How to Get Rid of a Lazy Eye (with Pictures)

2024 Author: Samantha Chapman | [email protected]. Last modified: 2023-12-17 09:13

Lazy eye, whose medical term is amblyopia, is an eye disorder that typically develops in early childhood and affects 2-3% of children. It is often a hereditary problem and is treatable if diagnosed early, but can cause loss of vision if neglected. Although amblyopia is evident in some cases, it is not always easy to spot it in children. Sometimes not even the child is aware of the problem; you should see an ophthalmologist or orthoptist as soon as possible to diagnose and treat it. There are techniques that help you understand if your child has a lazy eye, but you should always consult an ophthalmologist, preferably a pediatric one.

Steps

Part 1 of 6: Controlling the Presence of the Lazy Eye

Step 1. Learn about the causes of amblyopia

This disorder occurs when the brain has difficulty communicating correctly with both eyes, for example when one has much better visual acuity than the other. As a single disease, amblyopia is difficult to detect, as it may not be accompanied by any obvious deformities or abnormalities. A visit to the ophthalmologist is the only way for an accurate diagnosis.

• Strabismus is a very common cause of this problem. It is a misalignment of the visual axes in which an eye is deflected inward (exotropia), outward (exotropia), upward (hypertropia) or downward (hypotropia). Commonly, we speak of "crooked eyes". Eventually the "straight" eye dominates the visual signals that are sent to the brain and squint amblyopia sets in. However, not all cases of lazy eye are related to an ocular deviation.
• For example, it could be the result of a structural problem, such as eyelid ptosis.
• Other eye conditions, such as cataracts (a clouding of the lens) or glaucoma, can cause lazy eye. In this case we speak of "deprivation amblyopia" and must be treated surgically.
• Severe refractive differences between one eye and another (anisometropia) can also cause amblyopia. For example, some individuals have one myopic eye and the other farsighted (in this situation we speak of antimetropia). The brain in these conditions "chooses" the images sent by one eye and ignores the other. In this case we speak of "refractive amblyopia".
• Sometimes bilateral amblyopia, that is, it affects both eyes. A baby, for example, could be born with a congenital cataract in both eyes. The ophthalmologist can diagnose and treat this type of lazy eye.

Step 2. Look for common symptoms

The child may not even complain of his bad vision. Over time, an amblyopic person gets used to having better visual acuity in one eye than the other. The eye examination is the only method to ensure that the child has a lazy eye; however, there are some signs and symptoms you can look out for.

• Bad depth perception. The child may have some difficulty with depth perception (stereopsis) and may not be able to see 3-D movies. He may also complain that he cannot see distant objects, such as the blackboard in school.
• Strabismus. If your baby's eyes are misaligned, he may be suffering from strabismus, a common cause of amblyopia.
• The child often squints his eyes, rubs them and tilts his head. These can all be signs of blurry vision, a symptom present in amblyopia.
• The child gets angry or nervous if someone covers one eye. Some children react in this way when one of their eyes is covered and this could be a sign that the two eyes are not sending the same visual signal to the brain.
• Difficulty in school. Some children have problems with school performance because they are partially sighted. Talk to the teacher and ask if your child makes excuses when asked to read from a distance (for example, he may say he is confused or has itchy eyes).
• You should ask your eye doctor to see your baby when he is under six months old, looking for squint or vision problems. Vision is still developing at this age, so the tests you can do at home are inconclusive.

Step 3. Test with a moving object

See if one eye of the child reacts to a moving object slower than the other. Take a pen with a bright colored cap or another brightly colored object. Ask your child to stare at a specific part of the object (e.g. the pen cap or the lollipop ball).

• Ask him not to look away from the point he has chosen while following the movement with his eyes.
• Move the object slowly to the right and then to the left. Then move it up and down. Look closely at the baby's eyes as you move the object; you should notice if one of them follows it slower than the other.
• Cover one eye and move the object left, right, up and down again. Now cover the other eye and repeat the test.
• Observe the reaction of each eye to the movement. In this way you will be able to understand if one of the two is moving more slowly.

Step 4. Take the photo test

If you believe your child's eyes are misaligned, then you can verify this by looking at the photographs. This technique offers more time to analyze looking for signs of any problem. This is especially useful when you need to evaluate babies or toddlers who don't pay much attention for too long during a check of their eyes.

