What is lazy eye?


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Ever wonder what lazy eye means? What is amblyopia? How do you get it? How do you treat it? This presentation will walk you through this functional vision problem so you can understand what lazy eye is and how you can be successfully treated by your developmental optometrist no matter your age.

Published in: Health & Medicine
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What is lazy eye?

  1. 1. What is Lazy Eye? Dominick M. Maino, OD, MEd, FAAO, FCOVD-A Professor of Pediatrics/Binocular Vision Illinois Eye Institute/Illinois College of Optometry Optometrist, Lyons Family Eye Care
  2. 2. What is Lazy Eye? Lazy eye is also called Amblyopia and is characterized by reduced vision in one or both eyes. It is often associated with many other vision problems as well.
  3. 3. What is Lazy Eye? Amblyopia is a binocular vision (two eyed), brain problem. (Most doctors forget this.) This vision loss is not caused by a disease.
  4. 4. What is Lazy Eye? If this is not caused by a disease, what does cause lazy eye?
  5. 5. What is Lazy Eye? In order for lazy eye to be diagnosed, you need various amblyogenic factors present and you must rule out the existence of any ocular disease.
  6. 6. What is Lazy Eye? What are these amblyogenic factors?
  7. 7. What is Lazy Eye? Amblyogenic factors include: High refractive error in one or both eyes and/or a constant eye turn.
  8. 8. What is Lazy Eye? What is refractive error? Nearsightedness (myopia) Farsightedness (hyperopia) Astigmatism
  9. 9. What is Lazy Eye? Nearsightedness (myopia) makes it hard to see far away. You usually need a very high amount of nearsightedness to cause amblyopia.
  10. 10. What is Lazy Eye? Nearsightedness is usually what is discovered by most vision screenings. Vision screenings often miss other vision problems.
  11. 11. What is Lazy Eye? Farsightedness (hyperopia) usually causes problems with near vision. It is often missed during vision screenings and it takes a relatively small amount to cause lazy eye.
  12. 12. What is Lazy Eye? Farsightedness (hyperopia) is often associated with blur at near, headaches, eyestrain, asthenopia and reading problems.
  13. 13. What is Lazy Eye? Astigmatism causes your vision to be blurry no matter where you look and depending upon the type of astigmatism present, even a small amount can cause amblyopia.
  14. 14. What is Deprivational Amblyopia? Deprivational Amblyopia is caused by a congenital cataract or other blockage of light getting to the back of the eye and is a pathological cause of non-functional amblyopia. This type of amblyopia is not being discussed today.
  15. 15. What is Lazy Eye? Another cause of a functional vision loss is a constant strabismus. This is an eye turned inward, outward, up or down. It must be a constant eye turn to cause amblyopia.
  16. 16. What is Lazy Eye? Strabismus Exotropia: an outward eye turn Esotropia: an inward eye turn Hypertropia: a vertical eye turn
  17. 17. At What Age Can You Treat Lazy Eye? Despite what you may hear from those who have not kept up with the latest research, Lazy Eye can be treated AT ANY AGE! Children, Adults and Seniors may all benefit from treatment.
  18. 18. How Do You Treat Lazy Eye? Treatment always starts with the best prescription glasses possible. This prescription may change over time as the functional vision loss improves.
  19. 19. How Do You Treat Lazy Eye? If wearing the glasses improves the vision in the amblyopic eye, the doctor will often suggest a change in the prescription or continued wearing of the glasses before other treatment options are considered.
  20. 20. How Do You Treat Lazy Eye? If wearing glasses does not continue to improve the vision in the amblyopic eye, your doctor may suggest patching the better seeing eye. Usually patching 2 hours/day while doing hand-eye activities at home will improve how the patient sees.
  21. 21. How Do You Treat Lazy Eye? If this does not improve the vision in the lazy eye, your doctor may suggest additional hours of patching and additional home vision therapy.
  22. 22. How Do You Treat Lazy Eye? There are times when some children will not wear their eye patch. If this happens the doctor may recommend using atropine in the better seeing eye. This blurs the better seeing eye at near and forces the amblyopic eye to be used. Usually 1 drop in the amblyopic eye on Saturday and Sunday works as well as 1 drop daily.
  23. 23. How Do You Treat Lazy Eye? Next comes optometric vision therapy. Vision therapy is a doctor-supervised, non-surgical, customized program of therapeutic procedures designed to prevent, remediate, and/or enhance vision problems and/or improve visual skills. Vision therapy can include the use of lenses, prisms, filters, computerized procedures and non-computerized instrumentation. The goal of vision therapy is to treat vision problems that cannot usually be treated successfully with eyeglasses, contact lenses and/or surgery alone, and help individuals of all ages achieve single, clear, comfortable binocular (two-eyed) vision using the scientific principles of neuroplasticity.
  24. 24. Amblyopia Treatment Summary Diagnostic Evaluation • Full eye examination (with dilation cycloplegic refraction) • Visual efficiency assessment • Specialized testing Glasses • Full time wear • Rx may change as vision improves Patching • Patch better seeing eye • As little as 2 hrs/day may work well • May recommend hand-eye activities also Eye Drops • Atropine is used if child will not wear patch • 1 drop on Sat & Sun works as well as 1 drop daily Vision Therapy • In office • Out of office • A treatment prescribed by your optometrist and individualized for the each patient
