The medical name for a Lazy eye is amblyopia and it affects approximately 2-3% of children under the age of 7 years old. Unless it is treated early, amblyopia will persist into adulthood and there is currently no treatment. The earlier the lazy eye is detected and treated, the greater the chance it can be put right. Once you are beyond the age of about 7 years old your eye is said to be fully developed and will no longer respond to amblyopia treatment.
The primary treatment of amblyopia is occlusion therapy (patching), where the good eye is covered for a few hours each day (this can vary) in attempt to make the lazy eye work harder and hence improve the vision. The younger the occlusion therapy is started, the better the chances of the vision improving in the lazy eye. The reason for this is that during your early childhood your eye is still developing, meaning improvements to the vision can be made easier.
There are many causes of a lazy eye but the 2 most common reasons are as follows:
Both a squint and anisometropia have the same effect on your eyes when they are developing as a child. Put simply, the bad eye (squint or highest prescription) is not receiving all the same visual information as your good eye whilst it is developing. As a result of this, the seeing part of your brain (visual cortex) does not develop properly meaning you cannot see the same detail as you can with your good eye. Most people assume that a lazy eye refers to your eye being lazy but it is actually the visual part of your brain that has not developed properly. The actual lazy eye itself is the same as the good eye. It collects all the information via your retina (the same as your good eye does) and sends it to your brain (via the optic nerve), it is when it gets here that the problems occur. This is why there is currently no treatment for a lazy eye once you get beyond the age of 7. For this reason, most children are discharged from the care of the hospital aged 7 years old.
Most people (and parents) wrongly assume that a lazy eye can be corrected by laser eye surgery and this is mainly due to the poor understanding of the condition. Once you understand that it is the seeing part of your brain that is ‘lazy’, (and not your eye) then you will better understand why laser eye surgery cannot correct a lazy eye.
The easiest way to understand what laser eye surgery can do for a lazy eye is as follows:
Laser eye surgery can give you the exact same vision that your lazy eye currently has with the best glasses or contact lenses. So if you can only see half way down the chart at the opticians with your glasses or contact lenses in, then following laser eye surgery you will still only be able to see half way down the chart, only you won’t have to wear your glasses or contact lenses to do this!
Imagine the following scenario:
You are moderately long sighted. Your right eye is +3.00 Dioptres and your lazy eye is +6.00 Dioptres. With your glasses or contact lenses in, your good eye can see the bottom line of the eye test chart but your bad eye (with glasses/contact lenses) can only see the top letter. So you may say I just want to get my good eye lasered so I don’t have to wear contact lenses/glasses any more. The problem lies in the fact that your surgeon will be reluctant to perform the procedure on your good eye in the small chance that something may go wrong. Although the risks are rare there is still however a small risk. So if the surgery went ahead and something went wrong with your good eye, you may be left to rely on your lazy eye. Depending on how lazy the bad eye is, this may mean that you could no longer drive, carry on working etc.
Generally laser eye surgeons will only treat your good eye if your bad eye is not profoundly weaker. All surgeons have slightly different criteria for this and you will only ever know for certain once you go for a laser eye consultation. But the most important thing to remember is that laser eye surgery can only give you the same vision as you can currently see with your glasses or contact lenses.
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