When it comes to children’s vision, things are not always in balance.

Amblyopia, decreased vision in an eye, is the leading cause of vision loss in children. 

“A lot of people refer to it as a lazy eye,” Alison Smith, a pediatric ophthalmologist with Clemson Eye, said. “There are three different types of amblyopia.”

Refractive amblyopia refers to a difference in the eyes, commonly resulting in the brain preferring the vision from the eye that is clearer. 

“We have to give them glasses to give them a clearer image,” Smith said. 

Sometimes the good eye will be patched to help children use the weaker eye. 

Strabismic amblyopia refers to the drifting or crossing of an eye. 

“One eye is looking straight and one is looking in the wrong direction,” Smith said. 

In adults, the crossing may result in double vision. In children, the brain chooses a “favorite” eye and vision will decrease in the other. Depending on the cause, surgery followed by patching may be needed. 

Occlusion amblyopia occurs when something is in front of the eye, such as a cataract or droopy eyelid. Once the occlusion is fixed, patching may be needed.

Most children with amblyopia who are referred to Smith come as a result of a visit with their pediatrician. Vision screenings in children actually begin at birth when they are checked for cataracts. Schools do visions checks, as well as some day care centers and preschools. 

“Early screening is the key,” Smith said. “The earlier, the better.”

Amblyopia becomes more difficult to reverse as children get older.

“At some point, it will be impossible to reverse,” Smith said.

In some cases, drops may be an alternative to wearing a patch. If patching is needed, the length of time involved is completely individual, Smith said, but if the child does not wear the patch as required, it will take longer. 

“The younger the child is and the more compliant you are with patching, the faster it will reverse,” she said. 

And for those children who require glasses, they might end up being trendsetters, since glasses are becoming fashion statements. 

“Glasses are cool now,” Smith said. 

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