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Acupuncture

One study shows that acupuncture treatment may be effective in treating anisometropia, a condition in which one eye focuses much better than the other. Acupuncture can reduce the differences in refractive powers between the eyes so that both eyes can have similar image quality. This helps reduce the amblyopia problem. However, its long-term effectiveness remains unknown.

Allopathic treatment

In order to treat lazy eye, the doctor has to identify and treat underlying causes. Depending on these underlying causes, the doctor may recommend surgical or nonsurgical treatments, as discussed below.

Refractive error correction

If both eyes need vision correction, children are given prescription glasses for better focus and to prevent misalignment of the eyes.

Forcing the use of the lazy eye

In many children with amblyopia, only one eye has a focusing problem or weak muscles. In order to force the affected eye to work, the doctor will cover the strong eye with a patch for most of the day for at least several weeks. Sometimes, this treatment requires as long as a year. The eye patch forces the lazy eye to work and thus, strengthens its vision and its muscles. This is the most common method used to treat lazy eye. To prevent the strong eye from becoming weaken due to disuse, the child is allowed to remove the patch so that he can see with the good eye for at least a few hours each day.

Another way to force the lazy eye to work harder is to use eye drops or ointment to blur the vision in the strong eye so that the child has to use the lazy eye to see. This method is not often used because it is associated with more adverse effects.

Surgical treatments

If the problem is caused by imbalances of the eye muscles and is not treatable with nonsurgical methods, the eye muscles can be realigned surgically to help the eyes coordinate better. Sometimes more than one surgery is required for the correction. Eye patch, glasses, or orthoptic exercises may be necessary following surgery to help the child use both eyes effectively. Long-term follow-up of surgical treatment indicates that it is highly effective in correcting the problem.

In patients whose amblyopia is caused by a congenital cataract in one eye, the cloudy lens is surgically removed and replaced by an intraocular lens. However, after surgery—even with eye glasses or contact lenses—this eye will still have poorer image quality than the good eye. Thus, the risk for amblyopia remains high. Therefore, nonsurgical treatment for lazy eye is often started after cataract surgery.

For a child whose vision is affected by a drooping eyelid, ptosis surgery is needed.

Expected results

With early diagnosis and treatment, children with amblyopia are expected to restore the sight in the lazy eye. However, if left untreated, the weak eye never develops adequate vision and the person may become functionally blind in that eye.

Prevention

Most cases of lazy eye are congenital, occurring since birth. However, if diagnosed early, vision loss in the affected eye can be prevented.

BOOKS

"Crossed Eyes." In Reader's Digest Guide to Medical Cures and Treatments. New York: Reader's Digest Association, 1996.

PERIODICALS

Broderick, Peter. "Pediatric Vision Screening for the Family Physician." American Family Physician 58, no. 3 (September 1, 1998): 691–700+. <http://www.aafp.org/afp/980901ap/broderic.html>.

Mills, Monte D. "The Eye in Childhood." American Family Physician 60, no. 3 (September 1, 1999): 907–18. <http://www.aafp.org/afp/990901ap/907.html>.

Paysse, Evelyn A., et al. "Detection of Red Reflex Asymmetry by Pediatric Residents Using the Bruckner Reflex Versus the MTI Photoscreener." Pediatrics 108 (October 2001): 997.

ORGANIZATIONS

American Academy of Ophthalmology. P.O. Box 7424, San Francisco, CA 94120-7424. (415) 561-8500. <http://www.eyenet.org>.

American Association For Pediatric Ophthalmology and Strabismus. c/o Denise De Losada Wilson. P.O. Box 193832, San Francisco, CA 94119-3832. (415) 561-8505. aapos@aao.org. <http://med-aapos.bu.edu>.

National Association for Parents of the Visually Impaired, Inc. P.O. Box 317, Watertown, MA 02471. (800) 562-6265. Fax: (617) 972-7444. <http://www.spedex.com/napvi>.