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Amblyopia: What Is Lazy Eye?

Amblyopia is when vision in one or both eyes does not develop properly during childhood. It is sometimes called lazy eye. Amblyopia is a common problem in babies and young children.

A child’s vision develops in the first few years of life . It is important to diagnose and treat amblyopia as early as possible. Otherwise, a child with amblyopia will not develop normal, healthy vision.

What Is the Cause of Lazy Eye?

Amblyopia can develop from other eye and vision problems. Here are some conditions that may cause amblyopia in a child.

Strabismus  is when the eyes point in two different directions. One eye may be focused straight ahead while the other turns in, out, up, or down. To avoid seeing double , the child's brain may ignore the image from the eye that is not focused straight ahead. But this can keep that eye from developing properly.

Refractive errors

Having a refractive error means being nearsighted , farsighted , or having astigmatism (distorted or blurry vision ). A child may have a refractive error that is worse in one eye. That eye can "turn off," and vision will not develop properly. This can be difficult to tell since the child's vision seems fine when using both eyes.

Cloudiness in the normally clear parts of the eye

Some children are born with a cataract , where the eye's normally clear  lens is cloudy. This can keep vision from developing properly in that eye.

Droopy eyelid

Ptosis, or a droopy eyelid , can block vision in a child’s developing eye and lead to amblyopia.

Your child might not be aware of having better vision in one eye than the other. And you may not realize it either unless your child has  strabismus or another eye problem you can see.

Amblyopia Diagnosis

Ophthalmologists diagnose amblyopia by checking to see if vision differs between the two eyes. To check a baby's or young child's vision, the ophthalmologist may cover one of the child's eyes and watch how well they can follow a moving object. The doctor may also watch how the child reacts when one eye is covered. If one eye has amblyopia and the other is covered, the child may try to look above or below the patch, pull it off or cry.

The ophthalmologist will do a complete medical eye exam , looking for other eye problems that could be affecting vision.

Poor vision in one eye does not always mean a child has amblyopia. In some cases, wearing  glasses to correct a refractive error in one eye can improve vision.

When Should a Child's Vision Be Tested?

All children should have their vision checked by their pediatrician, family physician, or ophthalmologist at or before entering pre-K or kindergarten. If there is a family history of misaligned eyes, childhood cataracts or serious eye disease, an ophthalmologist should check their eyes when they are an infant.

Most doctors test vision as part of a child's medical exam. If they see any sign of eye problems, they may send a child to an ophthalmologist for further tests.

Amblyopia Treatment

Amblyopia is usually corrected by making the child use their weaker eye . This is often done by putting a patch over the child’s stronger eye. In some cases,  eye drops can be used to blur vision in the stronger eye. Or the child may wear eyeglasses with a lens that blurs vision in that eye.

It generally takes several weeks to several months for vision to get stronger in the weaker eye. Once the child has better vision in that eye, they may need to wear an eye patch part-time for a few years. This helps keep their vision strong. Remember to keep all appointments with the child’s ophthalmologist who will carefully monitor your child’s vision.

How to Choose and Use an Eye Patch

An eye patch should be comfortable, yet remain firmly in place. It should also not allow the child to peek around its edges. Most drug stores have a variety of sizes and types of eye patches. Decorated fun patches are available online. Do not use the black eye patches with elastic bands or ties (such as a pirate-type patches). These are too easy for a child to remove or peek around. To wear the patch, simply attach it to the skin around your child’s eye.

If your child wears glasses, there are patches designed to attach to the lens. These may be good for children who are used to wearing a patch, but they are not as good for a child new to treatment. This is because the patch can slip or the child may learn to peek around it. If your child wears glasses and is not used to patching, it is best to attach the patch directly around the stronger eye underneath the glasses.

Keep Your Child from Taking Off the Eye Patch

Children do not like to have their stronger eye patched or blurred. However, you need to help your child do what is best for them. Otherwise, treatment will not work.

Try distracting the child or having them do something that keeps their attention. Or reward the child with a treat for wearing the patch.

It can take a while for your child to get used to wearing a patch. Over time, this should get easier for them and you. Remember that strengthening the weaker eye is the only way to develop healthy, normal vision.

If your child still takes off the patch, as a last resort, you might cover his or her hands with gloves, mittens, or socks.

