Is it Lazy Eye, Amblyopia, or Strabismus?

Here at Lenhardt Optometric Group ( we get a lot of questions about “lazy eyes.”  What we have found is that the term is often quite misunderstood.  To be most accurate “lazy eyes” are eyes that are amblyopic, or unable to be corrected to 20/20 vision with prescription glasses.  Clear vision is impaired because adequate nerve development has not occurred to one or both eyes.  In fact Amblyopia is the leading cause of permanently decreased visual clarity if not treated in the childhood years.

Just by looking at someone you cannot tell if they have amblyopia, they need to have a full comprehensive eye examination by an Optometrist.  Optometrists are “vision doctors” who are trained to evaluate clear vision, but also mentally process that information in a useful way.

A school vision screening is often not involved enough to prevent amblyopia.  Often children will pass a screening, even though they have visually significant problems that will be noted in a full eye examination.

A related issue when discussing “lazy eye” is when the eyes are mis-aligned, which can be seen as an eyeturn.  This is known as Strabismus, where one eye will usually turn in or out.  This condition sometimes is a result of amblyopia in the eye that turns.  The brain ignores a portion of the information going to that eye and allows it to turn without noticing double vision.

Both Amblyopia and Strabismus are conditions that can be treated.  However there are limitations.  The earlier in life that amblyopia is detected the more easily it is treated.  Our brains are not as flexible as we get older, much like teaching an old dog new tricks.  Traditionally it has been stated that amblyopia cannot be treated after 10-12 years of age.  In my experience it is twice as easy to treat at 6 years old as compared to treatment at 12 years old.  Even at 20 years old it can be improved, but it is much more difficult for the patient, and the results may not reach the 20/20 vision level.  I always seek to improve the vision for my amblyopic patients and have noted improvement even for patients over 70.

Treating amblyopia begins with a comprehensive eye exam, and correcting BOTH eyes to their clearest possible vision.  It can also involve patching the stronger eye to strengthen the weaker eye, or using eye drops to cause the same effect.  Sometimes wearing specific types of bifocal reading glasses or bifocal contact lenses are prescribed.

Often strabismus will resolve if the amblyopia is treated successfully.  But in more severe cases eye surgery for the muscles may be recommended.

If you know, or suspect your family members of having an issues related to amblyopia, or strabismus and you would like an evaluation please do not hesitate to call us here at Lenhardt Optometric Group, 714-525-3350 or visit our website and schedule an appointment,