Amblyopia, more commonly known as lazy eye, commonly affects children as they are in the development and growing phase. The condition refers to reduced vision in one eye caused by abnormal visual development early in life. The weaker – or “lazy” – eye often wanders inward or outward.
The cumulative incidence worldwide is estimated at 2-4% of children up to age 15. Fortunately, with early detection and proper treatment, this condition can be reversed.
According to Dr Fiona Chew of Sunway Medical Centre Velocity, amblyopia can develop from birth, or the moment the child starts to use his or her eyes. It occurs when there is obstruction to vision and abnormal development of the eye-brain pathway.
Children usually do not complain about the issue as they do not know what normal vision is, making early diagnosis difficult. Indicators of amblyopia include:
- squinting, especially to view distant objects;
- abnormal eye movements;
- abnormal head posture;
- frequent falls or bumps into objects;
- problems with three-dimensional vision such as navigating stairs or solving puzzles;
delayed milestones; - problems with homework or even recreational activities.
The condition can also be hereditary.
Diagnosis and treatment
According to Chew, these days, children are being diagnosed with amblyopia earlier due to increased eye-screening programmes in kindergartens and schools, as well as greater awareness of the importance of eye health.
“Amblyopia can be confirmed after a full examination by an eye specialist, which includes assessments for visual acuity, refraction, orthoptics, or squinting, as well as a dilated eye examination to look for possible causes,” she explained.
Treatment varies depending on the cause. Children with refractive errors or squinting issues may be prescribed glasses; otherwise, the child might need to undergo dichoptic therapy, which involves blurring or restricting the vision in the good eye to force the brain to use the lazy eye.
Eye patches, eyedrops or special lenses come into play here. Dichoptic therapy also involves certain exercises or digital games to enhance eye-brain development.
Chew stresses that amblyopia is reversible with early treatment, and encourages parents to bring their kids for yearly eye examinations. “The younger the child, the more adaptable the brain is to change. Treated early, the eye-brain connections will recover more quickly.
“Children should get their eyes checked at six months, three years, six years, and every two years thereafter,” she advised.
Left untreated, amblyopia will only get worse and may become irreversible.
“Once a child has amblyopia, the eye alignment will not be good and he or she may develop a squint,” said Chew, adding that sometimes the vision gets so bad, the child becomes legally blind.