Scientific Studies on Lazy Eye

Scientific research has provided many beneficial breakthroughs in the way we understand and treat a lazy eye.

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What is a lazy eye?

Approximately 2-3% of American children have amblyopia, which is the medical term for a lazy eye. It is the main cause of loss of vision in children in one eye. Amblyopia is a condition that occurs when the eyes are not working together properly as a team along with the brain. Each eye is receiving its own image which is not coordinated with the other so in order to cope, the brain shuts off communication with one eye, nicknamed the ‘lazy eye’ by suppressing it. Clear vision is achieved by the other, stronger eye as the lazy eye cannot achieve 20/20 vision, even with an optical correction.

Studies on Treatment for Lazy Eye

It is important to understand what the standard method of treating a lazy eye used to be. The approach was generally to promote as much patching as possible. Patching means to close off the strong eye in order to force the lazy eye to step up and communicate with the brain in order to achieve clear vision. In addition, it was believed that patching was no longer effective after the critical time period of development, which is somewhere between the ages of six and nine so there was a rush to begin patching as early as possible. In addition to patching, it’s important to also provide an accurate optical correction. Since there used to be value to patching as early as possible, the patient would receive the appropriate optical correction and begin patching as soon as possible, often simultaneously.

Pediatric Eye Disease Investigator Group (PEDIG)

A group of optometrists and ophthalmologists, known as the Pediatric Eye Disease Investigator Group (PEDIG) are funded by the National Eye Institute to do clinical research on various pediatric eye conditions. Most of their research has focused on treatment for amblyopia in children and adolescents and comparing various methods to find the most effective strategy. These studies have come to be known as the Amblyopia Treatment Studies (ATS) which have greatly improved the way that eye care health providers are treating a lazy eye.

Amblyopia Treatment Studies (ATS)

The results of the ATS research have made a huge impact on how we treat amblyopia today. There are different elements to the overall treatment which will be discussed in further detail below.

Optical Correction: The accepted method of treatment is now to first provide the patient with an accurate optical correction. After 6-8 weeks of the patient wearing the new prescription glasses, a follow up appointment is scheduled. Some children will not need anymore treatment once they have been wearing the proper glasses. At this follow up appointment, the optometrist will decide if the child does need more treatment in addition to wearing the accurate prescription. If further treatment is required, the child is now at an advantage because he or she has clearer vision which allows for better compliance in the following steps.
Patching: For patients who require more treatment, the next step is occlusion therapy, or patching. A fascinating result of the study is the research that proved that two hours of patching daily in children with moderate amblyopia yielded the same results as patching for six hours a day. For children with severe amblyopia, six hours a day proved to be just as effective as a full day of patching. Also, there were children with severe amblyopia who had great results from just 2 hours of daily patching. In conclusion, we have clinical proof that less patching than what was practiced previously yields effective results and helps tremendously with compliance. It is important that no matter how long the patient is told to close the strong eye, one hour of patching should involve activities from a close up distance in order to stimulate the visual system.

Studies on Recurrence

Research has shown that approximately 20% of children who complete treatment for a lazy eye, will have the condition return. Therefore, it’s very important that even after treatment is completed, the patient is scheduled for follow up appointments to ensure proper monitoring.

In order to reduce the likelihood of recurring amblyopia, it is essential to provide the proper plan for ending treatment. Instead of abruptly ending the treatment, it is beneficial to progressively end by tapering down the treatment method.

Common Questions

Have any studies been done on using eye drops to treat a lazy eye?

Medicated eye drops which blurs vision when applied to the eye is used as an alternative to patching. The strong eye is blurred out using these eye drops, forcing the lazy eye to learn to work properly with the brain in order to provide clear vision. The drops are only obtained by prescription from a healthcare provider. It is important that all potential side effects are explained before using this type of eye drop. In addition to blurring vision, these eye drops can cause stinging and other such discomfort which makes compliance more challenging. The PEDIG research made a breakthrough in proving that for a moderate to severe case of lazy eye, using eye drops only on the weekends provides the same benefits as daily administration.

Can adults be treated for lazy eye?

Yes, lazy eyes can be treated for adults as well, not only children. There used to be a widespread misconception that after a child passes a particular age of development, believed to be approximately between ages six and nine, treatment for a lazy eye would no longer be effective. Thanks to scientific research, most notably that of the works of Levi, Li and colleagues, we now know that a lazy eye can be treated even in adulthood.

Summary

If you have any questions regarding a lazy eye, please don’t hesitate to call (360) 491-2121 to schedule a consultation at our office, American Family Vision Clinic. Dr. Levi Zurcher and staff have a lot of experience diagnosing and treating a wide range of eye conditions and will be happy to discuss and answer any questions you have.