What is lazy eye/Amblyopia?
How to Fix a Lazy Eye in Adults| Lazy eye is a condition in which one or both eyes have decreased vision caused by visual deprivation or abnormal binocular fusion.
The lazy eye develops in early childhood; hence it is a disease of childhood. Once a lazy eye has developed it becomes almost impossible to reverse the condition in some cases, while timely recognition of the lazy eye by the parents of the child can give a good prognosis for the vision.
As no organic cause can be determined by the examination, that is why lazy eye disease remains undetected until late. Some therapeutic procedures followed in children can result in the best visual results. However, compliance is a keep factor for the best results.
As the process of normalization is prolonged, many patients do not keep compliance which is a key factor in a poor outcome. The education of the parents is very important who is having a child with lazy eye or amblyopia.
According to research, lazy eye affects up to 1 in 33 of the population this means up to 10 million people in the USA may have a lazy eye
Classification of Lazy eye:
The causes of amblyopia can be divided as followed
Stimulus deprivation amblyopia:
One of the most common causes of stimulus deprivation is congenital cataract, an especially unilateral cataract that is highly amblyogenic. Other common cause includes drooping of the upper lid up to the eye’s visual axis.
Constant occlusion of one eye (> 1 week per year of age) due to any cause is very likely to develop amblyopia.
This condition arises when the refractive power between the two eyes is >1D. This is a highly amblyogenic stimulus.
When the symmetrical refractive error is >+5.0 DS or > -10.0 DS unilateral amblyopia may occur if correction is not done.
Astigmatic/ meridional amblyopia:
The relative risk of astigmatic amblyopic is increased if cylinder power is > 0.75 DC. Risk is more when there is a difference in axis or if the magnitude between two eyes is different.
Strabismic amblyopia is caused when one eye is preferred for fixation. If the process is alternating between the two eyes, then the risk is low.
Pathophysiology of Lazy Eye:
There is a reduction in the spatial resolving power of the retinal cells.
Lateral geniculate nucleus:
In the lazy eye, there is a reduced number of cells in all six layers of the lateral geniculate nucleus.
There is a reduction in the number of cortical cells.
Clinical Features of Lazy eye:
- Decreased visual acuity of two more lines on the Snellen chart.
- Crowding phenomenon.
There is an abnormality of contour interaction between the point of fixation and the adjacent objects. Visual acuity is better for single optotypes than for multiple optotypes.
- Normal ocular examination.
- Decreased contrast sensitivity.
- Binocular suppression of amblyopic eye.
Management of Lazy Eye:
- Patching: Covering the stronger eye with a patch can force the brain to use the weaker eye. This is a common treatment for lazy eye in children and can also be effective in adults.
- Glasses or contact lenses: Remove refractive error and perform cataract surgery for cataracts
- Vision therapy: Vision therapy is a form of rehabilitation that can help to improve the visual skills of the affected eye. This may include exercises to improve eye coordination and strengthen the eye muscles.
- Atropine eye drops: Atropine eye drops can be used to temporarily blur the vision in the stronger eye, encouraging the brain to use the weaker eye.
- Surgery: In some cases, surgery may be necessary to correct a misalignment of the eyes (strabismus), which can be a contributing factor to lazy eye.
Exclude other causes:
Other causes of decreased vision such as refractive error, cataract, and tumors should be excluded.
surgery for cataracts.
How Long Does it Take to Fix a Lazy Eye With an Eye Patch
Occlusion therapy (GOLD STANDARD):
The amount of occlusion therapy for lazy eye depends on the age, severity, and cause of lazy eye.
- Patching should be started as soon lazy eye is detected.
- For part-time occlusion, it depends on the age of the patient. 1 hour/day for each year of age.
- Full-time occlusion should not exceed 1 week per year of age.
- Patching should be continued for 3-6 months.
- If there is no progress for consecutive 3 months, patching should be considered a failure.
- Patching should be maintained up to the age of 9, which is labeled as the age of the matured visual system.
This method is preserved for non-compliant or patients who show a failure to patching therapy or lazy eye
1% atropine drop is placed in the better eye to blur the vision for near.
Image degradation is made in the better eye so that amblyopic has a competitive advantage.
In this method under correction, a better eye is made with optical lenses.
Additional Management Principles:
- Strabismic amblyopia:
- Occlusion therapy should be started before strabismus surgery. It is done because the fixation behavior will be harder to determine once the strabismic correction is made.
- Parent motivation towards patching is increased by the visual reminder of strabismus.
- Amblyopia due to refractive error.
- Refractive correction is made before patching therapy.
- Part-time occlusion is preferable if binocular interaction is present, amblyopia is mild and the child is in school.
- Stimulus deprivation amblyopia.
- Remove any barrier within the first 6 weeks of life.
There are several steps that can be taken to prevent the development of the lazy eye or amblyopia:
- Early detection: Regular eye exams are important for detecting any potential vision problems, including lazy eye, as early as possible. It is recommended that children have their first eye exam at 6 months of age and then at 3 years old and before starting school.
- Correction of refractive errors: If a child is found to have a significant difference in the refractive error between the two eyes, or one eye is more farsighted, nearsighted, or has a greater amount of astigmatism than the other, correcting the error with glasses or contact lenses can help prevent the development of lazy eye.
