Amblyopia, or lazy eye, is a common eye condition found in about 1 out of 30 people. It is  usually caused by an undetected need for glasses in an infant or toddler, but can result from an eye turn. When one eye has normal eyesight and the other eye has poor eyesight, the person learns to see out of the eye with good eyesight. 

Amblyopia is often a hidden disability. A well-child care visit at the pediatrician’s office will not detect amblyopia… a comprehensive eye examination is the only way to diagnose amblyopia. Some children seem to be unaffected by this when they are young, but when they are older they may struggle with school and sports performance. Left untreated, amblyopia can affect a child’s self-image, work and school. 

Although commonly termed “lazy eye,” the true problem of amblyopia is with the brain instead of the eye. Because the brain would have to exert so much effort to marry the pictures from both eyes, it actively chooses to ignore the amblyopic eye (i.e. suppression). Although suppression is less efficient than normal development, it prevents visual confusion and allows the individual to function better given the circumstances. Like a “second string” athlete, the lack of participation causes all visual skills of the amblyopic eye to be weaker compared to the other eye. In effect, the amblyopic eye-brain connection becomes learning disabled. These difficulties can result in struggles in school or uncertainty in daily activities and sports. Office based, optometric vision therapy programs offer the highest cure rates for lazy eye compared to eye surgery, glasses alone or patching without therapy. 

Most children do not like wearing an eye patch because it impacts their quality of life and other treatment methods like eye drops can cause light sensitivity and disorientation. Patching can also cause an eye to turn that once appeared aligned.  The first step is to be prescribed a pair of glasses or glasses that can be worn comfortably. This starts the process of correcting the original problem of one eye being able to see more clearly than the other.  Then, the ability for the two eyes to work together as a team must be developed through an individualized program of optometric vision therapy.  The person may still require glasses after the completion of the therapy program. The goal is for the patient to have normal visual skills, such as eye teaming, eye focusing and eye movement skills.

The earlier the condition is found and treated, the better the functional outcome; however, our office successfully treats patients well into adulthood. The Vision Therapy Institute provides advanced, evidence based, amblyopia therapy. This method emphasizes the development of binocular vision and visual information processing far beyond patching or atropine treatment. 

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Amblyopia Misconceptions That Persist Today

A common misconception is that amblyopia cannot be treated after the person’s neurological system develops beyond the critical period, previously considered the age of 7. This is FALSE! Evidence-based medicine has proven that it is possible to treat amblyopia at any age due to neuroplasticity. The earlier the patient receives optometric vision therapy the better and quicker improvements are seen; however, our office successfully treats patients well into adulthood.

Amblyopia was initially considered a one-eyed vision problem. As a result, “occlusion” (e.g. patching) quickly gained popularity. The thinking was to cover the “good” eye to strengthen the amblyopic eye. While research has shown this method to work for eye sight, it also suggests that the improvements are significantly limited AND do not last in many cases. More recent research unequivocally shows that amblyopia is a problem of eye teamwork. Yet, many doctors have not yet embraced newer treatment methods.

Eye Patching Alone is No Longer the Standard of Care

While eye patching remains the first line of treatment for many professionals, it is an “Old School” approach. The significant limitation of patching is inherent to the treatment itself. Suppression of the amblyopic eye ONLY occurs under two-eyed (binocular) conditions; therefore, patching does not offer a more efficient alternative since it only teaches the amblyopic eye to work better when it is alone.

“Unilateral patching therapy only teaches a patient how to be a “one eyed person” since it does not address the underlying cause for the amblyopia, which is the lack of binocular (two-eyed) vision development.” ~ Dr. Dan Fortenbacher, Developmental Optometrist

Asking a patient with amblyopia to wear an eye patch several waking hours per day over the “good” eye is similar to tying your dominant hand behind your back and expecting you to do your job. Thus, it is no surprise that the visual disruption of patching almost always causes frustration and emotional outbursts by the patient.

At Vision Therapy Institute, we emphasize communication between the two eye-brain connections to teach the brain a new, more efficient alternative to suppression. We train vision development through visually-guided activities supervised by trained therapists. Our in-office optometric vision therapy is supported by complimentary at-home exercises. This advanced approach normalizes the eye sight of the amblyopic eye, nurtures eye teamwork, and develops depth perception to create a more efficient individual.