Berkeley Parents Network: Amblyopia (Lazy Eye)

Berkeley Parents Network

Amblyopia (Lazy Eye)

Berkeley Parents Network > Reviews > Health & Medical > Amblyopia (Lazy Eye)

Questions

Lazy Eye not improving after Patching
My 1 year old daughter has a lazy eye
2-year-old's eye turning inward after cold
Optometrist for child's lazy eye
4-year-old diagnosed with severe amblyopia

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Lazy Eye not improving after Patching

July 2011

Hi..My son diagnosed with Lazy Eye from first year. We were given patching for some time and had surgery for his crossed eyes. Later given patching and his vision improved. We discontinued patching for some time and his lazy eye problem started again. He is now 4+ . We were asked to give patching for 4 hours/day but that didn't helpimproving his vision. Doctor suggested to apply drops on good eye for 2 months. That way he can use the lazy eye fully. Due to this, the good eye got affected and power is increased. Doctor asked to discontinue that treatment. Now everyday we are giving patching for 6 Hours and recently tested his eyes and there is no improvement.

Any of you faced similiar problem like vision not improving on Lazy eye ? what kind of action you have done to improve the vision??. I am more scared because he is growing and may not be able to get his vision. Any alternate treatments are available to jump start the vision of the affected eye? Your help on this greatly appreciated !! Manny

Unfortunately, 4+ may be too late for any further improvement. On the positive side, though, I had patches as a preschooler, and they didn't provide any lasting benefit. But I've gotten along fine anyway with just one good eye. jennifer

I had lazy eye as a child, pretty severely. I had one surgery at age 8 to correct it but am told three is common. It worked out beautifully since the correction was so close. I did have to wear glasses with prisms in them to correct the eye until I was about 18.

As you know, if lazy eye isn't properly corrected you can go blind; I have retained full function in my bad eye and my eyes look straight. So from my POV, surgery & corrective glasses worked very well and were a lot easier to deal with than having a patch over my eye for years. --Hope this helps

I had a lazy eye as a child. It was not diagnosed until I was 5 years old. The first few years treatment was not successful as i was only given corrective lenses. Later I did vision therapy throughout the Binocularvision Clinic at UC School of Optometry and was given bifocals to train my eyes to work together. Now my eye only turns in when I don't wear glasses to correct the imbalance between my prescription. I suggest switching eye drs. I will only take my kids to UC now. Lazyeyed mom

Hi there

my son was diagnosed with Lazy eye when he was 5. the doc said(consulted 2 docs & both said this), the earlier u try to rectify the better it is but the chances of improvement is much higher till the age of 11. so please keep trying. Also the cause for lazy eye might matter in recovery too. in some cases (like ours) surgery is not an option the only way is to do eye patch. and fortunately aT 7 it has reduced quite a lot. he can read with his week eye almost as much as the other eye. Here are a few things to keep in mind.

1. you have to be very strict/disciplined about patching. sometimes the kids try to see thru the wholes in the patch.

2. While our doc in the US said it was good enough to patch 2hrs/day we didn't see much improvement in it. When we were vacationing in India we visited my parents eye doc who strongly suggested we patch more often. So we increased it to all evenings and all the time he watched TV or read books or anything that required eye concentration. this helped a lot.

3. another piece of advise i got from a parent which helped as well is doing eye exercise. have ur child look up straight and concentrate at ur fingers while u move them from right to left and back. and repeat the saME FROM top to bottom. Make sure that he doesn't move his head up and down or side wAYS but simply move his eyes round. Shree

My 1 year old daughter has a lazy eye

Oct 2008

I have a 1 year old daughter that has a lazy left eye and she has been doing that since she was 6 months old, and i am not shure what i should do she does'nt do it all the time just maybe 89% of the time exspecialy when she is looking at you from ferther away.

I do have an eye Doctors appionyment for her on Nov/28/08 but i am hoping i can find out what i can do and what they might do for her since i really dont want her wearing glasses i dont want her going throu school being made fun of so i want to know if there is anything eles they can do? like lazer eye surgery??

