Lazy Eye

Diagnosis

Diagnosis for lazy eye begins with a detailed eye exam to check overall eye health, detect a wandering eye, identify differences in vision between the eyes or assess for poor vision in both eyes. Eyedrops are commonly used to dilate the eyes, causing temporary blurred vision that may last several hours or up to a day.

The method used to evaluate vision depends on the child’s age and development:

• Preverbal children: A lighted magnifying device may be used to detect cataracts. Other tests assess an infant’s or toddler’s ability to focus and follow moving objects.

• Children age 3 and older: Vision tests using pictures or letters are used. Each eye is covered one at a time to assess the other.

Treatment

Starting treatment early is essential, ideally before age 7, when the brain and eye connections are still developing. However, many children between ages 7 and 17 also show improvement with treatment.

Treatment options depend on the underlying cause and the severity of the vision difference. Options may include:

• Corrective eyewear such as glasses or contact lenses to treat nearsightedness, farsightedness or astigmatism

• Eye patches worn over the stronger eye for several hours daily to stimulate the weaker eye

• Bangerter filters placed on the eyeglass lens of the stronger eye to blur vision and encourage use of the weaker eye

• Eyedrops containing atropine to temporarily blur vision in the stronger eye, often used on weekends or daily

• Surgery for conditions such as droopy eyelids, cataracts or persistent eye misalignment despite corrective lenses

Activity-based therapies like drawing, puzzles or computer games are sometimes used, though their added benefit is not yet proven.

Most children experience improved vision within weeks to months, with treatment lasting from six months to two years. Ongoing monitoring is important because lazy eye can return in up to 25 percent of children, requiring treatment to restart.