About Lazy Eye:
Lazy eye is an eye condition where one eye is weaker than the other. It occurs in children and usually affects only one eye. This “lazy” eye looks normal, but has poorer vision.
Causes & Risk Factors:
Children with lazy eye have a weaker connection between the affected eye and the brain. This causes one eye to see a lower-quality image than the other. Over time, the brain starts to ignore the blurrier image, so the lazy eye becomes even weaker.
Some reasons for Lazy Eye include:
- Squint (eyes are crossed or point in different directions)
- Difference in refractive power (spectacles) between the eyes (one eye may focus better than the other)
- Severe eyelid drooping
- Cataract
Lazy eye is closely linked to eye development. So, the younger the child, the greater the risk. Children under the age of 8 are at the greatest risk for developing lazy eye.
Other risk factors include:
- Premature birth
- Small eye size at birth
- Family history of lazy eye
- Family history of Refractive Errors
- Developmental disabilities
The symptoms of the lazy eye are:
- One eye deviates inward or outward
- Both eyes do not work together
- Closing one eye to focus
- Abnormal eye movements
- Abnormal head posture
In some cases, symptoms are hard to notice. All children should get a complete eye exam between the ages of 2-5. Early treatment is the only way to stop the lazy eye from progressing.
Does my child have lazy eye?
Lazy eye can be hard to notice. Visit your child’s eye doctor if their eyes wander or point in different directions. Regular vision checkups are also important if:
- Family history of spectacle wear
- You have a family history of lazy eye
- Your child has had cataract, eyelid drooping, squint or other eye conditions.
- Your child is a premature baby
One way to check for lazy eye is by covering each eye, one at a time. Your child will become reluctant when you cover their good eye, but not the lazy eye. If so, this could be a sign that one eye is weaker than the other.
Lazy eye can be reversed if it is detected and treated early. However, the longer it goes untreated, the weaker the lazy eye gets. Eventually, vision loss in the weaker eye cannot be reversed.
The best treatment is to make your child use their lazy eye. Patch therapy is a treatment where one eye is covered to encourage the use of the weaker eye. It is most effective in helping young children strengthen an under-developed eye. The earlier the treatment begins, the stronger the weaker eye becomes. This is commonly used to treat lazy eye and squint.
In both cases, one eye is weaker than the other. The patch covers the good eye, forcing the child to use the weaker eye. In this way, the weaker eye becomes stronger.
What to Expect: About Patch Therapy
- Wearing the patch can be very uncomfortable. If your child wears spectacles, put the patch on before the glasses. The patch should be stuck on the face, not the glasses.
- The edge of the patch should be carefully sealed so the good eye is completely blocked.
- As an alternative, homemade patches / special glasses can be used instead of a patch in older children
- Patching schedules should be strictly followed.
- Young children may initially resist wearing the patch. Hence, start with short periods of time and slowly increase the timings for better results.
- During patching: Older children should read and younger children should play fun games/eye exercises.
- Your child will start accepting the patch when vision improves in the weaker eye.
- Regular follow-up visits are a must.
Side Effects:
Patch therapy is very safe and has no side effects.
What is patch therapy?
A patch is used to cover your child’s good eye, so the eye with lower vision is stimulated. This strengthens the weak eye.
How should the eye be patched?
Readymade patches are available. Sticker patches can be stuck directly over the eye. Patches made of cloth with sticking tape at the edges are also available.
When can we start patch therapy?
Immediately after the diagnosis and doctor’s advice.
Can patch therapy be used in a child above the age of 8?
Yes, if this has not been done earlier when the child is found to have difference in spectacle power.
How can we detect amblyopia early?
It can be hard to notice because most children do not complain of poor vision in one eye. Your child should get a routine eye checkup during the 1st and 3rd years of life. They should also get their eyes checked in school.
My child’s eye looks normal. Why have they developed amblyopia?
Lazy eye does not always affect the appearance of the eye. It may be due to a refractive error or a deviation of the eye. The eye becomes lazy because it is weaker, so the child relies on the good eye instead.
My child has amblyopia. Will they need other treatments in addition to patch therapy?
It depends on your child. In some cases, amblyopia is caused by another eye condition. This eye condition will also need to be treated. Some children may need:
- Spectacles – to correct any refractive errors
- Cataract removal surgery
- Squint surgery
How many hours of patch therapy should be done?
This depends on the severity of the amblyopia. Your doctor will make this decision. If vision is only slightly reduced, the patch may be worn for 4 hours a day. If vision loss is worse, it should be worn for 6 hours per day.
Can my child sleep during patch therapy?
No. The purpose of patch therapy is to get the child to use their weak eye. This cannot happen during sleep. So, your child should read books, draw, or use colored toys while wearing the patch.
If my child wears glasses, should they wear them during patch therapy?
Yes, but the patch should be stuck to the face, not the glasses. Glasses should be worn on top of the patch.
What can the child do while wearing the patch?
The patch should always be worn with adult supervision. Younger children should be encouraged to do drawing or colouring exercises. Older children should read.
My child is not co-operating with patch therapy. What can be done?
At first, the patch can be used for shorter times. Gradually, the time will need to be increased. Vision will only be improved if your child follows their patching schedule. As your child’s vision improves, they are more likely to accept the patch. But, they may need some encouragement and fun activities from their parents along the way.
For how long does the treatment have to be continued?
This depends on the improvement of vision. It may last a few months to a few years. The critical period for treatment is the first 8 years of life. Patch therapy will be continued as long as the vision is improving.
When and why does patch therapy end?
Once the vision reaches its maximum possible level, patch therapy is slowed gradually. Eventually, it is stopped completely. If the patch does not improve vision after two or three 6-month checkups, then the patch is also stopped.
How frequently should the child visit the eye doctor?
This will be decided by the doctor. If the patch is used to treat alternating squint, then the follow-up is every 2 months. Otherwise, it is every 3-4 months.
Why are we coming in every 3 months for a checkup?
At every follow-up, vision is checked to see if there’s any improvement. The checkups will gradually become less frequent as the child’s vision gets better.