Please any advice will help me, poeple or always asking me why she is crossing her eyes at them she for some reason does it more to poeple she does'nt know?? i really dont know why sounds weird i know, but she does'nt do it all the time i have tons of pictures of her with her eyes normal and i see her alot with her eyes going back to normal but then she will do it again only that left eye? if you have been throu the same thing let me know what you have done and what the doctors did? and anyone that just knows somewhat about this ''lazy eye'' problem? Thanks

My son (now 17) had/has lazy eye (amblyopia). It was diagnosed in kindergarten. I'd highly recommend going to the UC Pediatric Optometry clinic. They can do thorough exams and testing and are TOTALLY set up for kids (so that they thnk it's fun). It would be good to deal with this now when she's very young so that you can help her strengthen her eye sooner. There's a time when the brain is developed to a certain point and the eye will no longer strengthen(they say). My son wore a patch on his strong eye for x hours each day. He had eye exercises to do. Unfortunately as the years went on he became less cooperative, but there was a fair amount of improvement. There is one can do to work with lazy eye. Good luck. anon mom

I don't even know where to start about your post. If you think about what you're saying... it's pretty appalling. Your daughter has a very treatable condition that is not life threatening but you haven't sought services for 6 months because you are embarrassed to have a child who with glasses because they will look, I don't know, nerdy? dorky? Your child is 1 year old! Seriously... Imagine your daughter's world, she probably doesn't see things around her very clearly and may have never clearly seen your face or leaves on trees or animals at the zoo. It's so sad that you're keeping her from experiencing the world because you're worried about what she looks like.

Early intervention with glasses and possibly surgery is the only way to treat lazy eye. If you don't treat the lazy eye now, your daughter will definitely have lazy eye, possibly worse than it is now, for the rest of her life. The eyes are constantly changing as children grow so laser surgery to completely eliminate glasses is not an option.

My daughter has worn glasses since she was one year old and she does not get made fun of at all. Most people comment on how cute her glasses are. I also wore glasses since I was 5 years old. I can maybe remember that once or twice in my life some insensitive person may have said something to me. Once or twice in 30+ years! I'm sure by the time your daughter (and mine) are old enough, they can decide for themselves if they want contacts or surgery or whatever. get over yourself

I am sorry to hear about your daughter's eye problem. I was born with both eyes crossed. One was straightened with surgery when I was in second grade. That surgery, and another when I was 16, was not successful for my other eye, so I still have a 'lazy' eye. By the way, this is not really the correct term but it is the one that is commonly used to describe an eye that "wanders" . At any rate, it is very frustrating to me when it 'wanders' because I have no control over it. People can't tell if I am looking right at them when it is like that, even if I am. I cannot control it, just as your daughter cannot control her eye.

As a child, I was sent for eye exercise therapy, and my straight eye was also patched for awhile to try to strengthen the muscles in the crossed eye and make it work harder. I was teased about having 'cross-eye', I was teased about the patch, and I was teased later about having glasses when I finally got them in kindergarten. True, your daughter may be teased if she ends up getting glasses, but if not, she will probably be teased about her 'lazy eye'. The important thing is that she gets the treatment she needs for her problem. I am so glad that you have an eye appt for her so you find out the options that are available. There are better surgeries available now for children with this condition, too, so I think there is lots of hope that this problem can be corrected. Since she's only one, I would imagine they would wait until she is a little older to make a decision. Meanwhile please be assured that it is not something she is purposely doing. You've noticed it more when she is trying to look right at you, or when she is looking at you from a distance - these are just situations in which this condition is more noticeable. If people make comments you should tell them she does not have control over the muscles in that eye. It is very common for it to be more noticeable when a person is stressed or tired. That's when mine is generally most obvious, too. I also have many pictures where my eyes look perfectly straight ('normal') and others where the lazy eye is very obvious. Please do not blame her or reprimand her for it. She needs so much encouragement, especially since she is also shy. I wish you both a happy outcome! Signed, Are you looking at me?

