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Amblyopia & Strabismus

What is Amblyopia?

Amblyopia, also known as a “lazy eye”, is described as a reduced vision in one eye compared to the other. There are some rare forms of amblyopia that involve both eyes. Amblyopia is the most common cause of partial or total blindness in one eye in children.

The term lazy eye is misleading because the eye is not actually lazy. In fact, it is a developmental problem in the nerve connecting the eye to the brain, affecting the brain’s ability to use both eyes together. It is not a problem in the eye itself, but in the brain which actively ignores the visual input from the misaligned eye, leading to amblyopia in that eye.

In addition to poor visual acuity, people with amblyopia are more prone to having difficulties with depth perception, eye movements related to reading, and visual decision making while driving.

What Are The Causes of Amblyopia?

Amblyopia develops in childhood due to:

  • Significant differences in the prescription (refractive) status between the two eyes due to nearsightedness, farsightedness or astigmatism;
  • Constantly misaligned eyes or crossed eyes (strabismus);
  • An obstruction of vision in early childhood i.e. cataract, ptosis (droopy eyelid)

It is important to note that, because amblyopia is typically a problem of infant vision development, symptoms of the condition can be difficult to detect. Symptoms may include noticeably favoring one eye over the other, an eye turn (either upward-downward outward or inward) or a tendency to bump into objects on one side.

The best way to identify children who are at risk for or already have amblyopia is by performing comprehensive eye examinations.

Signs and Symptoms of Amblyopia

Schedule an eye exam if you notice any of the following signs or symptoms


shutting one eye

Shutting one eye or squinting

scratching eye

Rubbing eyes often

missed target

Poor eye-hand coordination

broken arm

Tripping often or accident prone

poor depth perception

Poor depth perception

eye movement

Difficulty with fine eye movements

trouble reading

Reduced reading speed and comprehension

eye focus

Poor eye focusing skills

crossed eye

A cross-eyed appearance

flickering eye

Unusual eye movements such as flickering or blinking

When should children be checked for Amblyopia?

Amblyopia often starts before there are any obvious signs that something is wrong. This is why babies and young children should have their eyes regularly checked. According to research, children should have eye examinations at the following times:

  • Before the child is 3 months old
  • Between 6 months and 1 year of age
  • At 3 years of age
  • At 5 years of age

If there are any concerns that the child may be suffering from or developing a “lazy eye,” have him/her examined right away. Children with a family history of amblyopia are at a higher risk for developing it themselves.

Early diagnosing and treating increases the chance for a complete recovery. Amblyopia will not go away on its own. If not diagnosed until the preteen, teen or adult years, treatment will take longer and is often less effective. The sooner the treatment begins, the better.



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The earlier a vision problem is found and treated, the better off your child will be in and out of school

That is why it is so important for kids to have regular eye exams with an optometrist. Both Dr. Alireza and Dr. Sana Somji are very experienced working with children of all ages. Come visit our office to learn more or call us to schedule an appointment for your loved one.


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How Is Amblyopia Treated?


Amblyopia can be treatable at any age, although the earlier the problem is found and treated, the more successful the outcomes tend to be.

Many children who have anisometropia or unequal vision, do not know they have an eye problem because the stronger eye and the brain compensate for that shortage. Over time, the weaker eye gets progressively worse, and amblyopia develops.

Vision Therapy has been proven effective in the treatment of Amblyopia and the improvement of the visual skills necessary for binocular vision.

Vision and learning

What is Strabismus?

Strabismus, often referred to as 'crossed eyes' is distinguished by a squint and sometimes as a "turn" where the eyes do not look in the same direction as each other.

This misalignment can be constant or intermittent and may affect one or both eyes. When a person has strabismus, their eyes may point in different directions, which can lead to problems with depth perception, eye strain, and difficulty with activities such as reading or driving.

Whilst often considered a childhood condition, the incidence of strabismus is actually higher in adults and most adult strabismus can be successfully treated and can have both positive functional and social outcomes.