- Treatment of strabismus: Strabismus, or a misalignment of the eyes, can lead to the development of lazy eye. If a child is found to have strabismus, prompt treatment with glasses, eye patches, or surgery can help prevent the development of lazy eye.
- Regular follow-up: Children with a high risk of developing amblyopia should have regular follow-up visits with an ophthalmologist or optometrist to monitor their vision and make sure that their treatment plan is working.
- Awareness and education of the primary care physician.
- Vision screening programs in all communities.
- The red reflex of every baby should be checked at birth.
Can a Lazy Eye Be Fixed
Amblyopia can be reversed up to the age of 7-8 years, after this age it is usually permanent. It is the average age for the development of normal vision in the human eye, after this, no therapy or treatment can reverse the vision.
Signs of Lazy Eye
The signs of lazy eye, or amblyopia, can vary, but may include:
- Poor vision in one eye: The affected eye may have a lower visual acuity than the other eye.
- A tendency for the eye to turn in or out: This is called strabismus and it is a common cause of lazy eye.
- Lack of depth perception: People with the lazy eye may have difficulty judging distances or perceiving the three-dimensional nature of objects.
- Crossed or uncrossed eye: The affected eye may appear to be turned in or out.
- The difference in the size of the pupils: The affected eye may appear smaller than the other eye.
- Sensitivity to light in one eye: The affected eye may squint or close when exposed to bright light.
It’s important to note that not all people with the lazy eye will have all these signs and symptoms, and some people may not have any obvious symptoms. It’s important to have regular eye exams, particularly if there is a family history of lazy eye or other vision problems. This can help to detect the condition early and increase the chances of a successful outcome.
At what age does a lazy eye develop
Lazy eye, or amblyopia, typically develops during childhood. The most critical period for the development of vision is between birth and age 7, during this time the brain is actively organizing and interpreting visual input from the eyes. If the eyes are not properly aligned or one eye is significantly more farsighted, nearsighted, or has a greater amount of astigmatism than the other, the brain may begin to favor one eye over the other. This can lead to the development of a lazy eye. However, it is important to note that amblyopia can also occur in adults as a result of injury, disease, or other conditions that affect visual acuity in one eye.
What if there is no response after 3 months of Patching therapy for children
If there is no improvement after 3 months, then consider the following
- Wrong diagnosis
- Uncorrected refractive error
- Failure to prescribe specific treatment
- Irreversible amblyopia
How to fix a lazy eye | Treatment for lazy eye
In children below the age of 9 years, patching therapy is considered a gold standard. It will force the lazy eye to do it function more effectively while the patch is placed on the better eye.
Lazy Eye Training
Games/activities designed to challenge the weak eye have proven to be very beneficial, but they are not enough as a single treatment to cure vision.
Lazy eye training tools include certain types of computer or iPad games and activities such as jigsaw puzzles and drawing pictures.
Training with computer games and videos to be effective in several small studies, one in 2016 and one in 2018. However, before it can be considered effective enough to be used without other forms of treatment, more research is needed, such as wearing an eyepatch.
Can lazy eye worse
If left untreated the lazy eye may get worse over time. The brain gradually stops picking signals from the lazy eye and it can render a blind eye.
How to fix a lazy eye in adults at home |amblyopia in adults
Until now there is no treatment option for the fixing of lazy eye in adults. The only possibility that can be provided is the optical correction to the best of its level.
But some optometrists say It is possible to treat amblyopia in adults via vision therapy.
What is Vision Therapy
Through a series of progressive therapeutic eye exercises, patients develop visual skills. Visual enhancement is achieved by improving the communication between your brain and eyes.
Vision therapy aims to improve a person’s visual abilities. Vision therapy is performed once per week under the supervision of an eye doctor in sessions lasting 30-45 minutes. uses a variety of ways – such as testing, eye exercises, occlusion (patching) prisms, and lenses to treat visual problems.
Please read my article about lazy eye exercises for adults
Home exercises are given in the office to reinforce the exercises learned during the therapy session. For best results, commitment to weekly sessions and therapy homework assignments is essential. Through vision therapy, both eyes will be trained to work together to achieve clear and comfortable vision.
Some vision therapy programs to treat lazy eye may include:
- Accommodation (focusing)
- Fixation (visual gaze)
- Saccades (switching eye focus, “eye jumps”)
- Pursuits (eye tracking)
- Spatial skills (eye-hand coordination)
- Stereopsis (3-D vision)
Lazy eye / Amblyopia affects 3 out of every 100 children. The condition is treatable and usually responds well to strategies such as eye patching and corrective lens wear.
A lazy eye is something that can be avoided only by having a check-up with a pediatric ophthalmologist at an early age. The best results for a lazy eye are usually seen when the condition is treated early, in children 7 years of age or younger.
Can lazy eye be cured in adults?
Studies funded by the National Eye Institute (NEI) found that lazy eye can be successfully treated even in adults. Vision therapy is a customizable, individualized treatment program performed under the supervision of an eye doctor
How do adults get rid of lazy eye?
Vision therapy is an effective treatment method for amblyopia in adults.
When is it too late to fix a lazy eye?
It’s never too late to get treated for a lazy eye. some optometrists say It is possible to treat amblyopia in adults via vision therapy
Can glasses fix a lazy eye?
Glasses are just a tool when treating your lazy eye. The main method is by patching the good eye.