Diagnosis and treatment of lazy eye in children

Amblyopia is one of the most common causes of vision loss in children. This problem occurs when one eye is not used enough during the child's life and cannot develop fully and the neural pathways between the eye and the brain do not develop properly. Lazy eye is not a structural problem in the eye itself, which means that the eye is completely healthy, but the brain ignores the necessary information from that eye. (More explanation will be given later) Therefore, timely diagnosis and treatment of lazy eye is very important, because this problem can only be treated in childhood.

With early diagnosis with methods such as using appropriate glasses, closing the strong eye (to strengthen the weaker eye), special exercises for the weak eye can improve the child's vision. In this article, we will thoroughly review the causes, symptoms, diagnosis methods, and the latest treatment approaches for lazy eye in children, so that dear parents can help maintain their children's vision health with full knowledge.

What is lazy eye (amblyopia) and why does it occur in children?

Lazy eye is a complication that reduces vision in one eye (in rare cases, both eyes) even if glasses or contact lenses are used. This happens when the brain and eyes cannot communicate properly. Early in visual development, the brain needs clear and equal input from both eyes to learn how to see. In simpler words, it can be said that the brain must learn to take the right image from both eyes and combine them. If one of the eyes sends a blurry or abnormal image to the brain, the brain will over time prefer to use only the stronger eye and ignore that eye. This issue causes the weaker eye not to grow well and eventually its vision will decrease.

Several reasons that cause lazy eyes in children:

• Eye deviation (strabismus): When the eyes are not aligned correctly and look in different directions (such as crossed or divergent eyes). In this case, the brain ignores the image sent from the deviated eye to prevent diplopia.
• Unequal Refractive Errors (Anisometropia): When one eye needs very different glasses than the other eye. For example, one eye may be nearsighted or more farsighted than the other eye and not send a clear image to the brain.
• Obstructive vision problems: Anything that blocks light from reaching the retina, such as a congenital cataract, severe drooping of the eyelid (ptosis), or corneal opacity, can lead to lazy eye. In these cases, the brain never gets the chance to learn to see with that eye.

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How to recognize the signs and symptoms of lazy eye in children?

Diagnosing lazy eye in children is not an easy task, because children are usually not aware of their vision problem or cannot express it. For this reason, parents and caregivers should pay attention to small symptoms and take periodic eye examinations seriously. Some of the signs and symptoms that may indicate lazy eye include:

• Marked deviation of the eye: One of the eyes constantly deviates inward, outward, up or down.
• Repeated eye rubbing or closing one eye: The child may close one eye or rub it continuously to see better.
• Tilting the head: To compensate for poor vision, the child may tilt his head in a certain direction.
• Eye covering: When one eye of a child is covered, the child is uncomfortable or cannot see well.
• Difficulty perceiving depth: The child may have difficulty with activities that require depth perception, such as catching a ball or pouring liquids.
• Academic failure or difficulty in reading: In some cases, visual impairment can affect a child's academic performance.

If you see any of these things, take the child to an ophthalmologist for a thorough examination because timely diagnosis can make the treatment faster and more effective.

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Methods to diagnose lazy eye

Feature screening examination (simple) Complete ophthalmology examination (specialized) Purpose Identify suspicious cases Definitive diagnosis and determination of cause and severity Duration At birth, 6 months, 3 years and before entering school Immediately after becoming suspicious or in the presence of risk factors by Pediatrician, nurse, optometrist Pediatric ophthalmologist Tools Light, simple vision cards Autorefractometer, ophthalmoscope, slit lamp, accurate vision tests Result Need to refer to a specialist Determination of treatment plan and follow-up

The importance of early diagnosis and effective treatment solutions for children's lazy eye

Early diagnosis and treatment of lazy eye is very important. Children's brains have high flexibility (plasticity) until about 8-9 years old. This means that at this age, the neural pathways between the eye and the brain are still developing and forming, and they can be stimulated and strengthened. The sooner treatment is started, the more likely it is that the vision in the weaker eye will improve. Delay in treatment can cause permanent vision loss in the lazy eye, which cannot be reversed even with surgery in adulthood. Therefore, the sooner the treatment is started, the better and more permanent result will be obtained.

5 common treatment methods for lazy eye

Treatment of lazy eye depends on its root cause and often includes several steps:

1. Correcting the underlying cause: If the lazy eye is due to cataracts, drooping eyelids, or severe deviation of the eye, the underlying problem must first be corrected with surgery or other methods.
2. Correction of Refractive Errors: If there is nearsightedness, farsightedness or astigmatism, the child should wear appropriate glasses continuously. This allows the brain to receive a clear image from the weak eye.
Patching: This is one of the most effective and common treatment methods. By covering the stronger eye for several hours a day, the brain is forced to use the weaker eye and its neural pathways are strengthened. How long and how to use the patch is determined by the ophthalmologist.
3. Atropine drops: In some cases, stronger atropine drops are placed in the eye instead of a patch. This drop temporarily blurs the vision of the strong eye and forces the brain to use the lazy eye.
4. Eye exercises (Vision Therapy): These exercises can help improve coordination between eyes, strengthen eye muscles and improve vision processing. These methods are usually complementary to the main treatments.

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