I had a lazy eye as a child. I ended up having eye surgery at age 6 to shorten one of the muscles, and I also had to do eye exercises for several months. I'm told that the really important thing was the eye exercises, and that surgery will not ''stick'' without them. My parents bribed me with TV privileges but it worked and I did the exercises. Today no one can tell that I had a lazy eye (except the eye doctors who can see the scar when they look into my eyeball). former amblyopic

I ordinarily wouldn't respond but ''lazy eyes'' are a real issue for me. I did not see your post. However, I am in my 50s, and I was the youngest of 4 children. My older brother had a lazy eye and my mother had it surgically corrected when he was a very young child, probably less than a year old. For reasons that she never explained and I don't understand, she choose not to correct my lazy eye surgically, and instead decided to use the patch and exercises. The result is that as I have aged, my lazy eye has gotten worse and I no longer use the eye sight in that eye. Insurance will not cover eye surgery to correct a lazy eye in an adult because it is deemed to be cosmetic (because once the good eye dominates the weak eye, surgical correction will not help use of the weak eye.) My lazy eye makes me self conscious; people never know if I am looking at them or not. Kids have commented on my weird eye, or asked why it is the way it is. Growing up, I was constantly teased about it. I hate having my picture taken.

Based on my experience, save your daughter from feeling self conscious and save her sight - have the surgery when she is young. Anon

i have a lazy eye that was found when i was 3-4years old...I went through eye stregthening therapy, eye patch, and glasses as a child...it all helped and i am now not reliant on glasses..Since high school i have only needed glasses for reading escpecially long texts....i was told that corrective surgery as an adult is not possible since it is muscular.. Most people don't even recognize i have it....i think the main thing is to catch it early enough where u can still train the muscles! t.

2-year-old's eye turning inward after cold

May 2008

My son had a bad cold late March and a result was one of his eyes looked lazy/inward. FYI: He is almost 2. I went to see Eugune Stern early April in Oakland and he said it was from this cold and that his nervous system just has to work harder. He asked that I come back once my son was all better since he still had a little of the cold at that time. I just went to see him on Monday, since my sons eye has not improved, he confirms again it is not lazy eye, that his eyes are healthy. The options were: glasses(which would be removed in a minute by my son), daily drops which would act like glasses(which would be a chore and stressful on my son and me), or to wait it out. He encouraged me to wait it out. Of course, not an option I can appreciate. I am afraid we will lose this window of correction I have read about. Any thoughts or refernces on docs?? Again he does not have lazy eye or ambro....but the treatments may be the same. Thanks concerned mom

Take your son to the UC Berkeley Optometry Center for a complte exam. They are great there and have a separate childrens eye center. It's not scarey for the kids...very kid oriented but they'll be so thorough and you can believe what they tell you. My son had lazy eye, diagnosed when he was 5. He was patched for about a year on and off and had eye exercises. He improved a lot. I don't know if your son has this or not but you definately need a 2nd opinion and UC Bkly is the place to go. anon mom

Oh dear. The ''wait til he outgrows it'' advice is simply awful. Vision develops during the first two years of life primarily, and continues to develop until age 6. If your child does not have amblyopia now, they will unless you intervene--they are young enough that they will start to lose vision. Since they have good vision from their straight eye, they will act like a normal kid, but they will be slowly losing vision. The eyedrop suggestion is meant to force them to use the unused eye. The easiest and best thing to do is to have your child wear glasses. IF their eyes are straight with glasses, rejoice! They won't lose vision, they will retain their fine depth perception--everything will be great. You can get a 2 year old to wear glasses. Yes, you can.

I suggest you go to UC Berkeley infant toddler clinic to have your child examined properly, and get some good advice. 642-2020 is their number. Call fast, their appointments are hard to get, and the longer you allow this to continue, the more your child's vision will be affected. Eye Doctor

I am not a medical professional, but I have never heard of a cold causing a person's eyes to turn inward. You did not mention if this person you visited was an actual doctor, but if he is not, please consider consulting an opthamologist. My husband has this condition (strabismus) and it is nothing that can be cured with drops or ''waiting it out''. concerned

If my child had any kind of eye issue, I would take him to the Infant-Toddler Clinic at UC Eye Center in Berkeley for a comprehensive assessment. 642-2020. Barbara

Get a second opinion! I highly recommend Dr. William Good. He specializes in kids, but I also see him. I had amblyopia as a child, which was thankfully caught early and treated by another doctor (long since retired). Dr. Good is watching my 1.5 year old daughter's eyes for the same disease. He is very thorough and cautious. He's seen her twice already, and wants to see her again in a year to make triply sure she doesn't have it. - former lazy eyed mom

hi, did your son's doctor look in your son's eyes - dilate them, etc.? i ask because my son had a similar inward eye (though he was only three months old) and, thanks to our amazing eye specialist, my son was diagnosed with coats disease - a rare condition that usually affects boys and is unilateral (in one eye). i won't go into the tx. but it might be something to ask your doctor. good luck!