Teach Your Child About the Eye Patch

Pre-school or school-age children might not want to wear an eye patch or use blurring eye drops. To help, parents should explain how important these treatments are to be able to see well. And reassure them that lots of children wear eye patches for the same reason.

Consider having a very young child practice putting an eye patch on a doll. Or let the child decorate his or her patch with crayons or markers.

Explain the amblyopia treatment to the child’s teacher. Ask the teacher to compliment the child on being so good about wearing the patch. Children thrive on positive feedback from their teachers.

Things to consider with patching treatment:

• In very rare instances it is possible to overuse the patch or blurring eye drops. This can affect vision in the stronger eye. Be sure to keep the child’s appointments with the ophthalmologist so that vision in both eyes can be closely monitored.
• The skin near your child’s eye patch can get irritated. To help, try a different size or type of patch, and angle the patch differently each day.
• Your child may initially be clumsy when wearing a patch. Try to keep an eye on your child when they are climbing stairs or being active.

Surgery to Correct Causes of Amblyopia

In some cases, the ophthalmologist will recommend surgery to correct certain eye problems causing amblyopia. After surgery, the child may need to keep wearing a patch or otherwise cover the stronger eye until their vision improves.

It is possible to prevent vision loss from amblyopia. For best results, amblyopia should be treated before a child reaches 7 or 8 years old. Many children do not like to have their stronger eye patched or blurred. However, you need to help your child do what is best for them.

Treating Amblyopia Using New Technology

A new treatment for amblyopia uses a virtual reality (VR) headset to help improve vision in children aged 4 to 7. A child watches videos wearing the headset, which helps them use their weaker eye. To learn more, ask your child’s ophthalmologist.

Treating Amblyopia for Better Lifelong Vision

When a child has amblyopia, it is important to make vision stronger in the weak eye. Even if eye problems causing amblyopia are corrected with glasses or surgery, the amblyopia itself must be treated. If not, the child may have lifelong vision problems.

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Amblyopia (Lazy Eye)

At a glance: Amblyopia

Poor vision in 1 eye

Eye drops or wearing an eye patch

What is amblyopia?

Amblyopia (also called lazy eye) i s a type of poor vision  that usually happens in just 1 eye but less commonly in both eyes. It develops when there’s a breakdown in how the brain and the eye work together, and the brain can’t recognize the sight from 1 eye. Over time, the brain relies more and more on the other, stronger eye — while vision in the weaker eye gets worse.

It’s called “lazy eye” because the stronger eye works better. But people with amblyopia are not lazy, and they can’t control the way their eyes work.

Amblyopia starts in childhood, and it’s the most common cause of vision loss in kids. Up to 3 out of 100 children have it. The good news is that early treatment works well and usually prevents long-term vision problems.

What are the symptoms of amblyopia?

Symptoms of amblyopia can be hard to notice. Kids with amblyopia may have poor depth perception — they have trouble telling how near or far something is. Parents may also notice signs that their child is struggling to see clearly, like:

• Shutting 1 eye
• Tilting their head

In many cases, parents don’t know their child has amblyopia until a doctor diagnoses it during an eye exam. That’s why it’s important for all kids to get a vision screening at least once between ages 3 and 5.

Is my child at risk for amblyopia?

Some kids are born with amblyopia and others develop it later in childhood. The chances of having amblyopia are higher in kids who:

• Were born early (premature)
• Were smaller than average at birth
• Have a family history of amblyopia, childhood cataracts, or other eye conditions
• Have developmental disabilities

What causes amblyopia?

In many cases, doctors don’t know the cause of amblyopia. But sometimes, a different vision problem can lead to amblyopia.

Normally, the brain uses nerve signals from both eyes to see. But if an eye condition makes vision in 1 eye worse, the brain may try to work around it. It starts to “turn off” signals from the weaker eye and rely only on the stronger eye.

Some eye conditions that can lead to amblyopia are:

• Refractive errors. These include common vision problems like nearsightedness (having trouble seeing far away), farsightedness (having trouble seeing things up close), and astigmatism (which can cause blurry vision). Normally, these problems are easy to fix with glasses or contacts. But if they’re not treated, the brain may start to rely more on the eye with stronger vision.
• Strabismus . Usually, the eyes move together as a pair. But in kids with strabismus, the eyes don’t line up. One eye might drift in, out, up, or down.
• Cataract. This causes cloudiness in the lens of the eye, making things look blurry. While most cataracts happen in older people, babies and children can also develop cataracts.

