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Ask Dr. Marla: Treatments for Lazy Eye

My daughter was born with a lazy eye.
What are our treatment options, or will it correct itself?

A. A lazy eye is known as strabismus. This is the medical term for misalignment of the two eyes. Simply put, the eyes are not straight. This occurs in about five percent of the population. Strabismus can run in families. The three most common types of strabismus are:

  • having a crossed eye, called esotropia
  • one eye turned outward called exotropia
  • eyes are out of alignment vertically, called vertical strabismus.

It is critical to get an accurate diagnosis and have definitive management. Your child’s eyes must be examined by a qualified eye professional who may then refer you to an ophthalmologist. This will not correct itself. Strabismus can happen because the eyes are out of focus or there can be a problem with the eye muscles or nerves. As well, this condition can be caused by a more serious problem inside the eye such as a tumour or cataract. When we look at an object we use both eyes, known as binocular vision. Children with strabismus have a problem with binocular vision, as they cannot use both eyes at the same time. The decrease in vision that results is called amblyopia. The goals of treatment are to preserve and improve vision, to straighten the eyes and to make sure the eyes work together. The doctor will determine if there is an issue with the muscles or the brain that controls the muscles. Treatment strategies may be different based on the underlying problem. They may include:

  • Patching the stronger eye (occlusion therapy) to help strengthen the vision in the ‘lazy’ eye.
  • Prescription eye drops to blur the vision in the healthy eye to make the other work harder.
  • Eye exercises to help make the eyes move better together.
  • Glasses, which may help eyes that are out of focus, especially when one is much worse than the other.
  • If required, surgery can correct the eye position, followed with patching and eyeglasses.

How much your child’s vision improves depends on how early in life the problem started and how quickly treatment is started. Seek professional advice as soon as possible.

Published in November 2010.

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