Lazy eye in children and the significance of early treatment
Children are susceptible to eye development conditions including amblyopia, or more commonly known as lazy eye, which occurs when there is obstruction to vision and abnormal development of the eye-brain pathway. As amblyopia can develop from birth, children might not be able to complain about the issue since they do not know what normal vision is, Sunway Medical Centre Velocity (SMCV) Consultant Ophthalmologist and Paediatric Ophthalmologist, Dr. Fiona Chew Lee Min, pointed out.
“Indications that a child may have amblyopia are peering to view distant objects, abnormal eye movements, squint, abnormal head posture, frequent falls or bumps into objects, problems with 3-dimensional vision such as going down the stairs, solving puzzles, delayed milestones, and even problems with sports or homework,” Dr. Fiona said.
Amblyopia can also be hereditary for certain conditions that cause it, such as squint or cataracts, added Dr. Lakana Kumar Thavaratnam, SMCV Consultant Ophthalmologist and Neuro-Ophthalmologist.
“Signs of amblyopia that parents or patients can look out for are squint, where the eyes point in two different directions or do not move in proper coordination; refractive errors such as being near sighted, farsighted or astigmatism; cloudiness in normally clear parts of the eye, with some children sometimes being born with cataracts; droopy eyelids, also known as ptosis and allergic conjunctivitis that can cause damage to the cornea and eventually amblyopia if not treated early,” Dr. Lakana explained.
According to Dr. Fiona, increased eye screening programmes in kindergartens and schools, as well as increased awareness of paediatric eye health have led to earlier diagnoses of amblyopia in children for which treatment can begin sooner than later.
Dr. Fiona stresses that amblyopia is reversible with early treatment, and cautions parents to bring their children for yearly eye examination. “The younger the child, the more adaptable the brain is to change. If treated early, the eye-brain connections will recover faster, hence early detection is crucial. It is recommended that children get their eye check-up at 6 months, 3 years, at 6 years and every two years after that to look for eye problems.”
For example, children who have refractive errors (needing to wear glasses), cataract, squint, droopy eyelids, and retinal problems should be treated, after which visual development should improve. Otherwise, the patient may need to undergo penalisation treatment or dichoptic therapy. The former involves blurring vision in the good eye to force the brain to use the lazy eye either with eye patches, eyedrops or special lenses. Dichoptic therapy involves certain exercises or digital games to enhance eye-brain development.
However, if left untreated, amblyopia will get worse and become irreversible – such that the child becomes legally blind.
Dr. Lakana said that amblyopia can be prevented from manifesting into early childhood or even into one’s teenage years if it is detected early and treated. Amblyopia treatment in adults takes longer to treat than in children, and involves medical imaging and targeted vision therapy.
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