How will my child’s doctor check for amblyopia?

As part of a normal vision screening , your child’s doctor will look for signs of amblyopia. All kids ages 3 to 5 need to have their vision checked at least once.

What’s the treatment for amblyopia?

If there’s a vision problem causing amblyopia, the doctor may treat that first. For example, doctors may recommend glasses or contacts (for kids who are nearsighted or farsighted) or surgery (for kids with cataract).

The next step is to re-train the brain and force it to use the weaker eye. The more the brain uses it, the stronger it gets. Treatments include:

Wearing an eye patch on the stronger eye. By covering up this eye with a stick-on eye patch (similar to a Band-Aid), the brain has to use the weaker eye to see. Some kids only need to wear the patch for 2 hours a day, while others may need to wear it whenever they're awake.

Putting special eye drops in the stronger eye. A once-a-day drop of the drug atropine can temporarily blur near vision, which forces the brain to use the other eye. For some kids, this treatment works as well as an eye patch, and some parents find it easier to use (for example, because young children may try to pull off eye patches).

After your child starts treatment, their vision may start to get better within a few weeks. But it will probably take months to get the best results. After that, your child may still need to use these treatments from time to time to stop amblyopia from coming back.

It’s important to start treating children with amblyopia early — the sooner the better. Kids who grow up without treatment may have lifelong vision problems. Amblyopia treatment is usually less effective in adults than in children.

Last updated: September 22, 2022

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Lazy Eye: Causes and Treatment

• Vision Problems
• Daily Management

If you or your child has a lazy eye ( amblyopia ), one eye is sending unclear images to the brain. while both eyes can be affected, usually amblyopia affects just one eye, with the brain relying on the stronger eye for visual information.

A lazy eye, which some people are born with, is the primary source of vision loss in kids, but adults with vision trouble in one of their eyes also can develop lazy eye later in life.

This article will discuss the causes of lazy eye, vision problems it causes, diagnosis, treatment, and management.

Illustration by Mira Norian for Verywell Health

How Do You Get Lazy Eye?

Lazy eye can develop anytime an eye is not functioning properly and fails to send sharp images to the brain. It is most common in young children. The condition affects up to 3 out of 100 children. Typically this happens in the following instances:

• If one eye over the other is much more nearsighted (able to see near objects more clearly than distant objects) or farsighted (able to see distant objects more clearly than near objects), the brain will begin to ignore the eye sending the fuzzier signals.
• In cases of strabismus , a condition in which the eyes focus on different images, such as if one eye wanders to the side instead of looking straight ahead, the brain will have to choose which eye to rely on for information. It then begins to ignore the other.
• If the normally clear lens (the structure that focuses light on the retina) develops a cataract (a clouding of the lens), after a while, the brain will tune out signals from the eye and will potentially never see normally.

These eye conditions are more likely to occur in some people than others. Those at risk for developing a lazy eye include children who were premature at birth or had a low birth weight and those who come from families where someone else has amblyopia.

Treatment: Can You "Fix" a Lazy Eye?

Effectively treating a lazy eye means first understanding what's causing it while aiming to correct the vision in the weaker eye. Treatment is particularly effective in children under the age 7 whose vision is still developing. Some treatments to consider include:

• Wear glasses to sharpen vision, particularly in the weaker eye.
• Put a patch over the stronger eye several hours a day to allow the brain to begin to rely on the weaker eye.
• Temporarily blur vision in the stronger eye with atropine drops .
• Surgically correct things interfering with vision, such as a drooping eyelid or a cataract .
• Watch videos wearing a virtual reality headset to strengthen the weaker eye (in children ages 4 to 7).
• Perform eye exercises to strengthen the weak eye .
• Undergo muscle surgery to allow the eyes to work better together.

Eye doctors, such as ophthalmologists, encourage early treatment. Seek treatment even if the lazy eye is not discovered until later or there is some other obstacle. Don't consider it to be too late.