What causes Strabismus?

There are six muscles that control eye movement and work together to point both eyes in the same direction. Patients with strabismus have problems controlling eye movement and cannot keep regular ocular alignment (eye position).

The precise cause of this lack of coordination can vary depending on the type of strabismus. Some possible causes of strabismus are:

  • the nerves that control eye movement may be damaged or not functioning properly
  • a difference in the prescription between the two eyes, or an eye disease that affects vision in one eye more than the other
  • family history, there may be a genetic component to the condition
  • trauma, certain medications, or systemic diseases

What Are The Symptoms?

  • poor depth perception
  • eye strain and/or pain
  • headaches
  • blurry or double vision
  • eye and/or general fatigue
  • eyes that don't look in the same direction at the same time
  • eyes that don't move together.
  • squinting or closing one eye in bright sunlight
  • tilting the head to look at an object

Vision Therapy


Vision therapy is an effective treatment method for amblyopia. It has been shown to greatly improve the visual skills of the lazy eye by re-training the visual system.

Vision therapy is a treatment plan that is intended to develop and improve a patient’s visual skills and abilities, with the goal of making their day to day life easier. You may also hear Vision Therapy referred to as VT. Although most commonly associated with children, whose visual skills are still naturally developing, adults can also benefit from vision therapy.

Any patient who does not have the necessary visual skills could find themselves suffering from a range of unpleasant symptoms, including headaches, eye fatigue, stiff neck and double vision. Fortunately, vision therapy is a simple, painless technique to help patients to enhance their visual skills and overcome any issues that they may have been experiencing.

A test of your visual skills will allow us to assess how each eye is performing individually and design a personalized program of Vision Therapy.


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What to expect from a vision therapy appointment?

Vision therapy is generally conducted as an in-office treatment, under the close supervision of your eye doctor. Each vision therapy treatment plan is personalized; tailored to the specific individual needs of each patient. Most patients can expect to schedule hour appointments once or twice a week. You may also be given specific exercises to complete at home, which will support the progress that you are making during your in-office appointments. The components of Vision Therapy Treatment are non-invasive and drug-free, making VT suitable for the vast majority of patients, regardless of their age, health and history. For many people, vision therapy is a safe alternative to conventional eye surgeries.

There are various techniques that can be involved in vision therapy. These include, but aren’t limited to:

  • Prisms
  • Patches
  • Occluders
  • Therapeutic lenses
  • Exercises
  • The use of tools designed specifically for use in vision therapy exercises

By attending regular vision therapy appointments, patients can see an improvement in their vision, visual comfort and experience an overall improvement with the ease in which they use their eyes for daily activites.

Other Treatments



To correct nearsightedness, farsightedness, or astigmatism. Glasses may also correct an eye turn. Sometimes, glasses solve the amblyopia, and no further treatment is required.

Cataract surgery

If a cataract is the cause of amblyopia, it can be removed surgically under either local or general anesthesia.


It is sometimes performed to improve the appearance of an eye turn, resulting in better alignment of the eyes. This may or may not improve vision.

Using an eye patch

For the better-seeing, an eye patch may be required for several hours each day or all day long and may continue for weeks or months. A child should be encouraged to do close-up activities while wearing the patch, such as schoolwork, reading, or coloring.

Patches can be made colorful and fun to help the child accept it.

Correcting droopy eyelids

In some cases, amblyopia is caused by an eyelid that is blocking the vision to the weaker eye, in such cases, the usual treatment is surgery to lift the eyelid. Once the vision is corrected and any underlying medical issues are treated, then there are several other ways to help improve vision and getting the lazy eye to work.

Atropine eye drops

Used to blur vision in the unaffected eye. Atropine is usually less awkward for the child, compared with a patch, and can be just as effective. Thus, children who cannot tolerate wearing a patch may be prescribed eye drops instead.


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