About lazy eye or amblyopia

Children with lazy eye or amblyopia can’t see properly or at all out of one eye. This eye is weaker or ‘lazy’.

Lazy eye develops when the part of the brain that controls how a child sees starts to favour one eye and ignore the other eye. This often happens because of a squint. Sometimes it’s because the eyes don’t focus equally, which can happen when the eyes have different amounts of long-sightedness, astigmatism or short-sightedness.

Structural problems with the eye can also cause lazy eye. Examples of these problems are scars on the cornea, droopy eyelids or cataracts.

Lazy eye affects 2-4% of children. It often develops during infancy or early childhood.

Premature babies or babies with low birth weight have an increased chance of getting lazy eye.

A family history of eye problems in children makes lazy eye more likely.

Signs and symptoms of lazy eye or amblyopia

Children with lazy eye or amblyopia often have no obvious symptoms. They might not look any different from other children or seem to have any problems with their vision. This is why routine testing of vision in all preschool-age children is recommended.

In some children, you might notice that one eye:

• turns in a different direction from the other (squint)
• is fully or partially shut (ptosis).

Occasionally, older children with lazy eye will say that they can’t see clearly.

All children should have an eye test before they start preschool, when they’re 3½-5 years old. Most states and territories run free vision screening programs through local child and family health services or schools. Check with your child and family health nurse, kindergarten, child care centre or school about what’s offered in your area.

Medical help: when to get it for children with signs of lazy eye or amblyopia

If you notice that your child has a squint or obvious droopy eyelid or you’re worried about your child’s vision, start by seeing your GP or child and family health nurse. They can refer your child to an optometrist or ophthalmologist for more tests and checks.

If a preschool vision screening test picks up problems with your child’s vision, they’ll be referred to an optometrist or ophthalmologist for a more detailed assessment.

Lazy eye or amblyopia: testing and diagnosis

If your child is referred to an optometrist or ophthalmologist to test for lazy eye or amblyopia, this professional will carefully examine your child’s eyes and vision to diagnose the problem and work out what’s causing it.

Lazy eye diagnosis involves various tests. For example, the optometrist or ophthalmologist will:

• check your child’s vision
• assess the health of your child’s eye, including the back of the eye
• measure the focus of your child’s eyes
• consider whether glasses might help your child’s lazy eye.

The optometrist or ophthalmologist might use vision charts, special equipment or medicine to do these tests.

Early diagnosis and treatment of lazy eye is essential. The earlier lazy eye is treated, the better the outcomes are. If lazy eye is left untreated, it can cause permanent vision loss.

Treatment for lazy eye or amblyopia

Lazy eye or amblyopia in children can usually be corrected with the right treatment. The right treatment depends on what’s causing an individual child’s lazy eye.

All treatments for lazy eye aim to strengthen the eye and get it working properly.

Glasses
Most children with lazy eye need glasses. If the optometrist or ophthalmologist prescribes glasses for your child, they’ll probably tell your child to wear the glasses for several weeks or months. After this, they might consider other treatments.

Patching
This is a common treatment to encourage the weaker eye to work harder. Patching is when your child wears a patch over their stronger eye for a period of time each day – usually 1-4 hours. The patch might stick directly onto your child’s skin. Or if your child wears glasses, the patch might go over one lens.

To start with, your child might need patching for several hours a day, 7 days a week. As your child’s vision improves, they’ll need fewer hours and/or fewer days of patching each week. If your child’s lazy eye is severe, patching might go on for several years.

Some children don’t cope well with patching. If patching isn’t working for your child, your child’s optometrist or ophthalmologist might give your child eye drops to blur the vision in the stronger eye.

Check-ups
Your child will need regular check-ups so your child’s optometrist or ophthalmologist can monitor the progress of treatment.

Your child’s optometrist or ophthalmologist might work closely with an orthoptist to treat your child’s lazy eye.