Friday, 8 December 2023

Lazy Eye in Children: Why does one need to detect it during childhood

 Source: https://timesofindia.indiatimes.com/life-style/health-fitness/health-news

​​Lazy eye in children​

Lazy eye, medically known as amblyopia, is a common vision disorder that affects children. It occurs when one eye has weaker vision than the other, leading to reduced eyesight in the affected eye. It is not related directly to any structural abnormality of the eye. It develops when there’s a breakdown in how the brain and the eye work together, and the brain can’t recognize the sight from the weaker eye. Early detection and intervention are crucial in managing this condition effectively. Amblyopia is one of the most common causes of preventable blindness in children.

Incidence of the lazy eye​

Dr. Soveeta Rath, Consultant - Pediatric Ophthalmology, Dr. Shroff’s Charity Eye Hospital, Delhi says, “Incidence of amblyopia ranges between 2-5%. It usually presents in children when they have refractive errors and are not corrected at the right time, because of delay in detection and treatment. Children with lazy eyes generally present to us with poor vision. The risk factors for amblyopia includes anisometropia which means there is significant difference in the glass description of both the eyes. If there is any cataract or corneal scar or any other causes that obstruct light entering to the eye become an additional risk factor for inducing amblyopia.”

Early signs and detection of lazy eye:​

Identifying lazy eyes in children can be challenging as they might not always exhibit obvious symptoms. However, certain signs could indicate its presence:

1. Squinting or closing one eye: Children might squint or close one eye to see more clearly.

2. Poor depth perception: They may struggle with judging distances or have difficulty with hand-eye coordination.

3. Head tilting: Tilting the head to one side to focus better could be a subtle sign.

4. Frequent rubbing of eyes: If a child frequently rubs their eyes, it might indicate eye strain or fatigue , indirectly implying chances of poor vision in one or both eyes.

Prevention of lazy eye​

Regular eye examinations are pivotal for early detection. Pediatricians often conduct basic eye screenings during routine check-ups. However, comprehensive eye exams by an eye care specialist, including testing for visual acuity and eye alignment, are crucial for detecting lazy eye.

Effective treatment strategies for lazy eye

The first step in treatment of lazy eye is prescription of correct glasses and ensuring the children constantly wear these glasses.

According to Dr. Rath, “Following constant wear of glasses, patching of the good /stronger eye remains the gold standard treatment. Covering the stronger eye with an eye patch for a few hours each day forces the weaker eye to work harder, stimulating its vision development. The duration of eye patching depends on the severity of amblyopia. Timely intervention plays a pivotal role in treating lazy eye in children. The effectiveness of treatment often depends on the child's age and the severity of the condition.”

Other treatment strategies​

Oral and topical medications like Citicoline , Atropine drops in the good eye are also used in refractory conditions. Video games using Ipad, dichoptic therapy, and perceptual learning are the software based practices that have gained importance in the recent past. These use various games that need a smartphone, laptop or desktop that are attractive for children to play which enhances compliance, and also avoids social stigma for the patch. Moreover in the absence of digital devices, virtual reality headsets are being used to treat amblyopia today. These therapies can be used in residual and refractive amblyopia as well as in adults.

Importance of early intervention​

Early detection and prompt treatment significantly improve the chances of successful recovery from lazy eye. Children below the age of seven tend to respond more effectively to treatment due to the brain's higher plasticity and ability to adapt. Adults with an undiagnosed lazy eye may not be able to correct the condition timely and effectively.

 

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