• You can use photos you've already taken if they clearly show eye details. If you don't have any photos available, ask someone to help you take new ones.
• Take advantage of the corneal reflection of light from a stylus flashlight to exclude lazy eye. Ask your caregiver to hold a small stylus flashlight approximately 90 cm from the baby's eyes.
• Ask your child to look at the light.
• As soon as you see the reflection of the light in your eyes, take a picture.

• See if the reflections are symmetrical in the pupils or irises.

  • If the light is reflected in the same spot in each eye, then there is a high probability that there is no misalignment.
  • If the reflections are not symmetrical, one of the two eyes can be deflected inwards or outwards.
  • If in doubt, take several pictures at different times to check the eyes several times.

  

  Step 5. Run a cover-uncover test

  This test is done on babies who are at least six months old. The aim is to determine the correct alignment of the eyes and to understand if they work in the same way.

  • Have your child sit in front of you or ask your partner to hold him. Close one eye with your hand or a wooden spoon.
  • Ask the child to look at a toy with the uncovered eye for several seconds.
  • Find out the eye you closed and see how it responds. Try to figure out if this "snaps" back into alignment after deflecting orientation while covered. This reaction may indicate an eye problem that needs to be investigated by the pediatric ophthalmologist.
  • Repeat the test with the other eye.

  Part 2 of 6: Submit the Child for a Pediatric Eye Exam

  

  Step 1. Find a good pediatric eye doctor

  It is an ophthalmologist who deals mainly or exclusively with the sight of children. Although any ophthalmologist can evaluate, diagnose and treat children's eye diseases, pediatric ones specialize precisely in the ailments of young patients.

  • Search online to find a doctor in your area. You can also consult the website of the register of ophthalmologists in your province.
  • If you live in the countryside or in a small town, you will probably need to look for a specialist in the nearest town.
  • Ask friends and family who have children for some advice. If you know someone with children who have vision problems, ask them to recommend a good eye doctor. This way you can get an idea if the doctor is right for your needs.
  • If you have private health insurance, you can go to an affiliated private practice. If in doubt, call the relevant agency and ask for confirmation that the doctor you are considering is working with your insurance company.

  

  Step 2. Familiarize yourself with some tests and diagnostic tools

  The ophthalmologist will determine the vision of your child's eyes and the presence of any medical conditions to determine if he has a lazy eye. If you understand and know the procedures, you will feel more comfortable during the visit and, as a result, your child will feel comfortable.

  • Retinoscopy. The doctor may use a hand tool, called a retinoscope, to examine the eye. In practice, it projects a beam of light inside the eye and moves it to understand if there is a refractive defect (myopia, astigmatism, hyperopia) by observing the red retinal reflex. This method is very useful for diagnosing tumors and cataracts as well. The doctor will most likely instill eye drops into the child's eyes to dilate the pupils before proceeding with the examination.
  • Prisms. The ophthalmologist may use prismatic lenses to observe the baby's corneal reflexes. If the reflections are symmetrical, the visual axes are well aligned; if they are not symmetrical, the child may be squinting (a cause of amblyopia). The doctor will hold a prismatic lens over one eye, gradually changing its power, until the reflections appear symmetrical. This technique is not as accurate as other strabismus tests, but it is indispensable when visiting a very young child.
  • Test for visual acuity. This type of exam involves several tests. The simplest and most familiar one uses "the optotype", a table with standard-sized letters that are gradually smaller and smaller that the child has to read. There are also other tests that evaluate the reaction to light, the pupillary one, the ability to follow a target, the control of color perception and remote examinations.
  • Photoscreening. This is a widely used test for evaluating ocular problems in pediatric patients. A camera is used that is able to identify visual anomalies such as strabismus and refractive defects thanks to the observation of retinal reflexes. Photoscreening is really very useful with young children (under three years of age), with those who are restless, uncooperative or who do not speak, for example because they suffer from autism. This test is generally very quick and takes no more than a minute.
  • Examination of refraction in cycloplegia. Thanks to this test it is possible to understand how the structure of the eye receives and transmits the images received by the lens. The doctor uses eye drops that dilate the pupil to test the baby.

