Lazy Eye Surgery

Tap to Read ➤ Lazy eye or amblyopia is a vision disorder. It can require surgery, if the condition is worsened due to any other associated eyesight disorder. Read on to find out about treatment options for lazy eye. Roshan Valder

Surgery in amblyopia is only required if the lazy eye is caused due to squint, ptosis or cataract.

Amblyopia, commonly known as 'Lazy Eye', is a complex disorder of the eye and brain coordination. It is an early childhood eyesight condition, whereby, vision of either one or both the eyes, deteriorates. As it is a congenital disorder, it is vital that it is diagnosed as early as possible, for the proper treatment of the condition.

Amblyopia is the most common cause of monocular blindness (partial or complete vision impairment in one eye) in the United States, affecting 2-3% of Americans every year.

Amblyopia - 'Lazy Eye'

Amblyopia is often confused with strabismus or squint eye. The term 'lazy eye', which is used to refer to amblyopia, is actually a layman's term for strabismus. To avoid such confusion, it is important to understand the difference between these two vision disorders.

According to the brain examinations performed by Nobel laureates David H. Hubel and Torsten Wiesel, amblyopia is not a disorder of the eyeball, rather caused due to failure of brain stimulation. The affected eye cannot send clearer images to the brain. So, the brain reacts by focusing on the images sent by the 'good' eye. This hampers the development of the visual center of the brain. If this condition is left untreated, it can cause complete blindness in the affected eye.

Symptoms

A person with lazy eye may have some or all of these signs and symptoms: poor depth perception sensitivity to motion blurred vision double vision a squint

With diminished vision in one eye, a child may find it difficult to focus. In such cases, the good eye tends to recover and have stronger vision. Gradually, the brain ignores any data sent by the affected eye, leading to complete monocular blindness. As a child's brain has more neuroplasticity, it habituates itself to consider images received by the good eye. This results in delayed detection of this condition.

Moreover, in many countries, children get their eyes examined for the first time at an average age of 5 - 6 years. Therefore, it is important that the parents schedule an eye test as soon as they find their child's eyes wandering, when they are just 2 - 3 weeks old.

Causes

Strabismus

It is a condition where the eyes are not properly aligned. The ocular muscles outside the eyes fail to act in synchrony, causing both eyes to focus on different objects. It may be caused due to any injury, long or short sightedness and illness. A history of strabismus or squint in the family increases the chances of a child being born with it. The squint can be either upwards, downwards, inwards or outwards.

Refractive Error

The condition caused due to difference in refraction of the two eyes, is known as anisometropia. The eye that sends clearer images to the brain becomes the preferred or dominant eye. In case the difference in refraction is too high, the eye with lesser vision may turn completely blind.

Although, lazy eye is not necessarily caused by these conditions, they can aggravate it. Any reason that leads to blurred vision can trigger amblyopia. Some other causes are: Congenital cataract Glaucoma Corneal ulcer or scar Ptosis Surgical injury

Treatment

Ophthalmologists and orthoptists recommend a two-step treatment for lazy eye.

Treating the basal problems

Unequal vision: Myopia and hypermetropia can be treated by prescribing glasses. Continual eye examination must be done to monitor the changes.

Strabismus: A slight squint can sometimes be cured by glasses. In case the strabismus has advanced, a corrective surgery can be opted for. Depending upon the extent of squint, more than one surgery may be required. Cataract and Ptosis: It can be removed by a minor surgical procedure.

Surgery for strabismus or crooked eye is very common, and is done mostly for cosmetic purposes. Though it may not completely cure the vision of the individual, it improves the eye alignment and gives it a normal appearance.

The surgery involves changing the structure or position of the extra ocular muscles by any of the following methods: loosening or weakening the eye muscles, tightening or strengthening the eye muscles, repositioning the eye muscles or using adjustable sutures. The use of these methods may vary according to the requirement of the patient.

Treating the affected eye

Eye-patch: A patch is used to close the good eye, and stimulate and train the brain to resort to images sent by the lazy eye. The duration of this treatment depends on the discretion of the ophthalmologist.

Atropine eye-drops: These drops are administered on the good eye to blur the vision. In comparison to the eye patch, drops are less conspicuous for kids.

Lazy eye surgery, in the case of strabismus, is a simple procedure which takes a few hours to complete, and the patient is able to go home within a day. The eye may show some soreness and redness, which soon goes away with proper care. Post-operation vision therapy is advised which includes, extensive eye exercises and use of corrective lenses or prisms. Contact an orthoptist for vision therapy to help improve vision in lazy eye.

This surgery is not recommended for young children, and can be avoided if the disorders are diagnosed and treated at an early age. Success rates for vision recovery in children is quite high. It is always best to take advice from professionals and certified healthcare providers.

Disclaimer: The information provided in this story is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.