Optometrist for child's lazy eye

September 2003

Can anyone recommend a good optometrist for my son? He has been diagnosed with one eye that is weaker and is not being corrected completely by glasses. We've been going to the UC Optometry but are thinking of switching over to a private doctor with more experience and consistency than the students. Someone in Oakland or Berkeley would work for us. Also any other thoughts on dealing with patching are welcome!! Leah

We go to Richmond Kaiser, so I don't have any private doctor recommendations (we see Dr. Tamura, who also works at Kaiser Oakland). However, I wish to stress the importance of patching. Our family knows a woman who is blind in one eye because of insufficient patching.

This may not be helpful since it's not exactly what you're asking since Optometrists and Ophthalmologist deal with 'lazy eyes' differently and he isn't in Oakland/Berkeley. But we LOVE Dr. William Good of Walnut Creek. [see Opthamologist for Amblyopia (Lazy Eye)]

For your son's ''lazy eye,'' you should consider an ophthalmologist - not an optometrist - who is experienced in treating amblyopia. This is an opportunity to save your child's sight. The pediatric ophthalmology staff at UCSF is at the forefront of research and care in amblyopia. Try Drs. Doug Fredrick or Dr. Jonathan Horton (415) 353-2289. Merry

As someone who comes from a long line of ''amblyopics'' and I would urge you to seek a consultation with William Goode ... [see Opthamologist for Amblyopia (Lazy Eye)]

Dear Leah. The best, and I mean it pediatric opthamologist is Dr. Creig Hoyt at UCSF. ... I do not have a lot of faith in optometrists, other than for prescribing glasses and contacts. Your son has a muscle problem and should see an opthamologist. [see Opthamologist for Amblyopia (Lazy Eye)]

I think you really want to see an opthamologist, not an optometrist (despite what the folks at the school of optometry tell you). We've seen, with our 7 year old, a number of people.

One doctor in Walnut Creek saw the amblyopia when our daughter was three, four and five and did not patch. I recently read studies that indicated patching is much more effective before age 5. ( I can send you references if you e-mail the moderator)

We tried patching with David Bui in Alameda when she was six and despite patching reliably there was no change after six months. We were then referred to Susan Day for surgery, who is the person you really want to talk to, I have found.

She is having my daughter wear glasses with -125 and a slight prism for six months to see if it will work, and if it doesn't she will schedule surgery.

I am still a little mad at myself for not reading the studies earlier, so I would know to make sure she got patched early enough.

In any case, you may want to get two opinions before you go any further.

Optometrist recommendations received: Benjamin Gaynor, Paul Odes, Larry Sarver

4-year-old diagnosed with severe amblyopia

March 2003

we learned recently that our four-year-old has severe amblyopia without strabismus. her vision's 20/400 and 20/40 uncorrected. we had no idea! we'd like to hear from other parents with similarly affected kids. please let us know if you have stories, experience, recommendations, or warnings to share. thanks. david and andrea

I have a lazy eye, so does my mother & my nephew...all in the right eye. Mind you, a lazy eye is not a wandering eye; a lazy eye moves in tandem with the other eye, it just doesn't see as well.

-My mother was not diagnosed until adulthood, she wears glasses with one lens MUCH thicker than the other.

-I was diagnosed at about 10 years old and was told I was too old to wear a patch so was told to wear glasses full time to correct/alleviate problem. (Which I must admit I did not do that often). I now wear contact lenses and there is still a pretty significant difference in vision for each eye. (Heaven forbid I mix up my lenses!)

-My nephew was diagnosed very early, like your daugher. His doctor had him wear a patch on his stronger eye during most of the day, then switch to the weaker eye for the rest, all while wearing glasses. His vision has greatly improved/evened out using this old fashioned method. He doesn't even wear glasses anymore.