  

  Step 3. Tell your child what will happen

  Young children may fear new situations, such as a visit to the doctor. If you explain to them what to expect during the procedure, you can calm them down and reassure them. This way your child is more likely to behave appropriately during the procedures. Whenever possible, make sure that he is not hungry, thirsty or sleepy when you take him to the ophthalmologist, otherwise he could be annoyed and make the visit more complex.

  • In all likelihood, the ophthalmologist will instill eye drops to dilate the baby's pupils. In this way he will be able to determine the possible refraction defect.
  • Additionally, he might use a stylus flashlight or other light source to observe corneal reflections.
  • The ophthalmologist may also use objects or photographs to evaluate ocular motility and strabismus.
  • The ophthalmoscope, or a similar instrument, allows to establish the presence of ocular diseases or anomalies.

  

  Step 4. Make your child feel comfortable with the doctor

  If a visual problem is encountered after the visit, the child will most likely have to spend a lot of time in the eye study or several appointments will be needed for checkups. Children who wear glasses, at a minimum, have to undergo one exam per year. The child and the ophthalmologist should have a pleasant cooperative relationship.

  • You should always feel that the doctor really cares about your child's health. If the ophthalmologist you chose at the beginning does not want to answer your questions and does not establish a relationship with you, contact another professional.
  • You shouldn't be treated hastily or bothered by the doctor. If you have had to wait too long, have had the feeling that you have been "liquidated" during the visit or the doctor has treated you as a "nuisance", do not hesitate to seek another ophthalmologist; eventually you will find a doctor that suits your needs.

  

  Step 5. Learn about the various treatments

  After evaluating your child's vision, the ophthalmologist will recommend the most appropriate care for him. If you have experienced amblyopia, possible treatments include the use of glasses, eye patches, and medications.

  There are chances that muscle surgery will be recommended to realign the eyeball. This procedure is performed under general anesthesia. The surgeon makes a small incision in the eye and then lengthens or shortens one or more muscles, depending on the type of correction that needs to be made. Sometimes an eye patch is required

  Part 3 of 6: Treating Amblyopia

  

  Step 1. Close the "healthy" eye with an eye patch

  When a diagnosis of amblyopia has been made, it is usually necessary to apply an eye patch or patch as part of the recommended treatment. This forces the brain to "use" the weaker eye. For example, although surgery has corrected a problem such as refractive amblyopia, it is still necessary to use the patch for a short time, to force the brain to recognize the visual signals sent by the eye that has so far been ignored.

  • Ask your doctor to give you some patches as a sample. For this technique to work, the entire dominant eye must be covered. Your doctor will teach you how to apply it.
  • You can use an elastic bandage or an adhesive plaster.
  • There are many types of patches on the market, do some research online.

  

  Step 2. Have the child wear the occlusion for 2-6 hours a day

  In the past, it was recommended to keep the eye covered all day, but recent studies have shown that children's vision can improve with just two hours of occlusion per day.

  • Your ophthalmologist may advise you to gradually increase the use of the patch until the recommended time is reached. Start with three 20-30 minute sessions per day. Gradually increase the time until your child wears the occlusion every day for as long as the doctor recommends.
  • Older children and those with severe amblyopia need to use the patch for more hours per day. The ophthalmologist will give you all the information about it.

  

  Step 3. Check for improvements

  Occlusion therapy can lead to improvements even within a short time, such as a few weeks. However, it takes several months to achieve lasting results. Monitor progress by having your child visit monthly or at the frequency recommended by the ophthalmologist.

  • Keep monitoring the evolution every month; amblyopia is known to improve with 6, 9, or 12 months of treatment. The answer varies according to the individual characteristics of the child and how he wears the patch.
  • As long as you see progress, keep putting your baby under occlusive therapy.

  

  Step 4. Engage him in activities that require hand-eye coordination

  Make sure that the weak eye is stimulated to work while the dominant one is covered by the patch; in doing so, the treatment will be even more effective.

  • Offer him artistic activities that involve coloring, painting, stitching, cutting and gluing.
  • Look with him at the pictures of a children's book and read the text together.
  • Ask him to focus on the details of the illustrations and to pay attention to the words of the story.
  • Remember that his depth perception is reduced due to occlusion, so games involving throwing and receiving objects could be a problem.
  • Video games could help develop eye coordination for older children. Do your research online, as computer games have been released on the market that are designed to treat amblyopia. Alternatively, ask your ophthalmologist if this option may prove useful for your child.

