Amblyopia

Treatment Overview

Treatment for amblyopia begins as soon after diagnosis as possible. Early treatment usually can reverse the condition. Treatment should begin before a child's vision has fully developed (around age 9 or 10). The younger the child is when treatment begins, the better his or her chances are for developing good vision.

Amblyopia can be hard to correct after age 9. But studies suggest that treatment beyond this age can still correct amblyopia.³

Amblyopia is usually treated by an ophthalmologist.

To be successful, treatment must address both the amblyopia and the underlying cause. Glasses or contact lenses improve some conditions, such as unequal vision. Other conditions, such as cataracts and some forms of strabismus, may require surgery.

A child born with a cataract or any defect that keeps light out of the eye needs immediate treatment because amblyopia may become permanent within a few months. Amblyopia that results from misaligned eyes (strabismus) or unequal vision in the eyes (anisometropia) usually develops more slowly.

Treatment corrects amblyopia by training the brain to use visual signals from the eye with weaker vision, building a stronger connection between the brain and the weak eye, and allowing vision to develop normally in that eye.

There are several ways to force the weak eye to get stronger. Methods include wearing an eye patch (also called occlusion) and using eyedrops or glasses (also called penalization).

Wearing an eye patch (occlusion)

By covering the stronger eye, the brain is forced to use and develop better vision in the weaker eye.

Covering the stronger eye with an adhesive patch or a dark patch on an elastic band is the most common method of treatment. If a child wears glasses, the doctor may patch part of one lens. The child may have to wear the patch all the time or for just part of each day over the course of a few weeks or months. Severe cases may take longer. One study showed that, along with an hour of activities that exercise near vision, wearing an eye patch daily for 2 hours produces improvements similar to wearing an eye patch daily for 6 hours.⁴

Using eyedrops or glasses (penalization)

These treatments blur or obscure vision in the child's dominant eye, rather than blocking it completely. This causes the brain to rely on the eye with weak vision. Eyedrops or glasses are used less commonly than eye patches. Eyedrops or glasses work best for mild cases of amblyopia: with severe amblyopia, it is difficult to blur or obscure the vision in the stronger eye enough that the brain will prefer to use the weaker eye. These treatments are also called penalization.

• Eyedrops. The most common type of penalization treatment uses eyedrops (usually atropine) to blur the vision in the stronger eye and force the brain to use the weaker eye.
• Glasses. Eyeglasses with a blurry lens over the stronger eye force the brain to use the weaker eye.

Your doctor will probably schedule some breaks during treatment to allow your child to use his or her strong eye, to prevent it from becoming damaged or weakened.

Amblyopia can return even after successful treatment, so children should have regular follow-up exams until age 9 or 10.

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Author:	Robin Parks, MS	Last Updated: July 17, 2007
Medical Review:	Michael J. Sexton, MD - Pediatrics Christopher J. Rudnisky, MD, FRCSC - Ophthalmology
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