About Lazy Eye (Amblyopia) in Children
Amblyopia, also known as a ‘lazy eye’, is a childhood condition where a child’s eyesight does not develop in the way it should. The problem is usually just in one eye but can sometimes affect both. If a child has weaker vision in one eye, the brain prefers to use the stronger eye and therefore the visual pathway is not stimulated enough and amblyopia develops.
Causes
- Strabismus (squint): a disorder in which the two eyes don’t line up in the same direction.
- Refractive errors: when one eye cannot focus as well as the other. This includes near sightedness, far sightedness and astigmatism.
- Cataract: a clouding in the lens of the eye.
- Droopy lid that cover the pupil.
- Genetics play a role, too. Amblyopia tends to run in families. It’s also more common in children born prematurely or those with developmental delays.
Symptoms
- Crossed eyes or any other eye deviation
- Poor depth perception.
- Squinting or shutting an eye.
- Amblyopia can be totally silent and discovered on routine exams
Reduced vision in one or both eyes can often be treated with glasses alone. Therefore, firstly, we correct any refractive error (need for glasses). Glasses can take up to 16 weeks to have their full effect on children’s vision. If after this time, the vision is still reduced in one eye we may begin amblyopia therapy.
Patching
By covering the stronger eye with a patch for a specific number of hours per day, we encourage the child to use the weaker eye, which can strengthen the amblyopic (weaker) eye and allow the visual development to ‘catch up’.
What should your child do when wearing a patch?
There are no specific tasks required while wearing the patch, however children tend to keep their patch on better when they are distracted, so tasks like drawing, reading, colouring, computer games are good. If your child’s sight is very poor, it is best for him/her to play with things that are big and bright so they can be seen more easily at first.
Which patch?
There are various types of patches available, but we always recommend a sticky patch rather than a fabric one. Children are much more likely to peak around the fabric one.
Atropine
Atropine is an eye drop that is another first line treatment for amblyopia. The drops are prescribed for use in the stronger eye, usually two times a week. Atropine is a cycloplegic drug that dilates the pupil and blurs the image in the non-amblyopic (stronger) eye when the child looks at things up close. This encourages the child to use their amblyopic eye when doing close work. Your Orthoptist will discuss and decide with you which method of amblyopia treatment is most suitable for your child.
Will my child be able to see well enough when using the drops?
Atropine only works when looking at things up close, distance vision is mainly unaffected by the drops, therefore when walking around, your child will see to a similar level to how they normally would. Although the near vision will be a little blurred, for most children it is not a significant problem. However, in some cases where the amblyopic eye is very weak, the drop can make school work a little tricky and so it is advised to mention to your child’s teacher that they may need some more time/extra help. If you feel this is causing significant problems for your child, please contact your Orthoptist.
Will they struggle with bright light?
Because the drop dilates one of the pupils, more light is let into the eye and children can be a little light sensitive. We recommend using sunglasses, hats and staying in the shade where possible.
FAQ
A lazy eye responds best to treatment when a child’s vision is still developing, which is why the earlier it is identified and treated, the better the outcome tends to be. Treatment is generally most effective before around seven or eight years of age. However, there is no single age at which treatment suddenly stops working; some older children and teenagers may still benefit, though improvement can be less predictable. If you have any concern about your child’s vision, we would encourage an assessment with a paediatric eye specialist as early as possible, so that treatment can begin at the most beneficial time.
If you have a longstanding lazy eye, an eye assessment is still worthwhile as it can confirm the diagnosis, check your current vision and overall eye health, and identify whether any other eye condition is affecting your sight. Amblyopia is much less responsive to treatment in adulthood, because the visual system has already completed most of its development, and treatments such as patching and atropine are not established treatments for longstanding amblyopia in adults. Your specialist can explain what can realistically be achieved in your individual case.
Many children with lazy eye achieve substantial improvement in vision when treatment begins early and is followed consistently, and some regain full vision in the weaker eye. The degree of recovery depends on the cause, how early treatment starts, and how closely the treatment plan is followed, so outcomes vary from child to child. Even where vision does not return completely, timely treatment can bring a meaningful and lasting improvement, which is why early assessment and steady follow-through matter so much.
Lazy Eye itself is not treated with surgery, as treatment focuses on helping the weaker eye develop better vision through glasses, patching or eye drops. Surgery may sometimes be needed to address an underlying cause, such as a cataract, a drooping eyelid, or a squint, rather than the amblyopia itself. Treatment for amblyopia may still be needed before or after surgery to help improve vision in the weaker eye. Your paediatric eye specialist will explain whether any procedure forms part of your child’s overall treatment plan.
Patching is an effective, well-established treatment for many children with Lazy Eye and is usually successful when started early and used as instructed. Its success depends largely on wearing the patch for the recommended number of hours each day. The Orthoptist will monitor your child’s progress at regular appointments and adjust the plan as their vision improves.
Many children need to wear their patch for a few hours each day rather than all day, although the exact amount varies. The Orthoptist will recommend the number of hours based on your child’s age, the level of vision in the weaker eye and how they respond to treatment, and will adjust the plan as their vision improves. If your child wears glasses, an adhesive patch is usually placed directly over the stronger eye with the glasses worn on top, unless your Orthoptist advises otherwise.
Atropine is used to temporarily blur vision in the stronger eye, particularly for close-up tasks, so that the weaker eye is encouraged to work more. Most children adapt well, although reading, schoolwork or other close activities may be more difficult while the drops are working. The amount of blur can vary from child to child. It is helpful to let your child’s teacher know that they are using atropine. If the drops are causing significant difficulty, please contact your Orthoptist for advice.
Lazy Eye can return in some children even after vision has improved with treatment. This is why treatment should only be reduced or stopped on the advice of your Orthoptist or ophthalmologist, and why follow-up remains important after treatment finishes. Regular reviews allow your child’s vision to be monitored so that any recurrence can be identified and treated promptly.
Delaying treatment for Lazy Eye can allow reduced vision to become permanent, which is why early detection and timely care matter so much. A child’s vision develops rapidly in the early years, and the weaker eye responds best while those connections between the eye and the brain are still forming. Seeking assessment as soon as any concern arises gives your child the best opportunity to recover good vision.
Patching a lazy eye does not straighten a squint, as the two are treated differently. Patching improves vision in the weaker eye, while eye alignment is a separate matter that requires its own assessment and, where appropriate, treatment. A child may need help with both, and the paediatric eye specialist will advise on the right approach for each.
Moorfields Eye Hospitals UAE works with a wide range of insurance providers across the country, and coverage for your child’s consultation, eye assessment and treatment will depend on your individual policy, as well as any prior approval your insurer requires. You can confirm the details of your cover directly with your insurer, or contact us before your appointment so we can help you understand what to expect. The full list of accepted insurance providers is available at moorfields.ae/insurance-provider/ .
Moorfields Eye Hospitals UAE has paediatric ophthalmologists and Orthoptists in Dubai and Abu Dhabi with expertise in assessing and treating Lazy Eye (Amblyopia). As part of a globally recognised eye care institution, our team combines this expertise with a warm, child-friendly approach so you and your child feel supported throughout the treatment journey.
Lazy Eye treatment at our specialist eye hospitals in Dubai and Abu Dhabi is delivered through established clinical governance, audit and patient safety processes, with protocols aligned to those followed by Moorfields Eye Hospital London and supported by JCI and ACHSI accreditation. We regularly measure and publish our outcomes to provide patients with clear information about the standard of care delivered. Learn more about our satisfaction rates and outcomes: https://moorfields.ae/our-satisfaction-rates/