Milton Eye and Vision Care - Dr Ron Strohan

When Is It Too Late to Treat Lazy Eye?

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Eye Care, Lazy Eye

July 31, 2023

Treating Lazy Eye

Lazy eye, or amblyopia, is a condition that occurs when there’s a disruption in the normal development of vision during childhood, leading to reduced vision in one eye. Early detection of lazy eye can result in strengthened vision.

Routine children’s eye exams can assess an infant’s or child’s vision in both eyes to see if one is weaker or has poorer vision. Even without early diagnosis, treatment for lazy eye is possible. However, the effectiveness of treatment may vary depending on the age at which it is diagnosed and addressed.

Understanding Lazy Eye

Lazy eye typically develops during early childhood. With lazy eye, there’s a significant difference in the refractive error or prescription between the two eyes.

When one eye has better focus or alignment, the brain relies more on the “stronger” eye, neglecting signals from the weaker eye. Over time, the brain’s preference for better vision results in reduced visual acuity and poor depth perception in the affected eye.

Lazy eye can result from developmental problems in the brain and the following:

  • Strabismus (misaligned eyes).
  • Family history of amblyopia.
  • Damage to one of your eyes from trauma.
  • Drooping of one of your eyelids.
  • Vitamin A deficiency.
  • Corneal ulcer or scar.
  • Eye surgery.
  • Refractive errors, such as nearsightedness, farsightedness, or astigmatism.
  • Glaucoma, which is high pressure in your eye that can lead to vision problems and blindness.

Lazy eye isn’t always easy to notice in children. Symptoms or signs of lazy eye can include:

  • Bumping into objects on one side.
  • An eye wandering inward or outward.
  • Eyes not working together.
  • Poor depth perception.
  • Double vision.
  • Squinting .

Early Intervention Is Key

The earlier lazy eye is detected and treated, the higher the chances of successful outcomes. During early childhood, the visual system continues to develop until age 9 to 12, and the brain is more receptive to visual input.

This plasticity allows for improvements in visual acuity and binocular vision. Binocular vision is when you have a properly working visual system, and your brain receives signals from both eyes to create an image.

Typically, the recommendation is that infants undergo a comprehensive eye examination by an optometrist or ophthalmologist before they turn one, and follow regular screenings throughout childhood. The recommended eye exam schedule includes:

  • One eye exam between the ages of 2 and 5 years.
  • Annual exams in school children aged 6 to 19 years.

During a children’s eye exam, your eye doctor will conduct tests to check vision clarity, eye muscle strength, and focusing ability. They can do this in the following ways:

  • Asking your child to identify letters or shapes on a chart.
  • Having your child follow a light with each eye, and then both eyes.
  • Looking at their eyes through a magnifying device .

Is It Too Late to Treat Lazy Eye?

As a general guideline, the earlier the treatment, the better the chances for improvement. After age 8, vision improvement can drop significantly, but this doesn’t mean treatment will be ineffective beyond this age.

Evidence shows that treatment for lazy eye in older children does result in improvements in visual function. One study found that 53% of children aged 7–12 showed a positve treatment response.

It’s important to note that the extent of improvement may vary in individuals. Regular visits to your eye doctor can help determine effectiveness even after the critical period has passed.

Treatment Options for Lazy Eye

Treatment Options for Lazy Eye

The primary goal of lazy eye treatment is to strengthen the weaker eye and promote binocular vision. A common treatment approach is to patch the stronger eye, forcing the weaker eye to work harder and develop better visual acuity, encouraging the brain to reestablish connections with the weaker eye and improve its visual function.

Other treatment options may include the following:

  • Glasses or contact lenses: Prescribed corrective eyewear for conditions that can cause lazy eye, such as refractive errors.
  • Atropine eye drops: These work similarly to an eye patch—the drops temporarily blur vision in the stronger eye to encourage using the weaker one.
  • Vision therapy: Includes eye exercises to improve eye coordination and focus Surgery: Can address the underlying causes of lazy eye, such as crossed eyes.

Customized Treatment for Lazy Eye

Lazy eye is a treatable condition, but early intervention is key for helping to strengthen vision. Detecting and addressing lazy eye during early childhood offers the greatest potential for improvement. However, treatment can still be effective beyond this age, with individuals of all ages experiencing visual acuity and binocular vision improvements. If you suspect your child may have a lazy eye, book an appointment with Milton Eye and Vision Care. Our team can provide a comprehensive evaluation, determine a course of treatment with a customized treatment plan, and guide you through the process to help improve you visual function and quality of life.

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Written by

Dr. Ronald Nicholas Strohan

Dr. Strohan has been an integrative optometrist in the Milton, Ontario area for over 40 years and has always stayed true to his philosophy of focusing on excellent patient eye care. He has studied behavioural optometry for more than 4 decades and is passionate about providing clear vision for patients of all ages. He takes pride in offering the latest eye care products and advancements in vision therapy.

See his other articles
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