VSP Blog

Joel Kestenbaum O.D. is a VSP provider in Long Island, NY.

Guest blogger Dr. Joel Kestenbaum returns with a post about amblyopia, a.k.a. lazy eye and the importance of early detection.

Lazy eye or amblyopia is reduced vision resulting from vision deprivation to one eye. Reasons include large differences in vision between the two eyes or misalignment of the two eyes resulting in one eye being stronger than the other.

If not corrected at an early age, the lesser-seeing eye may have permanent vision loss.   The brain will usually start to suppress the image of the poorer eye possibly resulting in useless vision.

As an aside, statistics show that 80% of a child’s learning comes through the eyes.  Early detection and early correction are imperative to a child’s binocular eyesight.  I see many young patients whose parents never realized that having an eye exam before age five can affect the child’s lifetime education.  And what is even worse, most pediatricians think that reading the eye chart in their office is an eye exam.  What they also don’t realize is that 20/20 does not mean 20/perfect.  As a result, the doctor’s that see the most children inadvertently do an injustice to their young patients.

Here is one example: Many kids can see 20/20 but if they are “farsighted” or hyperopic, their eyes work hard to focus on distance objects and work harder to focus on close objects.  It’s like the automatic zoom lens on a camera.  When the eyes point to an object, it is natural for the brain to signal the eyes to focus.  The problem is that a child’s eyes have a large amount of focusing power.  The other problem is that the harder a farsighted child has to focus, the more likely that the child will develop a crossed eye, possibly resulting in a lazy eye.

So what do we do about it?  First of all we need to educate the educators and the primary medical providers to screen children and to understand that an eye doctor should examine eyes just as a dentist should examine the mouth.  We need to catch lazy eye early.  Treatment for lazy eye includes eyeglasses, patching therapy, eye drops, surgery, and/or eye exercises.  If not treated, the amblyopic eye may never achieve good vision and may in fact develop functional blindness.

So the bottom line is early detection, early intervention and education.  See you in the next blog.