Misdiagnosed Lazy Eye

The human visual system is complex, this can lead to an incorrect diagnosis, which is why it is important to visit an optometrist that has extensive training and experience with lazy eye. A developmental eye exam performed by a developmental optometrist is recommended if a child is displaying symptoms of a lazy eye.

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What is a lazy eye?

A lazy eye, referred to medically as amblyopia, is the result of improper development of the visual system which leads to a decrease in vision. A lazy eye usually only occurs in one eye, while the other eye is the stronger dominant one through which the person is able to see. However there are rare cases when both eyes can be amblyopic.

Binocularity

Binocularity is an essential term to understand how the visual system works. Monocular vision refers to the vision in each individual eye on its own. However, we are born with two eyes and therefore when discussing the visual abilities of each eye, it is important to also understand the visual skills of each eye and how it relates to the other eye, as both eyes are part of a team working with the brain to comprise the visual system. This is referred to as binocular vision which is when our eyesight is using both eyes together.

Binocular disorders

There are many binocular disorders which occur when both eyes are not working properly together. Some of the main ones include:

Amblyopia
Strabismus
Convergence insufficiency
Double vision

Misdiagnosed Lazy Eye

It’s possible for amblyopia to be confused with other binocular disorders. It requires a professional optometrist who is well trained in the field of developmental optometry to provide an accurate diagnosis of a lazy eye or any other binocular disorder. There are very precise tests performed in a comprehensive eye exam which assist the optometrist to reach the correct diagnosis without confusing different visual functions or disorders.

It is possible to confuse a lazy eye with other disorders especially a strabismus because these two conditions can coexist, as one can cause the other. The important thing to know is that even if one finds out in adulthood that they were misdiagnosed as a child, it is still possible to get treatment for the correct diagnosis using vision therapy.

Example of a Lazy Eye that was Misdiagnosed

A woman was diagnosed in her childhood with an untreatable lazy eye. This was an incorrect diagnosis, however the fact that it was deemed ‘untreatable’ turned out to be a blessing. Her lazy eye could have been corrected with a surgery which would have been entirely the wrong approach. Even if indeed it was a lazy eye, treating it with surgery is often ineffective and requires repeated surgeries.

She found out in adulthood that in fact she has convergence insufficiency which caused a strabismus. To break those terms down into explanations:

Convergence insufficiency = in order to focus up close, our eyes need to work together to move inwards, however if a person has convergence insufficiency there is a lack of cooperation between the eyes, making reading and other visual tasks up close very challenging
Strabismus = a misalignment of the eyes, when the eye starts wandering or the eyes become cross eyes

In our example, the woman has convergence insufficiency, meaning her eyes are not moving inwards in sync in order to focus up close due to the fact that there is a misalignment of her eyes and one eye is moving outwards. This could resemble a lazy eye, but it’s important to understand the intricacies of the visual system to be able to properly diagnose why the eye is wandering outward, in order to provide the proper treatment.

Vision Therapy

The good news is that even if there has been a wrong diagnosis, vision therapy is not limited by the age of the patient so it’s not too late to strengthen the visual system with a wide variety of visual skills. Vision therapy incorporates different visual activities to train the brain and both eyes to work together properly as a team.

Common Questions

How do I know if I have a lazy eye?

It can be very difficult to notice a lazy eye and that’s why it’s so important to schedule a developmental eye exam for children. The optometrist performs a comprehensive eye exam, often with eye drops that dilate the pupils, as well as a comprehensive assessment of the visual skills and their level in comparison to other children at that age. Symptoms are not always so obvious, but they can include: Wandering eye Tilted head Closing or squinting one eye Poor vision Poor depth perception One way of detecting a sign of amblyopia, is if you close one eye, a child will get upset or cry, whereas if you close the other eye, the child won’t get upset in the same way.

What is the difference between amblyopia and strabismus?

The vernacular for these medical terms are as follows; amblyopia is a lazy eye and strabismus is cross eye. Many people confuse these two conditions because there is overlap and strabismus is actually the main cause of amblyopia, but it’s not the only cause. Amblyopia can exist without strabismus. Amblyopia is a decrease in vision that is not due to a medical condition and cannot only be corrected with glasses, whereas strabismus is a misalignment of the eyes. Both of these conditions can be corrected with vision therapy. If you have any questions about amblyopia and/ or strabismus, please schedule an appointment at our office and the optometrist will be happy to explain and perform a developmental eye exam to check for these conditions.

Summary

It’s important to be checked by a developmental optometrist for various conditions such as amblyopia, in order to avoid a misdiagnosis. Our professional staff have extensive training and experience in this field. Please schedule an appointment at our office for a developmental eye exam.