Amblyopia, also known as lazy eye, affects approximately 2-3% of American children. It is the leading cause of vision loss in children in one eye. Amblyopia, or lazy eye, is a condition in which both eyes do not work together with the brain, therefore the vision in the weaker eye is suppressed by the brain and only the stronger eye achieves clear vision.

The Pediatric Eye Disease Investigator Group (PEDIG) is a group that is funded by the National Eye Institute (NEI) responsible for performing really important research on amblyopia.

Appropriate optical correction for lazy eye

Among the most important studies they conduct is the amblyopia treatment study (ATS). A few important conclusions were drawn from that study.

First, it is important to ensure the child is receiving the appropriate type of optical correction. This means our eye doctor will prescribe the most appropriate glasses prescription for the child and they should wear them for approximately six to eight weeks, and then return to the office for a follow-up exam. At that time, our eye doctor will be able to determine if the glasses alone were sufficient to treat the lazy eye, or if the child needs additional treatment.

How long should a child wear a patch for lazy eye?

Another treatment they researched was patching. It was determined through the studies that for children who had a moderate amount of amblyopia, patching two hours a day while performing near tasks was just as effective as them wearing a patch for six hours a day.

In children with severe amblyopia, patching six hours a day was determined to be just as effective as patching for the entire day. In these children, the researchers also saw significant improvement even with just two hours of patching a day.

Atropine drops for amblyopia

Atropine drops were found to be as effective as 2 and 6 hours of patching in cases of moderate and severe amblyopia. This makes it an excellent first line treatment or an alternative to patching.

They also found that atropine drops do not have to be administered everyday, two times per week is also effective.

Atropine drops were found to be effective at treating moderate and severe amblyopia when administered on weekends.

Are there studies showing the efficacy of Vision Therapy for the treatment of Lazy Eye?

There are multiple studies that show the efficacy of in office vision therapy as part of the treatment of amblyopia (lazy eye). In office therapy is especially effective when combined with some form of occlusion such as patching or atropine. Rationale for refractive correction, occlusion and active vision therapy for amblyopia treatment. J Behavioral Optom. 1995;6(1):14, 18-19, demonstrated that vision therapy is more effective than occlusion (patching or atropine) alone.

The following studies showed that the focus of vision therapy on the binocular vision system (not just reconnecting the brain to the visual information from the amblyopic eye) improved the patient's overall vision and prevented regression after treatment for lazy eye.

  • Rouse MW, Cooper JS, Cotter SA, et al. Optometric clinical practice guideline: care of the patient with amblyopia. American Optometric Association. 1994.
  • Wick B, Wingard M, Cotter S, Scheiman M. Anisometropic amblyopia: is the patient ever too old to treat? Optom Vis Sci. 1992;69(11):866-78.
  • Frantz KA. Rationale for refractive correction, occlusion and active vision therapy for amblyopia treatment. J Behavioral Optom. 1995;6(1):14, 18-19.
  • Fitzgerald DE, Krumholtz I. Maintenance of improvement gains in refractive amblyopia: a comparison of treatment modalities. Optometry. 2002;73(3):153-9.
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