Amblyopia & Strabismus

Strabismus

At Zenith Vision Development Center, we provide a non-surgical approach to treating strabismus (eye turns). An eye turn or strabismus is a condition that makes it difficult to line your eyes up correctly or use both eyes in unison. One eye may appear to turn in, out, up, or down. The eyes may alternate which eye is turned in the wrong direction. Eye turns can change and may only appear after a person becomes tired or injured. Whether the eye turn is constant or intermittent, Strabismus always requires treatment. It will not go away on its own, and children will not outgrow it.

Possible Symptoms of Strabismus Include:

Blurry Vision
Double Vision
Head Turn or Tilt (favoring the better eye)
Rubbing or Closing an Eye
Poor Depth Perception (difficulty seeing in 3D - trips often, bumps into things, “misses” the table)
Difficulty with Coordination (such as riding a bicycle, driving, or playing ball sports)
Avoids Being in Pictures

When the eye turn is left untreated, the eye that turns may also have reduced vision. A condition known as Amblyopia or “lazy eye”.

Amblyopia

Amblyopia, also known as a “lazy eye”, is described as a reduced vision in one eye compared to the other, even with glasses. There are some rare forms of amblyopia that involve both eyes. Amblyopia is the most common cause of partial or total blindness in one eye in children.

The term lazy eye is misleading because the eye is not actually lazy. In fact, it is a developmental problem in the nerve connecting the eye to the brain, affecting the brain’s ability to use both eyes together. It is not a problem in the eye itself, but in the brain which actively ignores the visual input from the misaligned eye, leading to amblyopia in that eye.

In addition to poor visual acuity, people with amblyopia are more prone to having difficulties with depth perception, eye movements related to reading, and visual decision making while driving.

It is important for parents to understand that while Strabismus and Amblyopia often occur together, you won’t always see an eye turn when your child has Amblyopia. Amblyopia is often caused by Strabismus, but one doesn’t have to have an eye turn to have Amblyopia. It is also caused when there is a significant difference between how clearly each eye can see. It can also be caused by deprivation such as a congenital cataract or lid droop (ptosis) which blocks the vision in one eye.

Unless the Amblyopia is caused by Strabismus, it is easy to miss because there don’t appear to be many symptoms.

Symptoms of Amblyopia are similar to Strabismus and Include:

Blurry Vision/ Double Vision
Head Turn or Tilt (favoring the better eye)
Rubbing or Closing an Eye
Poor Depth Perception (difficulty seeing in 3D - trips often, bumps into things, “misses” the table)
Difficulty with Coordination (such as riding a bicycle, driving, or playing ball sports)
Poor Handwriting

Children are often unaware that their vision is causing their difficulties so it is essential that all children have a comprehensive eye exam before they begin school or as early in the school year as possible.

Most parents assume if their child can see things in the distance then both eyes must be seeing correctly. Unfortunately, this is not always the case. A child may only be using their one good eye and ignoring the image from the eye that can't see well. These children may not be aware of the visual challenges they face because they think this is the way that everyone sees. To a child, since they are still able to see out of one eye, they don’t even know their vision is abnormal.

Treatment for Amblyopia and Strabismus

Surgery is not the only way to treat an eye turn and there are more effective treatment options for strabismus and amblyopia than eye patching or eye drops. Treatment for strabismus and amblyopia are different depending on which doctor you see, and new research indicates that it is never too late to treat these conditions. However, the earlier the problem is found and treated, the more successful and easier the outcomes are achieved.

Traditional treatment options typically rely on patching or the usage of atropine eye drops. Newer options include training the two eyes to work together to improve vision in the weaker eye. Strabismus can often be treated non-surgically with a optometric vision therapy program, directed by a developmental optometrist in the office. As a parent, it is important to educate yourself on ALL treatment options, understanding that children do not outgrow eye turns or amblyopia.

If you are concerned your child has an eye turn or amblyopia or is in need of a comprehensive eye exam, please reach out to our office to schedule an appointment today.

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