Amblyopia: What does the Data Say?

April 2021

Amblyopia is an impairment of the vision in one or both eyes. It's usually caused by abnormal visual development during childhood, but may also be present at birth. Amblyopia leads to decreased vision and a poorly developed field of vision.

In some cases, symptoms of lazy eye develop gradually as the person ages due to the brain’s inability to learn how to process two images coming from each eye into a cohesive three-dimensional image.

A lazy eye is sometimes mistakenly called an "amblyopic" eye, when the condition is due to developmental or visual deprivation in childhood. The importance of vision rehabilitation to the amblyopic adult and child has been well recognized for some time; however, most rehabilitation programs have been designed for children.

At this time, there is no published evidence of the benefit of vision rehabilitation programs for adults with amblyopia. Several types of therapy are used in vision rehab to treat amblyopia. The most common treatments are occlusion therapy and vision therapy.

Amblyopia may be present in both eyes, but if only one eye is affected, the other eye can develop normal sight. In this case, the primary goal of treatment is to achieve binocular vision (using both eyes together) using methods similar to those used in treating strabismus (squint). The patient learns to see out of both eyes together; however, only when the patch is removed.

Experience shows that children with both eyes amblyopic may have a better chance of developing binocular vision if patches are not required. Getting the amblyopic eye to look in the direction of the healthy eye (perpendicular gaze) is also important. The patch is then gradually removed, leaving only so much correction as is needed to get a good near vision and some concomitant benefits such as stereopsis (depth perception).

In some cases, when neither eye has been treated, one or both eyes may eventually develop good vision. This requires no special treatment and does not lead to "amblyopia". It occurs when one of the eyes doesn't develop properly in early childhood. The brain learns to use images from the stronger eye to see instead of the weaker eye. But if you don't treat amblyopia quickly enough, problems with depth perception can develop in adulthood and become permanent.

The good news is that it's simple to fix this problem — with just a patch or some glasses and treatment from an orthoptist or ophthalmologist – and icky medications aren't needed! Behavioural Optometry and Vision Therapy  is one way to treat amblyopia. Today's Refractionists are the last hope for these children, whose parents have been told that nothing else will ever work! It is because of this that many Vision Therapists, Optometrists and Orthoptists are currently fighting in court to keep parents from taking their children out of public schools in order to seek treatment for their lazy eye. Of course, all of these professionals do not believe that they are murdering the ability of a child to focus, but rather saving them by "just wearing glasses." Glasses only cover up the problem temporarily. They do not permanently correct it.

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