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your child has a lazy eye what now

As the parent of an infant, you’re used to noticing the unfocused gaze, which often includes a “lazy eye” as both eyes learn to focus on the world around them and connect with the optic nerve. For some babies and children, however, the weaker eye lets the stronger eye do the bulk of the focusing work. Over time, the weaker eye barely works at all, so it rolls inward or outward “lazily” attempting to focus. 

As a result, the weaker eye loses its ability to focus and contributes to overall vision loss for the child. This is why it’s so important to schedule an appointment with your pediatrician and get a referral to an optometrist if you notice any signs your child is struggling to see clearly. 

Schedule An Optometry Appointment At Age 3 & Before Kindergarten 

Regardless of whether your child has symptoms of a lazy eye or not, the American Academy of Pediatrics (AAP), as well as the American Optometric Association (AOA), recommend that you schedule an appointment with an optometrist when s/he is six months old, again at three years old and definitely before kindergarten. At that point, everyone should have vision checks every year – and more often if your optometrist recommends it due to your diagnosis. 

It’s easy to miss small signs a child can’t see well. However, the tools we have in the optometrist office (symbols, images, and shapes rather than letters) allow us to watch how the muscles of the eye are working (or not) as the child tries to focus on the images presented. In this process, we can see issues that may not show up via general home and life observation. 

A Lazy Eye Needs Energetic Attention From Parents Or Guardians 

Lazy eyes typically reveal themselves within the first few weeks to the first seven years of a child’s life. While that eye may be lazy, parents or guardians should act swiftly and energetically. The sooner it is diagnosed, the better chance your child has of getting the correct optical therapy, treatment, and/or vision prescription to prevent further vision loss or atrophy (wasting away or shrinking) of key eye muscles and functions. 

Unfortunately, it is difficult (and can become impossible) to successfully treat lazy eyes once patients reach the age of 17 years or older. 

We can’t emphasize enough how important it is to have your child’s eyes examined whenever you see signs indicating s/he is struggling to see. Eye issues, like all health issues, are almost always easier to treat sooner rather than later – preferably before age 17. 

According to the Optometrists Network: 

A supported research study conducted by the National Institute of Health/National Eye Institute (NIH/NEI) has disproved the long-held belief that children with lazy eyes, or amblyopia, cannot be helped after a known cut-off age. In the past, the cut-off age for treating lazy eyes was said to be anywhere from seven to nine years. 

This research was conducted at 49 eye centers across the U.S., including the Bascom Palmer Eye Institute, Mayo Clinic, The Emory Eye Center, The Ohio State University, Southern California College of Optometry, and the State University of New York, College of Optometry. 

The study included 507 children between the ages of 7-17 and found that it is possible to improve eyesight even in children up to age 17. 

Signs of a lazy eye 

The most common signs of a lazy eye include: 

  • Squinting. You’re witnessing their automatic response to diminished vision. Regular squinting isn’t normal in normal childhood vision development. This is always a sign that a baby, toddler, and child are struggling to see clearly. 
  • Winking (one eye shut). This look can be awfully endearing but, like squinting, it means that your child is struggling to focus.  
  • Poor depth perception. Once they start reaching, crawling, stepping – babies and toddlers with amblyopia may have difficulty judging accurate depth perception. 
  • Tilting their head to see things. Like winking, this can also get lots of positive remarks from parents and loved ones because it’s adorable. Unfortunately, it’s another way their body is working to bring things into clear vision. 
  • The eye rolling inward or outward. This is the ultimate sign of a lazy eye and can take time to develop as the weaker eye continues to get weaker. 
  • Abnormal results from basic vision tests. Children with vision loss will have a harder time distinguishing shapes or symbols. Even if they’re too young to vocalize those things yet, we can tell whether their eyes are focusing properly or not through our phoropter and autorefractor divides. 

Risk factors for having a lazy eye 

While there is no way to predict, there are certain risk factors that elevate a person’s chances of having a lazy eye: 

  • Family (genetic) history of amblyopia, cataracts, or other vision loss issues 
  • Premature birth 
  • Small birth weight 
  • Developmental disabilities 

How To Treat Lazy Eyes (Amblyopia) 

If your child has amblyopia, there are a variety of corrective and/or treatment options available, depending on the severity of the lazy eye. While we say “weak eye” there is also a growing lack of connection between that eye and the brain that is essential to correct before the brain shuts that connection off altogether. Treatments always work to support both the eye and the eye-brain connection. 

We treat a lazy eye by: 

Putting a patch on the stronger eye. If we catch it early enough, and the weak eye is still strong enough to repair itself, we may use a patch. Your pirate-esque little one may not like it at first, but once s/he adjusts to it the patch will force the weaker eye to work harder – which builds strength in the muscles and nerves. 

Blurring drops for the strong eye. In a reverse version of that, we may use special drops to blur vision in the strong eye. This is used for babies and toddlers who are less likely to keep that patch on. It’s another way to get the weak eye to strengthen and to form a stronger connection to the optic nerve and brain. 

Corrective lenses. Your child may need glasses. We’ll still use corrective therapies to strengthen their eye, but there may be other vision corrections that need to be addressed. 

Exercises (eyeball physical therapy!). There are eye exercises we’ll give you to work on with your little one once or multiple times a day to keep that lazy eye from giving up and rolling over. It’s like physical therapy for the eyeball and vision process. 

In extreme cases, your child may need surgery to realign the eye(s) so it has a better chance of getting back on track with the previously mentioned treatments. Typically, amblyopia only affects one eye. However, if both eyes are affected, simple outpatient surgery may be a first step – after which the treatments are exponentially more effective. 

Have questions about your child’s eyes or vision? Schedule a consultation with us here at the Atlantic Eye Institute. 

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