If you end up using a patch like my nephew, don't worry too much about what other kids say. They have some pretty cool looking patches these days! My nephew had quite a variety to choose from in fabrics/patterns/graphics. Almost like playing dress up!

Hope this is somewhat helpful. Best wishes! Anon

you didn't say whether or not you are taking any steps to treat the amblyopia. at age 4, there is still a chance that the amblyopia could be lessened. definitely pursue this with your optometrist.

there are plenty of people out there who do fine with untreated amblyopia. your child has already learned how to compensate for it and will continue to. the warning is that you must take extra care to protect the ''good'' eye. wear polycarbonate lenses, wear protective eyewear for sports, etc. there maybe some career choices that will not be possible for a person with significant amblyopia.

an optometrist

My now 5 year old daughter had this exact same diagnosis when she was 2. Our pediatrician referred her to Dr. Susan Day, at California Pacific Medical Center in SF. Dr. Day is a pediatric opthamologist who is really the best in the biz. She has excellent diagnosis skills, and had my daughter wear glasses to correct the problem for about 6 months, and sure enough, she grew out of the problem, which many kids do, and doesn't even have to wear glasses any more. Try Dr. Day - she's worth the trip to the city... Lisa

My 5-year old has accomodative esotropia so our situation is a little different from yours. She was diagnosed at age 2 and has been wearing corrective lenses to deal with the issue. For us that is helping but not making the problem go away. Now that she is 5 I may look into Vision Therapy at the UC Eye Center.

There is an active yahoogroup which deals with this issue. They were very helpful when I first started exploring the issues around 'lazy-eyes'.

To enroll send an email to: LazyEye-subscribe at yahoogroups.com

They also have an archive of messages that you can check out. Evaa

I had ''lazy eye'' as a young child and had to wear an eye patch on my ''strong'' eye through all of first grade. Since I know children nowadays with eye patches, I know that's still a prevalent way of dealing with the syndrome (and exercises). I ended up with 20/20-25 vision on both eyes and never wore glasses (well, until I became middle aged....) The hardest thing was being teased by other children about wearing a patch (and being ''different'') and the fact that the patch itched. I always talk to kids that I know who have patches about that I used to wear one too to help them have some perspective(I also used to have to wear corrective shoes, but that's another story). Karen H.

I wanted to address this as a person who was diagnosed with amblyopia as a child and how things went as I grew up. When I was a child I was made to wear a patch over my good eye. My eyes improved really well. Unfortunately, as I got older, I got vain. My optometrist gave me a pirate's patch to make it more interesting and I wore that for a while, but eventually I stopped using a patch at all. Unfortunately, I was not forced to wear it. My eyes gradually deteriorated again and when I decided I wanted to try again, I was told the damage had been done and it was too late to do that. I spent a great part of my adult life having daily headaches. I was supposed to wear glasses (I had 20/20 vision in my good eye and something much worse in my bad one), but again, was too vain and never really liked the frames I ended up with. Long story longer, I finally found a pair of frames that I liked, started wearing them daily, and I didn't have headaches any longer. What is my point? Make your kids wear their glasses and patch! I noticed a colleague's daughter with a really cool patch under her glasses recently. She has amblyopia. I told her the same thing - make her wear the patch!

Hindsight is 20/20 (pun intended)

Important to know about amblyopia:

--has to be addressed before age 5, otherwise the weaker (''lazy'') eye will not accept any more visual messages and ''go to sleep'' (become blind, partially blind, or mostly blind)

--you should be seeing a ped. ophthalmologist (not an optometrist)

--best area ped. ophthalmologist (and considered one of the top in the country) is William Goode, M.D.--various locations: San Ramon, Walnut Creek, SF, Marin County, Stanford.; he has a lovely bedside manner, clnically and surgically brilliant, and, somehow, manages to run on time

--in treating amblyopia (patching, glasses, etc.) you are not only preserving the vision of the eye but you are also preserving stereopsis (the ability to see 3-D), and lessening the issue of not only a functional issue but also a cosmetic issue (often the untreated eye will turn out/in from lack of seeing/use. Often there is a ptosis (drooping of upper eyelid) associated with amblyopia.

--finally, amblyopia has a strong familial presentation; I had it (was treated successfully at an early age), my father and maternal grandmother had amblyopia as well. Consequently my children were (are) screened for it by Goode.

