Preschoolers and Lazy Eye (Amblyopia)

Amblyopia, or lazy eye, is a particularly common disorder in preschoolers. Your preschooler may not be aware that how they see may not be the way they should see, and so they may never complain. Parents should be alert for the symptoms and signs of lazy eye because, in its most insidious form, it may be undetectable without an eye exam. Left untreated, lazy eye can cause a lifetime of visual problems.

Exploring Amblyopia

The public normally uses the term lazy eye interchangeably to describe any sort of eye turn or reduced vision, whatever the cause. Technically, this usage is incorrect.

This article discusses amblyopia, a medical term for lazy eye. It refers to reduced vision that has a specific neurological cause.

Why Amblyopia Occurs?

Amblyopia occurs when the vision cells in the brain do not properly develop. This is caused by a lack of “normal” visual input to the brain during the “critical years” of vision development, from birth to about 5 years of age.

Causes and Symptoms

What causes this lack of “normal” visual input? One of the following is present in those with amblyopia:

1. A constant eye turn (strabismus) in one eye

One eye that constantly turns (in, out, up or down), is an obvious symptom of amblyopia that needs immediate attention.

2. An extremely high prescription in both eyes

This will probably manifest in symptoms of blur. Your preschooler may rub their eyes, complain of difficulty seeing, tilt the head to see better, squint frequently, complain of headaches when reading, or move closer to see things.

3. Unequal prescriptions between the two eyes

This is the most dangerous cause of amblyopia because it is not obvious. In many cases, there are seemingly no symptoms because your preschooler will rely on the better seeing eye and vision can appear “perfect” to many parents and teachers. Preschoolers with unequal prescriptions may close one eye frequently. Covering each of your child’s eyes and asking if they notice a difference in vision may be helpful, but this is not a substitute for an eye exam or screening.

A Lifetime of Amblyopia

Amblyopia is the most common cause of vision impairment in childhood.

Left untreated, amblyopia can have lasting effects into adolescence and adulthood, affecting function in school, the workplace and life in general. One of these lasting effects include reduced depth perception which can affect activities like sports, driving and certain occupations. Also,there is an increased risk for blindness because if the better functioning eye is lost, there is no backup.

Tips

1. Your preschooler needs an evaluation, by an optometrist, pediatric ophthalmologist, or pediatrician, usually by 6 months, even if all seems fine.
   
2. Pay close attention to your preschooler’s visual behavior and eye appearance.
   
3. Amblyopia treatment may include glasses, patching, eye drops, vision therapy, eye surgery, or a combination of these things along with close management with an eye care professional. The goal of treatment is to reverse vision loss as much as possible.

By: Pia Chaparro

References:

1. National Institutes of Health. “Amblyopia: Fact Sheet” Available on http://www.nih.gov/about/researchresultsforthepublic/Amblyopia.pdf

2. Centers for Disease Control, “Improving the Nation’s Vision Health: A Coordinated Public Health Approach” Retrieved 11 November 2007.

3. Daw, Nigel W. “Critical Periods and Amblyopia” Archives of Ophthalmology 1998 April. Retrieved 14 November 2007.

4. National Eye Institute. “Amblyopia: Resource Guide” Available on www.nei.nih.gov/health/amblyopia