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What Is a Lazy Eye and How Can You Fix It?

What Is a Lazy Eye and How Can You Fix It?
Key Takeaways
  • Amblyopia, or lazy eye, is a common vision disorder in children that occurs due to improper eye-brain communication, leading to blurry vision in the weaker eye, which can drift or misalign over time. Lazy eye typically occurs in one eye, though both eyes can be affected. 

  • Early diagnosis and treatment of lazy eye are crucial, especially before age 7, as it can prevent lifelong vision issues. Treatment methods include corrective lenses, eye patching, and sometimes surgery.

  • Although lazy eye typically develops in childhood, adults can also experience it, often due to untreated vision problems or eye injury during childhood. It's important to address symptoms early to prevent worsening vision problems.

A lazy eye (medical term: amblyopia) is reduced vision or blurry vision in one eye. This eye condition typically affects children younger than 7 years of age. It occurs due to problems with vision development early in life when connections between the eye and brain are still forming. Normal vision requires good communication between the brain and the eyes. If you have amblyopia, one eye is stronger than the other. Over time, the brain ignores the weaker eye (lazy eye), causing it to drift out of position (inward or outward), resulting in poor vision in the affected eye. Rarely, amblyopia can affect both eyes.

Experts estimate that 2-4% of the U.S. population has amblyopia (commonly called lazy eye). 

Amblyopia vs Strabismus

Amblyopia (lazy eye) and strabismus (crossed eyes or squint) are both eye conditions that can affect a child’s vision. However, they are not the same. 

Amblyopia is a problem with visual acuity or eyesight (where one eye has better vision than the other). Strabismus is a problem with alignment of the eyes (where both eyes do not look in the same direction at the same time).

Untreated strabismus can lead to amblyopia. Although both can cause similar symptoms, strabismus is easier to spot. 

 

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Symptoms of Lazy Eye  

Common Signs and Indicators

It’s not easy to tell that a child has a lazy eye. In fact, most children are diagnosed with amblyopia (lazy eye) when they have their first eye exam. Signs and symptoms of lazy eye include:

  • Inward or outward drifting of one eye.

  • Eyes that don’t seem to work together.  

  • Poor depth perception.

  • Squinting frequently or shutting one eye.

  • Frequent head tilting to one side.

  • Clumsiness or bumping into objects (especially on one side).

  • Favoring one side of the body.

  • Crossed eyes.

  • Droopy eyelid.

Identifying the Severity of Lazy Eye Symptoms 

Assuming normal vision (6/6) in the stronger eye, eye doctors classify amblyopia as follows:

SeverityVisual acuity in the affected eye (amblyopic or weaker eye)
Mild amblyopia6/9 to 6/12
Moderate amblyopia6/12 to 6/36
Severe amblyopiaWorse than 6/36

Who Is At Risk Of A Lazy Eye?

Children are at a higher risk of developing amblyopia if they:

  • Are born prematurely (before 37 weeks of pregnancy).

  • Are smaller than average size at birth, or less than 2.5 kilograms (kg) or 5 pounds 8 ounces.

  • Have developmental delays.

  • Have a family history of lazy eyes, childhood cataracts, or other eye conditions.

Causes: How Does A Lazy Eye Happen?

A lazy eye happens because of abnormal visual development in early life. In children with amblyopia, the nerve pathways between the retina (the thin layer of light-sensitive cells at the back of the eye) and the brain do not form properly in one eye. As a result, this eye becomes the weaker eye (lazy eye). Over time, the brain ignores signals from the weaker eye, and the eyes lose the ability to work together. This interferes with binocular vision (the ability of both eyes to integrate visual signals and view an object as a single image). 

Strabismus Amblyopia

Strabismic amblyopia is the most common cause of lazy eye. It develops in children with strabismus (crossed eyes or misaligned eyes) due to an imbalance in the muscles that control eye position, preventing the eyes from working together. Over time, the brain starts relying on the stronger eye and ignoring the blurry eye.

Refractive Amblyopia

Refractive amblyopia develops when there is a significant difference in sharpness of vision between the two eyes. This occurs due to refractive errors, which are changes in the shape of the eye that blur vision. Over time, the brain becomes dependent on the better eye. Examples of refractive errors include: 

  • Hyperopia (farsightedness or trouble seeing close-up objects)

  • Myopia (nearsightedness or trouble seeing far away objects)

  • Astigmatism (close objects appear blurry)

Note: Some children develop amblyopia (lazy eye) due to a combination of strabismus and refractive errors.

Deprivation Amblyopia

Deprivation amblyopia affects children with eye diseases that prevent light from reaching the retina. For example:

  • Childhood cataract (cloudy lens) 

  • Ptosis (droopy eyelid that blocks vision on one side)

  • Corneal scar or abrasion

  • Nystagmus (eye movement disorders)

This is a severe type of amblyopia that requires urgent treatment in the first 6 months of life to prevent permanent vision loss. Check out these 5 tips for healthy eyes.

Diagnosing Amblyopia (Lazy Eye)  

Eye Exams and Tests  

Most children with amblyopia are diagnosed by a healthcare provider before the parents notice any changes in the child’s eye or vision. This is because amblyopia (lazy eye) affects very young children who cannot communicate that they have poor vision.

Your child’s pediatrician will screen for general eye problems, including a wandering eye (strabismus), blurry vision (refractive errors), and lazy eye (amblyopia). They may do a vision test using eye drops to dilate the eyes and get a better look. 

