What Causes a Lazy Eye?
Amblyopia, or lazy eye, is when someone has poor or decreased vision in one eye. Approximately 2 to 4 percent of the U.S. population has this condition.
Amblyopia occurs when the brain fails to coordinate nerve signals from the affected eye. This causes it to rely on the stronger eye and stop using the weaker one.
A lazy eye can develop until late childhood. Common risk factors include:
- Premature birth
- A family history of other eye conditions
- Developmental disabilities
- Strabismus or crossed eyes
- Refractive amblyopia
Lazy Eye Symptoms
Symptoms of amblyopia include:
- Shutting one eye
- Persistent head turning or tilting
- Impaired depth perception
- Poor peripheral vision
- Eye shaking
- Eyes that don’t move in the same direction when focusing
Do You Need to Correct a Lazy Eye?
Lazy eye should be corrected as soon as possible, specifically during visual development between birth and 7 years of age. If the condition isn’t treated, it can lead to permanent vision loss or decreased depth perception.
Treatment is more effective in children, so doctors advise parents to bring their kids in for routine checkups every year. Early detection is key as the condition is more challenging to treat after age 6.
Available treatment options for lazy eye include:
- Corrective eyewear. Prescription eyeglasses correct problems such as nearsightedness, farsightedness, and astigmatism that can cause a lazy eye.
- Eye patch. This can be placed over the eye with better vision to stimulate the weaker eye. It also improves alignment and binocular vision.
- Bangerter filter. A special filter that is placed on the eyeglass lens of the stronger eye.
- Eyedrops. A medication called atropine, or Isopto Atropine, can temporarily blur vision in the stronger eye.
- Eye muscle surgery. This procedure can correct underlying conditions that cause lazy eyes and prevent permanent vision loss.
How is Lazy Eye Diagnosed?
An eye exam is the only way to determine if someone has amblyopia. Parents should bring their children to the doctor for their first vision screening once they are between 3 and 5 years old.
Vision typically improves in just a few weeks after treatment. However, it can take months for vision to correct completely. Doctors will also recommend additional treatments to prevent the lazy eye from returning.
How Does a Lazy Eye Affect Vision?
Amblyopia affects the visual function of the affected eye in several ways. It can:
- Cause blurry vision
- Reduce eye movements
- Affect depth perception
- Impair reading abilities
Doctors often recommend cataract surgery if your child is born with cataracts. This is a condition that causes cloudy vision in one or both eyes.
What to Expect For Lazy Eye Surgery?
The surgical treatments available to people with amblyopia don’t directly address the condition. Instead, they fix possible underlying causes like:
- Droopy eyelids
- Corneal scars
Strabismus surgery is one of the most common procedures for amblyopia. It repairs the muscles responsible for keeping the eyes aligned. It also weakens or strengthens them to change the position of the lazy eye.
Doctors generally don’t recommend surgical procedures for adults. If they do, it’s usually for cosmetic reasons and to improve depth perception. Lazy eye surgery is generally more common and effective in children.
How to Prepare for Surgery
If you need surgery to treat amblyopia, your ophthalmologist will plan a procedure based on the following:
- Eye examinations
- Eye muscle testing
- Computerized tomography (CT) scan
You might need to undergo specific tests to evaluate conditions like congenital cataracts. You’ll also need to discuss specifics with your healthcare provider, such as if the surgery uses a laser.
You may be prohibited from eating certain foods and drinks that could affect the type of anesthesia used. They may also tell you to stop taking certain medications, such as blood thinners and anti-inflammatory medications.
Lastly, you’ll need to avoid wearing makeup or eye makeup.
Before getting lazy eye surgery, a person should consult their primary care doctor and the doctor who will perform the surgery. They can provide critical care information about pre- and post-surgery healing.
Before surgery, you will also undergo preoperative testing that includes:
- Blood tests
- Urine tests
- Chest X-rays
These tests are necessary for the anesthesiologist to refer to during the surgery. You’ll need to share information about any allergies, current medications, and family health history with the doctor.
