Welcome to Vision Therapy and Behavioural OptometryClick to listen highlighted text!Welcome to Vision Therapy and Behavioural Optometry
Shaylers Vision Centre
How do I know if my child has a lazy eye
A lazy eye does not usually cause symptoms. Younger children are often unaware that there is anything wrong with their vision and, if they are, they are usually unable to explain what is wrong.
Older children may complain that they can't see as well through one eye.
Some groups are more likely to develop lazy eye
a child who has a parent with lazy eye
a child who has a parent with a high degree of hypermetropia (long sighted)
a child who has a parent with a high degree of astigmatism
a child born prematurely
a child born as a result of IVF treatment
a child with conditions such as Downs syndrome or Williams syndrome
In some cases you may notice that one eye looks different to the other. However, this is usually a sign of another condition that could lead to a lazy eye, such as a squint (when the eyes don't look in the same direction).
The only way to ascertain if a child has a lazy eye is for them to have an eye test by an eye doctor (ophthalmologist) or Optometrist (ophthalmic optician)
Your child does NOT need to be old enough to read a letter chart. Optometrists can use a range of tests, even for babies, to identify if your child may have a lazy eye. The earlier it is diagnosed, the better the chance of improved vision for life
REMEMBER All children in the UK are entitled to free (NHS funded) eye tests
Amblyopia (lazy eye)
Amblyopia, more commonly called "lazy eye" is a condition where one eye has failed to develop the same quality of vision as its partner.
"Lazy eye" is a condition that is frequently associated with strabismus, or where there is a big difference between the refractive error (strength of glasses) of the two eyes
"Lazy eye" is a lifetime condition
"Lazy eye" is a condition that affects about 3% of children and is the major cause of (uniocular) sight loss in children
"Lazy eye" can also impact on choice of occupation with many professions requiring good binocular vision
Recent research has indicated that elderly patients with "lazy eye" have a greater risk of a fall
Any injury or disease to the "good" eye can seriously impact on a persons quality of life
Amblyopia Treatment 1 - patching
Medical treatment for lazy eye (amblyopia) is typically carried out by "patching" the good eye, however, at Shaylers Vision Centre, we consider this is a very negative treatment, it fails to improve the binocular system and can actually cause an increase in eye turn.
Long term studies often show that, though some improvement may initially take place it may not last ...
Consider this situation, a child is born with weak muscles in one leg. The "Ophthalmology" concept of treatment would be to strap up the good leg and make the child hop around on the weak leg - this is theoretically what they are doing with patching! A crazy concept???
In most cases we can consider that Amblyopia is part of a "binocular vision problem", patching does not address this binocular problem, though we may use some form of short term patching in vision therapy
Amblyopia, other wise known as “lazy eye”, is the most common cause of preventable blindness in children. . This type of “blindness” occurs in approximately 3 out of 100 healthy children. In amblyopia the loss of vision is not from a disease of the eye but rather the lack of development of the visual brain. Therefore, by definition, a child with amblyopia has healthy eyes, yet the brain can not see.!!!
Today’s “best practices” approach for the treatment of amblyopia involves a combination of monocular and binocular training of the visual brain through office-based vision therapy. This is done with a vision therapist under the direct supervision of a behavioural optometrist
"binasal" patching, which encourages the use of the right eye when looking to the right and the left eye when looking to the left as well as encouraging binocular view when looking straight ahead
drawing with a red pen, whilst wearing a red lens over the good eye -the good eye just sees a red sheet of paper, the uncovered "poor" eye sees what is being drawn, so the child is carrying out a monocular activity in a binocular world
red/blue anaglyphs (3D pictures) or special polarised picture activities to encourage and develop binocular fusion (see video)
We do not expect the "poor" eye to achieve the same standard as the good eye, but typically a minimum 2 to 3 line improvement
A Case Study of an 11 year old the hospital could not treat!
An eleven year old child discovered he could not see with one eye. He was taken by his parents to his GP who referred him to the hospital where a diagnosis of refractive amblyopia or lazy eye was made.
The hospital advised him that he could have specs, but he would not find them beneficial. He could try patching but as he was over 8 years old this process was unlikely to improve his lazy eye!
(NOTE: school screening missed his problem)
His parents brought him to Wareham. His Right eye was +3.50 =6/60 (just able to read the letter at the top of the chart). Left eye was plano = 6/6 (normal and no lens needed)
His lazy eye was fitted with a contact lens, to provide balanced magnification, which would not have been achieved with specs. Once he was comfortable and used to wearing his contact lens, vision therapy was instigated
He is now 16 years old and the improvements have remained
With his right eye he now reads the 6/9 line of letters (the line just above the normal line) or 6 lines further down the chart - no longer a "lazy eye"!
30 year old man with lazy eye blinded in good eye
This gentleman came for advice after he lost the sight of his good eye leaving him to "cope" with his remaining lazy eye, only able to read the top letter on the chart. The hospital could not help and simply registered him as "partially sighted". His previous occupation involved detailed figure work on an number of "work sites", which as could not drive or read was no longer possible!
Just 2 weeks after starting vision therapy, he was able to read small print and after 3 months, his vision was up to driving standard!