  25. 25. Amblyopia FAQs Where do I find a doctor that treats amblyopia and provides vision therapy? In Chicago go to Lyons Family Eye Care (LFEC). To find a doctor close to you go to the College of Optometrists in Vision Development, Optometric Extension Program Foundation and American Optometric Association websites.
  26. 26. Amblyopia FAQs What credentials should my doctor have so I know he/she will provide the best care? Your doctor should have one or more of the following: Completed a residency in pediatrics, binocular vision and vision therapy Fellowship and/or membership in the College of Optometrists in Vision Development Membership in the Optometric Extension Program Foundation Diplomate in Pediatrics/Binocular Vision from the American Academy of Optometry
  27. 27. Amblyopia FAQs Does vision therapy work for amblyopia? Yes! The College of Optometrists in Vision Development and the Optometric Extension Program Foundation have many articles supporting vision therapy for the treatment of amblyopia and other functional vision problems. The American Optometric Association also has Clinical Guidelines for amblyopia that include vision therapy as well. The National Institutes of Health National Eye Institute sponsored PEDIG clinical trials that support the interventions noted in this presentation about amblyopia. PUBMED lists hundreds of articles that clearly show amblyopia can be treated at any age.
  28. 28. Amblyopia FAQs Tell me more about vision therapy There are 4 phases to vision therapy Glasses Patching Eye Drops This was previously described Monocular • Hand-eye • Focusing • Eye movement Biocular • Same as noted in monocular phase and antisuppression Binocular • Same as noted previously plus convergence and divergence therapy Integration & Stabilization • Hand-eye, eye movement, focusing, convergence and divergence therapy done simultaneously
  29. 29. Amblyopia FAQs Tell me more about the vision therapy program Functional optometrists will use computer programs, lenses, prisms, and other specialized equipment during the therapy both in office and for you to use at home.
  30. 30. Amblyopia FAQs Tell me about home vision therapy Home vision therapy can vary from doctor to doctor. I recommend a minimum of 20 to 30 minutes per day, 5 days per week. Some doctors do not prescribe home vision therapy, but I find that the in office therapy program progresses at a faster rate of speed if home therapy is conducted.
  31. 31. Amblyopia FAQs What does vision therapy cost? This will vary from office to office but is comparable in cost to occupational, physical, and/or speech/language therapy. Some offices charge for each individual visit while others have a “program” similar to that of having braces applied by your dentist.
  32. 32. Amblyopia FAQs Does insurance cover the cost of vision therapy? Yes. No. Maybe. Some time ago most insurance would have picked up about 80% of the cost. Then my impression was that the insurance companies just seemed to stop reimbursement for therapy. Now they are once again picking up some of the cost. Know your insurance policy. Do not take “NO” for an answer. Your doctor’s office will usually assist you when it comes to insurance, but it is ultimately your responsibility.
  33. 33. Amblyopia FAQs Where do I learn more about treatment, especially from a parent’s or patient’s point of view? Go to: Parents Active in Vision Education Vision Therapy Parents Unite! Vision Therapy Changed My Life Convergence Deficiency/Insufficiency Living with Diplopia
  34. 34. Amblyopia FAQs Amblyopia InfoGraphic
  35. 35. Amblyopia FAQs Amblyopia InfoGraphic
  36. 36. Amblyopia FAQs Amblyopia InfoGraphic (Courtesy of VisionHelp.com)
  37. 37. Amblyopia FAQs Where can I get additional information on pediatrics, binocular vision, vision therapy, children wearing glasses and more? MainosMemos VisionHelp blog COVD blog Discovering Vision Therapy blog Wow Vision Therapy blog SOVOTO Little Four Eyes
  38. 38. Amblyopia FAQs Reading List Fixing My Gaze: A Scientists Journey into Seeing in 3 Dimensions By Susan Barry, PhD Eyes For Learning: Preventing and Curing Vision-Related Problems By Antonia Orfield When Your Child Struggles: The Myths of 20/20 Vision By David Cook, OD The Suddenly Successful Student: A Parents’ and Teachers’ Guide to Learning & Behavior Problems: How Behavioral Optometry Helps By Hazel Dawkins, E. Edelman, O.D. & C. Forkiotis, O.D. Suddenly Successful: How Behavioral Optometry Helps You Overcome Learning, Health & Behavior Problems By Hazel Dawkins, E. Edelman, O.D. & C. Forkiotis, O.D. Thinking Goes To School By Hans G Furth, Harry Wachs, O.D. Your Child’s Vision By Richard Kavner, O.D. See Vision Therapy Rocks for more resources
  39. 39. Amblyopia FAQs Where can I get additional help? Call or email us at Lyons Family Eye Care. Lyons Family Eye Care 3250 N. Lincoln Ave. Chicago, IL 60657 Click here to view a map of our location Phone Number: 773-935-2020 Email: info@lyonsfamilyeyecare.com “LIKE” us at Vision Therapy at Lyons Family Eye Care This PowerPoint template was provided free by www.presentationmagazine.com
  40. 40. About Dominick M. Maino, OD, MEd, FAAO, FCOVD-A