  

  Step 5. Stay in touch with your doctor

  Sometimes the treatment does not bring the desired results because the visual system and the brain of children are very plastic and adapt quickly to different situations. The ophthalmologist is the best person to evaluate it. For this reason it is very important to develop a collaborative relationship with him, to always be informed of the new options available for the child.

  Part 4 of 6: Evaluating other Treatments

  

  Step 1. Ask your doctor about atropine

  This is an alternative if your child is unable or unwilling to wear the patch. The drops of atropine blur the vision of the dominant eye forcing the little patient to use the "weak" one. This eye drop does not cause a burning sensation like others.

  • Some studies seem to suggest that atropine is as effective as occlusive therapy for the treatment of amblyopia, if not more so. This may be partly due to the fact that the drops cause less social isolation than the patch and therefore the child is more likely to cooperate.
  • There is no need to use eye drops as much as the patch.
  • Atropine has side effects, so don't use it without your eye doctor's advice.

  

  Step 2. Evaluate Eyetronix Flicker Glass treatment

  If your child's amblyopia is refractive, this treatment could be an effective alternative. It is very similar to sunglasses and works by rapidly occluding and opening one eye according to the frequency prescribed by the ophthalmologist. These glasses may be a good choice for older children or those who are unresponsive to other treatments.

  • This method is more effective for small patients with moderate anisometropia amblyopia (ie amblyopia caused by a different refraction in the two eyes).
  • Treatment with Eyetronix Flicker Glass typically lasts 12 weeks. It will likely not be effective if your child has already attempted occlusive therapy.
  • As with any other alternative treatment, always ask your eye doctor for advice before trying.

  

  Step 3. Consider RevitalVision treatment for amblyopia

  This visual training method uses a computer to stimulate specific changes in the baby's brain to improve vision. The computer treatment (on average 40 40-minute sessions) can be followed at home.

  • It can be particularly effective for older patients suffering from amblyopia.
  • You will need to consult an ophthalmologist to purchase this product.

  Part 5 of 6: Taking Care of the Eye Area

  

  Step 1. Monitor the eye area

  The surrounding skin may become irritated or infected while using the patch. If you notice any rashes or lesions around the eye, call your eye doctor or pediatrician to find out how to treat them.

  

  Step 2. Reduce irritation

  Both elastic and adhesive bandages can inflame the skin around the eye and cause a mild rash. If possible, choose hypoallergenic patches to reduce the risk of skin problems.

  Do an online search to find the products that are most respectful of your child's skin. The Ortopad brand offers hypoallergenic patches that can also be applied to glasses. You should always ask your eye doctor for advice

  

  Step 3. Change the size of the patch

  If the skin under the sticky portion of the occlusion becomes irritated, then try to cover a larger area than the patch using gauze. at the end fix the gauze with medical tape; at this point you can apply the patch directly to the gauze.

  You can also cut out part of the sticky area so that it touches a small portion of the skin. Just make sure the whole eye is covered and the patch doesn't come off

  

  Step 4. Try an occlusion that can be attached to the glasses

  These do not come into contact with the skin, so they cannot irritate the skin. It is a good solution for children with sensitive skin.

  The patch over the lens offers good coverage of the dominant eye; however, it may be necessary to add a side panel to prevent the child from "peeking" around the occlusion

  

  Step 5. Care for the skin

  Wash the area around your eyes with water to remove any irritants that may remain after removing the patch. Use an emollient or moisturizer to keep the affected area soft. This allows the skin to heal on its own and protects it from future inflammation.

  • Skin creams and ointments can reduce inflammation, but you must strictly follow the instructions contained in the leaflet and do not abuse them. In some cases the best treatment is not to act and let the skin "breathe".
  • Talk to your pediatrician for advice on the best treatment for your child's skin irritation.

  Part 6 of 6: Providing Support for an Amblyopic Child

  

  Step 1. Explain to him what is happening

  For occlusive therapy to be successful, the child must follow it for as long as indicated. It will be easier for him to cooperate if he is told why he has to wear the patch.

  • Describe how the patch can help him and what might happen if he doesn't wear it. Remind him that occlusive therapy will make his eye stronger. Without frightening him, tell him that without this treatment his vision will deteriorate.
  • If possible, involve him in organizing the daily occlusion schedule.