A child’s parent or guardian will need to sign a consent form. They will also have to stay in the waiting area during the procedure.
What Should You Know Before Going Into Surgery?
Children cannot take aspirin or ibuprofen 2 weeks before the surgery. They should also avoid vaccinations of any kind a day before the procedure.
Infants and children under 13 can eat solid foods up to 8 hours before the surgery. Breast milk and clear liquids are allowed until 4 hours and 2 hours, respectively, before surgery.
Adolescents and adults can’t have anything to eat or drink at least 8 hours before the procedure. They should also stop taking any medications 2 hours before.
Doctors also cannot perform surgery on you if you’re experiencing:
- Upper respiratory congestion
- Sore throat
The surgery takes approximately 45 minutes to 2 hours under general anesthesia. The duration depends on the type of surgery and whether one or both eyes need correction.
During the procedure, an eyelid speculum holds the eye open. This allows the surgeon to make a small incision on the membrane covering the whites of the eye. They will either detach or reattach the muscles to the eye through this opening.
The surgeon will then close the incision with stitches that dissolve on their own. Adults might need adjustable sutures, which shorten or lengthen the muscle for further alignment within 24 hours after surgery.
Recovering from anesthesia can take several hours. If the surgeon needs to make any adjustments post-op, they will apply numbing eye drops.
After the adjustment, the doctor will prescribe antibiotics and steroid drops to prevent infection and treat inflammation. They might also prescribe drops to dilate the pupil.
It takes the eye 6 weeks to fully heal. Postoperative checkups are required a day after the procedure. The second checkup is due 5 days after surgery, and the third is after 4 to 6 weeks.
How Long Does It Take to Recover From Surgery?
Children and adults can return to normal daily activities a few days after surgery.
However, for at least 2 weeks, children and/or adults should avoid:
- Contact sports
- Swimming in pools or lakes
- Eye makeup
- Playing in sandboxes
- Operating heavy equipment
The doctor can assess the procedure’s success once the eye heals completely.
Side Effects and Risks of Lazy Eye Surgery
After surgery, the eye can feel sore and appear red. Other common side effects include:
- Light sensitivity
- Mild pain
- Matting of lashes
- Double vision
These symptoms can last from 2 days to a few weeks, depending on the person’s recovery speed.
Severe Side Effects of Lazy Eye Surgery
More severe side effects that can be a cause for concern include:
- Green or yellow discharge
- Vision loss
- Worsening pain
- Increased swelling
- High fever
- Nausea and/or vomiting
- Scar tissue growth
Other serious but less common complications of lazy eye surgery include bleeding, muscle detachment, and scarring. Call your doctor immediately if you notice these symptoms within the first week after surgery. This is a common time for infections and problems to occur.
Risks of Lazy Eye Surgery
Adjusting the eye muscles can make correcting a lazy eye easier. However, there are risks associated with surgery for amblyopia, including:
- Needing glasses indefinitely to see properly
- Double vision
- Partial or complete failure of the procedure
There may also be a recurrence of strabismus. When this happens, you’ll need multiple surgeries to address the issue.
Is Lazy Eye Surgery Worth It?
Surgery doesn’t directly address the cause of amblyopia, but it can be part of the solution for this complex condition. Benefits of this procedure include:
- Improved physical appearance
- Reduced eye strain and/or fatigue
- Better functionality between the eyes and other facial structures
- Fewer difficulties during lazy eye therapy
- Enhanced depth perception
Talk with your doctor about whether or not lazy eye surgery is right for you. Examining the benefits and potential risks before opting for an invasive procedure is essential.
- Lazy eye, also called amblyopia, is caused by poor nerve coordination between the brain and the eyes.
- Amblyopia can develop early on in children until late childhood, and treatment is more effective in children than adults.
- Doctors will likely recommend surgical treatment if a child is born with cataracts or develops strabismus.
- Doctors typically recommend non-surgical treatments like corrective lenses, eye patches, or atropine eye drops before lazy eye surgery.
- Surgical treatment for amblyopia doesn’t address the disconnect between the brain and the eye, but it can supplement other lazy eye treatments.
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