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Also known as Lazy Eye, amblyopia is a disruption to the normal eye development in children and is a common factor in reduced vision in early years.
It is thought to affect about 3% of children and most cases are very successfully treated if early detection has been made. Late detection however can result in serious impairment which is usually permanent or even blindness.
The causes of amblyopia are most commonly resulting from either strabismus (squint) or refractive error (long-sightedness, short-sightedness or astigmatism).
A squint is when the two eyes point in different directions. This would commonly cause double vision or at the very least blurred vision. However, to avoid this, a young persons brain is able to suppress the image from one eye, causing that eye to become 'lazy'.
If there is a real difference in the error of refraction between the two eyes such as one eye being more long-sighted than the other, then the brain suppresses the image from the weaker of the two causing it to be amblyopic.
A high refractive error in both eyes, (eg. both eyes being very long-sighted) may cause amblyopia in both eyes.
Congenital cataract (cataract present at birth) or an eye tumour may also cause amblyopia but this is far less common.
Young children with amblyopia are normally unable to alert a parent to any symptoms they might be experiencing. It is generally a parent or close family relative that will notice any changes. Eyes crossing or turning outwards or the child covering one of their eyes are generally early symptoms. Older children may develop difficulty with depth perception.
If the condition is not picked up by the family then its generally a full eye examination that will detect it. There is no minimum age to when a child's eyes can't be fully examined.
Because of the importance of early detection, all children should be routinely eye tested at pre school age.
Treatment will be dependent on the causing factor.
If causes such as short sightedness, long-sightedness or astigmatism, are aggravating the lazy eye then prescriptive glasses or contact lenses can be given. This alone may correct the vision.
A common treatment especially in early detection for younger children is eye patching which involves stopping your child using their 'good eye', and forcing them to use the lazy one. I recall patches with superhero stickers of choice to decorate them. A useful tool for the less enthusiastic patient. The alternative to a physical patch is to use eye drops in the good eye which blurs the normal vision.
Opthalmic surgery will sometimes be performed which will cut the muscles to correct the imbalance. This is often an outpatient procedure provided there are no additional complications. A cataract may also require removal by a surgical procedure.
As with most prognosis, the earlier amblyopia is detected and treated the higher the chance your your child will regain normal vision.