In non-verbal children under 3 years of age, the doctor may check the child’s ability to fix gaze and follow a moving object. They can also use a magnifying device to look for cataracts. 

In older children above 3 years of age, the doctor may use pictures to check if something is affecting vision. They will cover each eye in turn and test the other one.

Importance of Early Detection 

Lazy eye (amblyopia) is the leading cause of decreased vision in children. Early diagnosis of lazy eyes is important to prevent lifelong vision problems. The best results with amblyopia treatment are obtained in children younger than 7 years of age because the connections between the eye and brain are still forming. Timely diagnosis and treatment of amblyopia can, therefore, ensure the child develops normal, healthy vision in both eyes. 

Your child’s doctor (pediatrician) will perform routine vision screening to ensure eye problems are caught early. The National Eye Institute recommends a complete eye exam for all children between ages 3 and 5 years.

Amblyopia Treatment Options: How To Fix Lazy Eye?  

It’s important to treat amblyopia in childhood to prevent permanent vision problems. As noted, the best results from amblyopia treatment are obtained in children under 7 years of age, but children up to 17 years of age and adults can also benefit.

Depending on the cause, the eye specialist may recommend the following treatment options for lazy eye:

  • Corrective eyeglasses or contact lenses are a treatment option for amblyopia due to refractive errors such as farsightedness, nearsightedness, or astigmatism.

  • Eye patching of the better eye for 2-6 hours a day forces the brain to use the weaker eye. Wearing an eye patch for longer can cause reverse amblyopia in the patched eye. 

  • Bangerter filters are plastic filters that fit the back of the eyeglass lens of the stronger eye. Bangerter filters are useful for children who can’t tolerate eyepatches as they provide similar results as eye patching. 

  • Atropine eye drops (Isopto Atropine) in the stronger eye temporarily blur vision. This once-a-day drop may be prescribed for daily use or weekend use to encourage the child to use the amblyopic eye. However, unlike an eye patch, atropine eye drops can cause side effects like light sensitivity and eye irritation.

  • Amblyopia (lazy eye) surgery. This may include:

    • Cataract surgery to replace a cloudy lens with an artificial lens.

    • Surgery to correct a droopy eyelid if it is causing deprivation amblyopia. 

    • Refractive surgery to correct anisometropia (significant difference in refractive power between the two eyes). In this case, refractive amblyopia may not respond to standard treatments (eyeglass or contact lens use).

    • Eye muscle surgery for treating strabismus.

Activities, like puzzles, art, and video games have been developed to encourage children with amblyopia to use the blurry eye. However, the effectiveness of adding these activities to standard amblyopia treatments has not been proven.

How Long Does Amblyopia Treatment Last?

In most cases, the child’s vision improves within a few weeks to months of starting amblyopia treatment. Most children receive treatment for 6 months to 2 years. However, in about 1 in 4 children with amblyopia, the lazy eye recurs, and treatment needs to be started again.

FAQ: Common Myths and Concerns  

Can You Get A Lazy Eye As An Adult?

Yes, you can get lazy eye as an adult. Amblyopia in adults can be due to: 

  • Untreated childhood amblyopia or strabismus.

  • Conditions that affect clear vision in one eye, such as:

Can Screen Time Cause Lazy Eye? 

Yes, screen time can potentially cause lazy eye in young children. Studies in clinical ophthalmology have found that early exposure to screens puts children at a high risk of astigmatism (blurry close-up vision), especially children under 1 year of age. The risk of astigmatism increases with total daily screen time and total years of screen exposure. Astigmatism and other refractive errors (nearsighted, farsighted) can lead to amblyopia, especially at a young age when the child’s brain and eye connections are still developing.

Learn about computer vision syndrome, along with the symptoms and treatments available.

What Vitamin Deficiency Causes Lazy Eye?

Vitamin A and vitamin B12 deficiencies may cause lazy eye. There are case reports of nutritional amblyopia and night blindness due to vitamin A and vitamin B12 deficiency. Other vitamins, minerals, and nutrients that are important for eye health include vitamin C, vitamin E, omega 3s, zinc, zeaxanthin, and lutein.

Is A Lazy Eye A Disability?

Lazy eye may be considered a disability if treatments have not improved vision and a vision check reveals poor vision (blurry vision, double vision, poor contrast sensitivity, or poor depth perception) that prevents you from doing your job.

What Causes Blurry Vision In One Eye?

Possible causes of blurry vision in one eye include:

  • Refractive errors (nearsightedness, farsightedness, astigmatism)

  • Eye infections

  • Eye injuries

  • Corneal abrasion

  • Amblyopia (lazy eye)

  • Stroke or transient ischemic attack (TIA)

An eye doctor (an optometrist or ophthalmologist) can make a proper diagnosis and offer appropriate treatment. Seek emergency medical care if you develop sudden vision loss in one or both eyes.

How Do I Test If I Have A Lazy Eye?

Only a healthcare professional (optometrist or ophthalmologist) can diagnose a lazy eye. However, you can suspect lazy eye if:

  • You often shut one eye or squint to focus on things.

  • Your eyes point in different directions (squint or strabismus).

  • You tend to tilt your head to one side when looking at something. 

  • You have difficulty following a moving object.

  • You struggle with catching and throwing things.

  • You are clumsy or are always bumping into things.

  • You experience tired eyes or headaches.

Does Lazy Eye Affect a Child’s Vision?

Yes, lazy eye can affect a child’s vision and cause lifelong vision problems if left untreated or inadequately treated.