Amblyopia, or lazy eye, is reduced vision in one eye because the brain did not develop normal vision pathways for that eye in early childhood. Common causes are strabismus, a large difference in focusing power between the eyes, or something blocking vision such as a cataract.
Key symptoms
- Often no complaint; found on vision screening
- Eye that turns in or out
- Squinting, closing one eye or tilting the head
- Poor depth perception, bumping into things
What you find on exam
- Visual acuity in each eye with an age-appropriate chart
- Red reflex test for cataract or other blockage
- Cover-uncover test for strabismus
- Corneal light reflex (Hirschberg test)
Tests
- Instrument-based vision screening in young children
- Cycloplegic refraction by an eye specialist
- Dilated eye exam to rule out structural eye disease
Treatment basics
- Correct refractive error with glasses
- Patch the stronger eye for some hours each day
- Atropine drops in the stronger eye as an alternative to patching
- Treat the cause: cataract or strabismus surgery when needed
- Start early; results are best before about age 7
Red flags
- Absent or white red reflex (leukocoria)
- New eye turn with headache or other neurological signs
- Sudden drop in vision in a child
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations. Written by Making Synapses. Making Synapses is not affiliated with these organizations.