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Refractive Amblyopia and Other Types of Lazy Eye

Amblyopia, or lazy eye, is an ocular condition where the brain favors the signal it receives from one eye over the other.

The relationship between the eyes and the brain is highly complex—the eyes receive light and transmit those signals to the brain so that it can form an image of what the eyes are currently focusing on. If the brain favors the signals provided by one eye, it means there is something wrong with the signals of the other eye. Miscommunication occurs somewhere along the optic nerve connecting that eye to the brain. As the brain continues to favor the other eye, the weaker eye becomes less and less used, or “lazy.”

Amblyopia is a common condition among children and affects nearly 3% of kids. It’s also something that can be corrected if caught and treated early enough. However, lack of treatment can lead to permanent vision impairment or even total vision loss in the weaker eye, which can then lead to a lifetime of depth perception issues.

Signs of Amblyopia

Amblyopia is difficult to notice at home; it requires proper testing from your child’s eye doctor. However, there are some warning signs that could indicate your child is developing it. Signs and symptoms include:

  • Misalignment in the eyes (strabismus)
  • Inability to see up close or far away
  • Frequent squinting
  • Frequent head-tilting
  • Frequent covering of one eye in an attempt to see better.

If you notice these signs and suspect your child suffers from amblyopia, schedule an appointment with their optometrist or ophthalmologist for a thorough vision test.

Types of Amblyopia – Refractive, Strabismic, and Deprivation

While all forms of amblyopia lead to the same issues (vision impairment and depth perception issues), not all cases of amblyopia stem from the same root causes. There are actually three main types of amblyopia that could affect a patient:

Refractive Amblyopia

As the name suggests, refractive amblyopia is a type of amblyopia that occurs due to a refractive issue with the eyes. Refractive errors can include:

  • Myopia, or nearsightedness – Light hits the eye in such a way that objects close to the eye are clear, but objects in the distance appear blurry and are difficult to see without correction.
  • Hyperopia, or farsightedness – Light hits the eye in such a way that objects far away are clear, but closer objects appear blurry and are difficult to see without correction.
  • Astigmatism – Astigmatism occurs when the cornea is egg-shaped instead of rounded, which affects how light hits the eyes. When the brain receives warped light signals, the image it creates can be blurry or distorted.

These refractive issues cause one or both eyes to develop focusing issues or weak vision. If the problem with one eye is worse than the other, the brain may begin favoring the stronger eye and ignoring the other, creating a lazy eye.

Refractive amblyopia can be difficult to detect at home, but it can be caught during an eye checkup.

Treatment for Refractive Amblyopia

Patching the stronger eye for a period of time is the most common way to treat refractive amblyopia. Blocking the stronger eye forces the brain to rely on the weaker eye, which strengthens communication between the two, strengthens the weaker eye overall, and trains the brain to stop ignoring the weaker eye when the stronger eye is available.

It can take several months to build up the weaker eye through patching, and often, the patient will need to patch off and on for a few years until both eyes are equally strong.

Strabismic Amblyopia

Some children with amblyopia actually have an additional eye condition called strabismus, wherein one of their eyes is misaligned. Whether the eye turns outward, inward, upward, or downward, a misaligned eye immediately sets the other eye up to be the one the brain is going to rely on for vision.

Strabismic amblyopia is easier to catch at home because you will be able to see that one of your child’s eyes is not pointing in the same direction as the other. Even subtle misalignment can be noticeable.

Treatment for Strabismus Amblyopia

If the misalignment is mild enough, your child’s strabismus can be corrected through specialized eyeglasses or eye patching techniques. In more severe cases, your child may require surgery wherein the muscles causing the misalignment are detached and reattached elsewhere to realign the eye.

Deprivation Amblyopia

Some patients develop amblyopia due to structural issues that obstruct the eye and deprive it of the ability to see and develop properly. These issues can include ptosis (an eyelid that droops to cover the pupil) or cataracts (cloudy lenses).

Treatment for Deprivation Amblyopia

Treatment for deprivation amblyopia can vary based on the issue causing the obstruction.

  • Ptosis – Surgery is an option for ptosis patients wherein the surgeon lifts the eyelid and clears the pupil to be able to see clearly. Ptosis patients may also benefit from Botox injections or eyedrops that are designed to target your eyelid muscles and contract them to open your eyelid wider.
  • Cataracts – Cataract removal is a viable solution for patients with cataract-related amblyopia, even for children as young as one to two months old. Your eye doctor will evaluate the severity of the cataract and will determine the correct next steps for treating it. If the cataract is small, they may suggest eyeglasses or patching first before surgery.

To ensure your child is not unknowingly developing refractive amblyopia or any of the other types of amblyopia, schedule a visit with the eye doctors at Vision Eye Group.

Amblyopia can be a sneaky but serious issue for your child and can lead to life-long vision issues if left untreated. Don’t let your child’s eye conditions go unnoticed—schedule an eye exam with our team today. Our optometrists and ophthalmologists conduct thorough eye exams to catch any underlying vision issues early and correct them as soon as possible.

We invite you to schedule an appointment with our team today: 478-744-1710

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