This requires as early intervention as possible.

G Advocate of Early Intervention

I thought you might find this article useful, as a drop in the eye once a day is a lot easier to keep up with than an eye patch.

http://healthlink.mcw.edu/article/1030635385.html

selection from article: Amblyopia: Eye Drops Could Be as Effective as Patching

Amblyopia, or “lazy eye,” is the most common cause of visual impairment in children. For years the standard treatment for this disorder has been to patch the unaffected eye in order to stimulate use of the “lazy” eye. In a recent study, researchers found that atropine eye drops, given once a day, worked as well as patching. This research finding may lead to better compliance with treatment and improved quality of life in children with amblyopia. The results appeared in the Archives of Ophthalmology.

After six months of treatment, researchers found that the drug atropine, when placed in the unaffected eye once a day, works as well as eye patching and may encourage better compliance. Compliance is an important factor in the success of amblyopia therapy.

''These results are important because they provide an effective alternative treatment that helps prevent permanent vision impairment for children with amblyopia,'' said Paul A. Sieving, MD, PhD, director of the National Eye Institute, one of the Federal government's National Institutes of Health and the agency that sponsored the study. ''Amblyopia is currently treated by wearing an eye patch over one eye for weeks to months. Children us -ually do not like this treatment approach because of quality of life issues, such as irritation of the skin and teasing by other children. This new study found that atropine eye drops had a higher acceptance rate and better compliance by children and their parents than did patching. This may well become a new standard treatment for some forms of amblyopia.'' susan

I just really also want to encourage people to deal with a ''lazy eye'' as early as possible, not only by going to the doctor but also by communicating to your child the reasons behind an eye patch (or whatever corrective option you decide). I also had a lazy eye when i was younger, but instead of wearing the eye patch all day, I would take it off when I got to school and then put it back on before I went home. Since nobody had explained to me why I was wearing it, it was only an irritating thing that kept me from running around and having as much fun as I wanted. It wasn't vanity, it was just harder to see while wearing it and I didn't understand why I had to wear it everyday. I regret now that nobody took the time to explain to me the importance of fixing my eye. Today I wear a contact on my other eye, and I don't use the ''lazy eye'' at all- my other eye compensated and sort of took over.

Good luck, and please take care of lazy eyes early and talk to your child about it! anon

I was diagnosed with a lazy eye when I was in preschool. I don't remember much about the diagnosis since I was so young, but I do remember wearing a patch on my good eye for several months (maybe more). The patches I had were similar to fabric bandages with adhesive around the edge and my mom used to draw pictures on the patches (for example, a birthday cake when I went to a birthday party). I then wore glasses from about kindergarten to 8th grade and now do not need glasses or contacts. Hopefully, your child will not be adverse to wearing the patch and glasses because diagnosing and treating a lazy eye early can mean a full recovery. I don't have any recommendations for doctors because I did not live in the area at the time. Good luck. Anon

patching is one of the therapies for amblyopia. you can consider the atropine eye drops but sometimes people need to consider all that goes with instilling medications to your child.

early intervention is the key. i would recommend going to see dr. deborah orel-bixler at the UC Berkeley School of Optometry Clinic. she is kind, great with kids and makes things go as painlessly as possible. she is also a kid specialist. When you make an appointment (642-2020 or make an appointment via online http://www.caleyecare.com/), make sure you request dr. orel-bixler in the infant/toddler clinic.

hope that helps. judy

As someone who comes from a long line of ''amblyopics'' and who is medically trained, I would urge you to seek a consultation with William Goode, M.D. (925-277-1135, San Ramon and a host of other local locales), someone I (and a lot of my ophthalmologist colleagues) consider to be the finest pediatric ophthalmologist in No. California. Lazy eye (Amblyopia) is really considered the purview of an ophthalmologist (M.D.) not an optometrist (O.D.)

Most importantly, the earlier lazy eye is addressed, before 5 years of age, the greater the chance of reclaimed vision. After age 5, the eye, essentially, goes to ''sleep'' because the brain will not recognize visual input. As well, because there are different types of amblyopia, there are different protocols for dealing with the problem--patching as well as other things. Good luck

Physi Patched successfully at a wee age

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