2 to 3 out of every 100 children suffer from amblyopia, one of the most common causes of vision problems in children.

For a long time, patching was considered the mainstream treatment for lazy eye or amblyopia. In the event that a patient's right or left eye cannot be corrected to 20/20, then a patch is recommended to put over the better seeing eye. During that time, the brain is forced to pay attention to the weaker eye.

In theory, the brain would develop a better connection with the weaker eye over time, and once the patch was removed, both eyes would again be able to work together as a team. One of the challenges with patching was and is compliance, meaning getting a child to wear the patch for extended periods of time. Another challenge of patching was the ability to achieve the best results with patching alone, which while effective at reconnecting the weaker eyes connection to the brain, was not as effective at integrating the weaker eye into the binocular (two eyes) visual system.

However, based on the findings of many studies on amblyopia, we now know that there is a more effective treatment option besides patching alone. In the vision therapy room, we often use this concept, known as monocular fixation in a binocular field (MFBF).

What is monocular fixation in a binocular field (MFBF)? How is it used for children with amblyopia (lazy eye)?

Monocular fixation in a binocular field basically means training one eye at a time while both eyes are open. In vision therapy, we may be able to train the amblyopic eye through the use of filters or polarization, while the other eye is still open and receiving visual information.

An example of a vision therapy activity involves a child wearing red and green filters, also known as anaglyph glasses, and completing a maze that is designed using red ink. Consequently, the amblyopic eye is being trained and it will be able to see the maze while the other eye will be able to see the hand and the marker as you trace along the mace. It is a great alternative as children who are non-compliant with patching find it more fun. Furthermore, it does not require parents to constantly monitor their children like patching does. Additionally this treatment by its nature trains the brain to integrate the weaker eye in coordination with the stronger eye, this is the crucial aspect, and the aspect that was most missing from traditional approaches that used patching alone.

What are the different symptoms of lazy eye?

A child with amblyopia may:

• Frequently bump into something on a particular side.
• Experience a large difference between your farsighted and nearsighted vision.
• Give preference to one side of the body.
• Have droopy eyelids.
• Squint a lot or close one eye.
• Tilt their head to one side.