The term “lazy eye” isn’t very specific and therefore can’t be talked about as one problem with one solution. Strabismus is the condition most people somewhat incorrectly associate with the term. It can manifest as exotropia and esotropia (goggle-eyes and cross-eyes), in which one eye deviates outward, inward, or both. The term “lazy eye” is more correctly associated with how the brain makes one eye dominant over the other (amblyopia). It can be caused by strabismus, uncorrected vision, or cataracts. These kinds of conditions are usually discovered in early childhood and can be corrected on their own. If they do not, I have laid out a few of the most common remedies that you should discuss with your physician or ophthalmologist.
The first thing you should do if you are concerned that your child may have a problem with their eyes is to talk to your doctor. While there are things you can do at home to help the situation, without a specific diagnosis you run the risk of causing further harm or prolonging a problem that may have been easily resolved. However, there are steps that can be taken to tackle lazy eye.
What is a lazy eye?
The term “lazy eye” is used to describe several ocular conditions. It could refer to the way the human brain compensates for a lack of binocular vision, which is to choose to use the visual information from one eye and not the other. The term could also refer to a misalignment of the eyes: One eye might be normal while the other deviates outward or inward. It could also deal with a physical problem in the optic nerve or other parts of the eye that affects the ability to see with both eyes.
Getting Rid of a Lazy Eye
Vision therapy uses several techniques to improve visual acuity. This form of corrective therapy is practiced by eye specialists known as orthoptists. The idea is to use a variety of exercises and techniques to strengthen eye muscles and also gain control of eye coordination through practice. These methods are usually prescribed in conjunction with other corrective measures, as they are rarely successful on their own. The exercises include practicing convergence and alignment of the eyes at near and far distances, tracking objects in motion, and improving peripheral vision and depth perception. Most of these exercises can be practiced at home. Making time to get involved with your child’s motor-visual development will greatly improve the outcome.
Corrective lenses can help negate visual inequalities. Lazy eyes can arise when your child is born with genetic eye problems like myopia (nearsightedness), hyperopia (farsightedness), an astigmatism (corneal or lens defect), or if it manifests in one eye more than another. Our brain has this amazing ability to adapt and compensate for weakness and injury, but in this case that ability actually makes the situation worse by essentially ignoring the information from one eye. Your pediatrician should catch these kinds of problems early on, as they test for it during regular childhood checkups. Wearing corrective lenses can correct this problem all on its own, but you should watch your child to make sure their condition is improving.
Patches are often used to strengthen weaker eyes. Our body’s ability to adapt is pretty remarkable. If your child’s eyes have developed asymmetrically, it means that in order to compensate for a weakness (blurriness or misalignment), your child’s brain has decided to favor one eye over another. If not corrected, this condition could lead to permanent loss of vision in the weaker eye. A very common and effective treatment involves covering the dominant eye with a patch and correcting the original problem in the weaker eye. This forces the child’s brain to compensate and depend on the weaker eye, which will improve with time. An alternative to a physical patch is the use of a paralytic eyedrop that disables the dominant eye to the same effect.
Prisms are another type of corrective lens. If your child’s problem with amblyopia is caused by a misalignment of the eyes (strabismus), one option is to bend the light with prismatic lenses in order to match that misalignment. When dealing with confusing visual information, our brain compensates by ignoring the images that don’t line up—thus favoring one eye and allowing it to become dominant. We all know that a prism bends light by refracting it through angled glass. With that knowledge, an optometrist can design a lens to accommodate for an eye that is out of alignment. It’s not always the best option and can lead to a certain amount of visual distortion, but it is one possible alternative to surgery.
Botox injections can help make lazy eyes less noticeable.When we think about Botox (botulinum toxin), or at least when I think about Botox, Hollywood celebrity culture comes to mind. Those people, obsessed with fighting off the inevitable signs of aging, pump their lumps and wrinkles so full of this paralytic poison that their faces become slack and emotionless. But that same paralytic effect can have a positive use in cases of strabismus-type lazy eyes. A very small amount of Botox is injected into one or more of the interocular muscles that control eye movement. This will temporarily make that muscle lose tension and proper eye alignment can be achieved. Treatment must be repeated every 2–3 months.
Lazy Eye Surgery
Sometimes the best option is a surgical one. In cases involving a strabismus-type lazy eye, patches and corrective lenses may help the patient see more normally, but leave them with an uncorrected cosmetic abnormality that can be as bothersome and debilitating as the physical condition. In many cases, an uncorrected strabismus lazy eye can lead to an amblyopia lazy eye, as the brain compensates for the loss of binocular vision. Surgery is often most successful if done earlier in life, but it isn’t uncommon in adults.
The surgery, which is done under general anesthesia, involves opening the skin around the eye to expose the muscular attachments that move and point our eyes in the right direction. By detaching and reattaching one or more of those muscles, the surgeon can change the tension on the patient’s eye. This makes it line up with its mate, thereby alleviating the stigma attached to having a lazy eye. Recovery is usually less than a week.