Amblyopia (lazy eye)

What is amblyopia?

Amblyopia (lazy eye) is a childhood condition where your vision is not immediately improved (to the normal level) even after wearing glasses (if necessary). This condition can affect one or both eyes.

Research shows that visual development in children starts from birth and stops gradually around the age of seven when the aspect of the brain concerned with vision development has matured. An interruption to vision development during this period may cause amblyopia. What causes amblyopia?

• A turn in the eye, which is known as a strabismus or squint.
• A need for glasses.
• An obstacle which blocks your vision from developing. For example, a droopy eyelid or cataracts (cloudy patches on the lens of your eye).
• If one eye is more long-sighted (when you have difficulty seeing objects close by) or more short-sighted (when you have difficulty seeing objects far away) than the other eye, this may cause amblyopia. The brain will favour the eye receiving the clearer image and ignore what the other eye with the blurry vision is seeing.

How is amblyopia treated?

In most cases, we try to improve the vision with glasses first (if necessary). They should be worn full-time. It takes time for the eye and brain to get used to the glasses. Specialist eye doctors, called orthoptists, will check your child’s vision a few months later and decide if further intervention is needed. A treatment plan and any risks will be discussed.

Your child will usually be reviewed every three months once treatment has started. Treatment will be stopped if the vision is the same in both eyes, when there is no significant improvement over time, or the risk of developing a complication is suspected.

The improvement in your child’s vision is dependent on the level of vision at the start, what is causing the amblyopia and how well your child co-operates with treatment. Amblyopia will not get better by itself. if it is not treated your child’s vision will remain unchanged or worsen. Your child will still need to wear glasses after treatment is completed.

Older children (seven and older) have a lower success rate in achieving a satisfactory result. This is due to their visual system is fully developed at this age and the risks of complications are higher. The treatment will be tailored to your child. They will be monitored for risk of any complications.

Common treatment options

Occlusion (patching)

This is the most common way of treating amblyopia. This treatment involves covering the ‘better seeing’ eye to encourage the weaker eye to work. It should be carried out with your child’s glasses on (if given).

Medication (Atropine – eye drops)

Atropine may be another alternative to patching for some children. This medication blurs the vision in the better seeing eye and encourages the use of the weaker eye. This treatment option will be discussed with you if it is suitable.

Optical (spectacles or contact lens)

Sometimes the strength of the glasses is adjusted to encourage the use of the weaker eye. In some cases, wearing glasses may be the only treatment needed. This treatment option will be discussed with you if it is suitable.

Your child’s appointment

The Royal Free London runs eye clinics for children at Barnet Hospital, Edgware Community Hospital, and the Royal Free Hospital. If you need to change or cancel your appointment at any hospital, please telephone 020 7443 9757.

You can also cancel or change your appointment. If your GP made the appointment through the ‘choose and book’ system, please contact the national telephone appointment line on 0345 608 8888. Your GP should have advised you if this is the case.

If on the day of your child’s appointment you need to contact the eye clinic, please use the following numbers:

Barnet Hospital

Tel: 020 7794 0500, extension 27301.

Edgware Community Hospital

Tel: 020 8216 4329.

Royal Free Hospital

Tel: 020 7443 9757.