Amblyopia Strabismus

About Amblyopia/Strabismus

At Vantage Point Eyes, we do not use treatments that involve using a "pirate patch" or “blackout patch,” but rather the newest treatment approaches for amblyopia and strabismus and often achieve excellent vision in both eyes by doing vision therapy.

Amblyopia
Amblyopia is commonly known as a “lazy eye” and is described as reduced vision in one eye compared to the other. Less commonly there are forms of amblyopia that involve both eyes. According to the National Institute of Health, amblyopia is the most common cause of visual impairment among children.

A “lazy eye” is not lazy at all. Recent research has shown that amblyopia is a disorder of the brain’s ability to use both eyes together as a team. Amblyopia is an active process due to suppression, or the brain actively ignoring the information coming from one eye. In addition to poor visual acuity, people with amblyopia are more prone to have difficulties with depth perception, eye movements related to reading, and visual decision-making while driving.

Amblyopia develops in childhood due to:

Significant differences in the refractive (prescription) status between the two eyes due to farsightedness, nearsightedness or astigmatism;
Constantly misaligned eyes or crossed eyes (strabismus);
An obstruction of vision in early childhood i.e. cataract, ptosis (droopy eyelid)

It is important to note that a child with amblyopia rarely has any symptoms. Comprehensive eye examinations are the best way to identify children who are at risk for or already have amblyopia.

Treatment of Amblyopia

Amblyopia is treatable at any age, although the earlier the problem is found and treated, the more successful the outcomes tend to be. Until recently, patching the better-seeing eye was the only proven method of treating amblyopia. Recent research has shown that a binocular approach to treating amblyopia may be an effective alternative to patching. Treatment that relies less on patching may avoid unnecessary emotional stress on a child or their family.

Treatment may include:

Eyeglasses or contact lenses (proper lenses can help reduce stress so that the under-used eye can start to work more efficiently);
Patching or penalization of the better-seeing eye;
Binocular vision activities;
A program of vision therapy to help improve the visual abilities of the eye with amblyopia including accommodation (focusing), fixation, saccades, pursuits (eye tracking) and spatial skills (eye-hand coordination). A program of vision therapy may reduce the frequency of patching since the goal of amblyopia therapy is to improve eye coordination, improve stereopsis (depth perception) and reduce suppression.

Strabismus:
Strabismus, or crossed eyes, is the inability to point both eyes in the same direction at the same time. One eye may appear to turn in (esotropia), out (exotropia), up (hypertropia), or down (hypotropia). The eye turn may occur constantly or only intermittently. Eye-turning may change from one eye to the other, and may only appear when a person is tired or has done a lot of reading. Strabismus may cause double vision. To avoid seeing double, vision in one eye may be ignored resulting in a lazy eye (amblyopia).

Crossed eyes most often develop in infants and young children, although it can occur in adults. This may also be caused by:

Inadequate development of eye coordination in childhood
Excessive farsightedness (hyperopia) or differences between the vision in each eye
Problems with the eye muscles that control eye movement
Head trauma, stroke, or other general health problems

Treatment
In most cases, the problem does not improve as the child grows. Treatment varies depending on the cause of the eye-turning, and may include: