LAZY EYES IN CHILDREN

 

Lazy eye affects many children. It is sad that it is detected quite late in many instances. It is usually when the child is older and undergoes an eye test at school that this condition is usually noticed.

Causes

Amongst the causes for lazy eyes, the most common is uncorrected refractive error. The other causes include presence of squint, presence of a media opacity like cataract or corneal opacity which prevents the eyes from seeing clearly. Even the presence of a cylindrical refractive error like high astigmatism can cause the occurrence of lazy eyes.

Treatment

The first step in the management of lazy eyes is the correction of any refractive error by the prescription of glasses. It has been shown that correction of refractive error with glasses can itself improve the vision can cure amblyopia in 25% of children. Correction of astigmatism is a must in children. It is important to understand that not all refractive errors in children need to be corrected. Only in the presence of high refractive error one needs to prescribe glasses. This is because the eyes have a tendency to normalize, an event called as emmetropization. 

Patching is the best way of improving the vision and prolonged hours has given astounding results like improvement from 6/36 to 6/6 in children as old as 11 years. It is important to prescribe near activities which need tremendous concentration like mobile and computer games during patching for good improvement. Sincerity and dedication is a must while patching. Proper counseling has helped me in making sure that the compliance is really good. There are drops as well like atropine which need to be used on weekends to help improve the vision in cases of amblyopia. 

I guess one should follow the guidelines of the American Academy of Pediatric Ophthalmology and Strabismus which mentions all children undergo an eye check up by the age of 3 years. This will help us check preventable visual impairment and blindness due to lazy eyes.