  

  Step 2. Ask friends and family members for support

  Communication is the key to helping your child feel comfortable with the patch. Children who are ashamed or embarrassed by the treatment are unlikely to respect it properly.

  • Ask people who come in contact with your child to show empathy and encourage them to continue with treatment.
  • Remind your child that there are several people he can turn to if he has a problem. Be honest in answering their questions. Explain to friends and family the function of the patch so they can support the baby.

  

  Step 3. Talk to your child's teacher or kindergarten caregiver

  If the child has to wear the occlusion during school hours, describe the situation to his educators.

  • Ask the teacher to explain to classmates why your child needs to wear the patch and tell them to help. Inform school staff and teachers that teasing about the occlusion will not be tolerated.
  • Also consider the opportunity to implement special school measures for the period in which the child has to wear the occlusion. For example, ask the teacher to give your child more time for particularly demanding homework, to develop a tutoring or study program, and to check his student progress each week. This way the child will feel less intimidated by the presence of the patch and can continue to have good grades at school.

  

  Step 4. Support the child

  Despite all your best efforts, his peers may still tease him or throw offensive comments at him because of the occlusive therapy. Listen to your child's complaints, calm them down and reassure them that the patch is only a temporary measure and that it will lead to good results.

  • You should think about wearing a band-aid too as a sign of solidarity. Even if you only do this on an occasional basis, your child may feel less ashamed of wearing the occlusion, if adults wear it too. Patch dolls and stuffed animals as well.
  • Encourage him to view the occlusion as a game and not as a punishment. Although he understands that the patch is necessary for a good reason, he may see it as a punishment. Show him pictures of pirates and other "strong" characters wearing the eye patch. Suggest that he can challenge himself by holding the occlusion.
  • There are several children's books that deal with occlusive therapy. You can do some research online, in the library or in bookstores with a large children's section. Knowing that other children are using the patch will help your child live the experience normally.

  

  Step 5. Establish a reward system

  Make sure to reward the child when he wears the patch without complaining or resisting. Rewards help keep him motivated (remember that young children don't have a good sense of long-term results and rewards).

  • Display a calendar, black or white board to record your progress on.
  • Give him small rewards such as stickers, pencils, or small toys when he achieves certain goals, such as wearing the patch every day for a week.
  • With very young children, use treats as a distraction. If your child, for example, tears off the occlusion, put it back on and give him a toy or other treat to distract him from the patch.

  

  Step 6. Help your child adjust every day

  Each time you place the occlusion on his dominant eye, the brain needs 10-15 minutes to get used to this situation. Amblyopia occurs when the brain ignores visual messages coming from one eye, but the occlusion forces the brain to consider them. This experience could scare your child who is not used to this condition. Spend time together to comfort and reassure him.

  Do something fun with him to help him get through this transition more easily. Let him develop a positive association between the patch and a pleasant experience, so that the occlusive treatment is easier to manage

  

  Step 7. Be creative

  If you have to use an adhesive plaster, let your child decorate the outside with stickers, glitter, or pencil drawings. Ask your eye doctor for advice to make sure the decorations you use are safe and how you can apply them without doing any harm.

  • Never decorate the inner side of the occlusion (the one that rests on the face).
  • Some image websites, such as Pinterest, offer several suggestions regarding this type of decoration.
  • Throw a creative party. You can give your child's friends some new patches to color and embellish. This way the child will feel less isolated during the treatment.

  Advice

  • Follow the techniques described in this article in combination with the treatment prescribed by the ophthalmologist. Do not attempt to diagnose and treat lazy eye on your own without consulting an ophthalmologist or orthoptist.
  • Always keep communication open with your child and also with the doctor. Ask the ophthalmologist any questions that arise.
  • If your child has a squinting eye, tell the photographer so that he or she takes a position that minimizes the evidence of deviation in the photographs. In this way you help the child not to be too embarrassed when, for example, he has to lend himself to class photos at school.

  Warnings

  • If amblyopia is a birth defect, remember that the rest of the body developed in the womb at the same rate. Ask your pediatrician to check your child carefully for other problems.
  • If you notice any abnormal side effects, take your child to the emergency room or contact your pediatrician immediately.
  • Any eye problem should be brought to the attention of an ophthalmologist. Early diagnosis and treatment are essential to prevent vision loss.
  • If amblyopia is left untreated, the child may experience mild or even severe loss of vision.