What is amblyopia(lazy eye)?

It is very difficult sometimes for some patients and their family (parents) to understand this term which is why today it shall be explained in the simplest terms possible.

In past articles we have mentioned amblyopia (lazy eye) whilst talking about other diseases. Today we will continue to enrich our knowledge of ophthalmology by dedicating our chat to this affliction as it is the most common cause of visual impairment in childhood. You will remember, my fellow reader, that light coming from the exterior entering the eye is converted into a sign or nervous impulse which travels to the brain via the optic nerve and the brain’s response is the image that we perceive and we are able to see our environment. {{more}}We will now define amblyopia as a medical term used when the vision in one eye is reduced due to the brain and this eye not working together properly with the eye itself having a normal appearance; the other eye is favored by the brain. In the majority of cases there is no abnormality in the anatomy of the affected eye; we will remember that brains’ visual cells start developing as from birth, the first three months being the most fundamental.

What causes amblyopia?

The most frequent cause at birth is when the eyes are not well aligned (strabismus). Another important cause is anisometropia (different vision/prescription in each eye), in this case the brain when confronted with this difference always takes the easier option, that is, it chooses the eye that has the best vision and simply abandons the other. Other causes occur when there is difficulty in light entering the eye for example, congenital cataract, ptosis (droopy eyelid) and corneal cloudiness.

The baby should be taken to the ophthalmologist if any of the following is observed:

• sensitivity to light,

• white spot in the pupil,

• deviated eyes, and

• visual difficulty.

Successful treatment of amblyopia is achieved in most cases if the disease is detected at an early age (before the child is one year old) and its objective would be to obtain and maintain a utile vision in the lazy eye or getting the brain to use this eye. In order to achieve this there are several forms of treatment such as the occlusion (using an eye patch) of the unaffected eye so that the lazy eye is obliged to work, if there are any refractive problems existing (high myopia, hyperopia, high astigmatism) glasses or contact lens are prescribed whilst congenital cataract, ptosis and corneal cloudiness are corrected surgically as early as possible. The surgery would then facilitate the immediate commencement of the before mentioned treatments and the visual rehabilitation to try and accomplish a good vision.

Amblyopia can only be corrected in childhood and not in adulthood hence the importance of its early detection and treatment before it is too late. Do not forget my fellow reader that our children are our relievers and tomorrow’s hope.

I would like to end this article expressing my profound apologies to all of my patients (especially those who were recently operated) for the abrupt interruption of my attention. This was due to circumstances totally out of my control although I did everything possible to continue seeing you until this service is continued by another physician. My profound gratitude to my fellow colleagues and all my patients for keeping me in mind, I will always remember the hundreds of patients who on a daily basis would tell me:

“GOD BLESS YOU DOC”.

Dr Pedro A. Ferrer Suarez

Cuban-Vincentian Ophthalmologist