyopia since the brain is not using that eye.

The best treatment for lazy eye or amblyopia is Vision Therapy, a type of physical therapy for the eyes. Surgery cannot treat amblyopia by itself. Surgery may decrease the amount of an eye turn cosmetically, but Vision Therapy is still needed to train the eyes to work together, and to stimulate the weaker eye to track, fixate, and see. Surgery usually requires multiple surgeries unless Vision Therapy is done to train the brain how to use the eyes together. It's like doing knee surgery without going through Physical Therapy: you cannot get a functional cure without doing therapy to improve eye muscle control and coordination.

Vision Therapy for amblyopia works on:

• Improving clarity of eyesight by stimulating the lazy eye. Patching one eye during Vision Therapy and recommended activities allows the weaker eye to be used more.
• Straightening the eyes by improving eye muscle coordination
• Gaining depth perception by training sensory fusion of the two images after eliminating suppression of one eye

Vision Therapy can be successful at any age, but is recommended to begin as soon as possible to enjoy a lifetime of good vision. For more information, visit the College of Optometrists in Vision Development at www.covd.org, as well as www.strabismus.org.