Research suggests that even adults can potentially improve their vision. Although it was once believed that the vision center of the adult brain could not hold on to any new experiences or information, research has shown that this is not true, and it is possible to improve vision somewhat.

Identifying Lazy Eye

It helps to know the symptoms of lazy eye to be able to identify it in your child or yourself. Symptoms can be subtle and include:

• A tendency to shut one eye
• Tilting the head to see better
• Squinting to see more clearly
• Eyes that appear to be working on their own rather than together
• Eyes that are inwardly or outwardly turned
• Trouble with depth perception
• Decreased vision in one eye

Because signs in children may be subtle and difficult to discern, it's important to take children between the ages of 3 and 5 for regular vision screenings.

The cause of lazy eye will determine whether and when surgery is needed. For instance, if an infant has a dense cataract, surgery will need to be performed right away. But if the child is older and the cataract is just a small dot, the eye doctor may try other measures first, like patching the eye that doesn't have the cataract.

For children with strabismus (depending on their age), the eye surgeon may want to perform eye muscle surgery as early as possible. Those under age 4 tend to have better outcomes than older children.

While strabismus surgery typically ranges from $5,000 to $10,000 out of pocket, much of the cost usually is covered by insurance.

Vision Problems With Lazy Eye

If children with lazy eye are treated early enough (before age 5), they tend to recover fully, with no lingering vision problems. But if treatment is delayed, the child may have problems with depth perception . Those over age 10 may only recover some vision with treatment and may have some permanent vision loss in the affected eye.

Keep in mind that the impairment in the eye can be mild, with vision in the 20/30 range, or severe, leaving the child legally blind in the eye with 20/200 vision.

Amblyopia Daily Management

In many cases, amblyopia is managed daily with treatments like using drops or patching the stronger eye for a period of time.

If patching is used, you'll initially be asked to cover the stronger eye for about two hours daily. The eye doctor will then monitor vision every six to 12 weeks. If there is not enough improvement, you or your child will be asked to wear the patch up to six hours daily.

Getting a child to keep a patch on can be challenging but is of utmost importance. Some strategies to try if a child resists include the following:

• Rewarding the child for using the patch with computer, device, or TV time
• Motivating them with stickers on a patching chart or diary for hours when the patch is worn

The use of atropine drops is an alternative to patching. Each day a drop is placed in the stronger eye to widen the pupil . It then forces the other eye to be used for close-up tasks like reading.

Also, each day you can encourage your child to perform eye exercises to strengthen the weaker eye, such as the following:

• Viewing dots
• Coloring within the lines
• Playing computer games
• Following an object like a lollipop stick
• Viewing stereograms (a two-dimensional image that can cause an optical illusion if viewed in a certain way)
• Eye relaxation

These can be fun exercises for your child and work to alleviate lazy eye.

Amblyopia (lazy eye) usually affects one eye. With this, the brain begins to rely on vision signals from the stronger eye and ignore those from the weaker, "lazy" one. Reasons why a lazy eye may develop include a cataract, which makes it difficult to see out of the eye; strabismus, in which the eyes are focusing on different points; and a difference in refractive error, in which one eye sees better than the other.

Treatment ranges from patching the stronger eye or blurring with drops, to surgery to remove any obstruction that may cause the vision to be unclear, such as a cataract or drooping lid.

National Eye Institute. Amblyopia (lazy eye) .

Stanford Medicine. Causes and risk factors for lazy eye .

National Health Service. Lazy eye .

American Academy of Ophthalmology. Amblyopia: what is lazy eye?

National Health Service. Orthoptic exercises young person .

American Academy of Ophthalmology. Amblyopia: types, diagnosis, treatment, and new perspectives .

Levi DM. Rethinking amblyopia 2020 . Vision Res . 2020;176:118-129. doi:10.1016/j.visres.2020.07.014

Mount Sinai. Amblyopia .

Boston Children's Hospital. Amblyopia .

Review of Optometry. Recommended strabismus surgery as early as possible.

NVision. The cost of strabismus surgery or correction.

Penn Medicine. Amblyopia (lazy eye).

American Academy of Ophthalmology. Amblyopia treatment modalities.

By Maxine Lipner Maxine Lipner is a long-time health and medical writer with over 30 years of experience covering ophthalmology, oncology, and general health and wellness.