Lazy eye (amblyopia)

Symptoms of lazy eye 

Amblyopia symptoms aren't always obvious ‑ especially in younger children who cannot speak or express themselves fully yet. If a child has had a lazy eye all their life, they often don't realise they even have vision problems. 
 
This is why it's so important to get your child's eyes tested during early childhood. Optometrists can identify problems that might otherwise be missed. 
 
Here are some of the more common signs and symptoms of lazy eye. 

A squint

Some people with a lazy eye also have a visible squint or strabismus, which is when their eyes don't line up. 

Covering the eye

Children sometimes cover their lazy eye with one hand to help with focusing ‑ this is one of the 'telltale' signs of lazy eye. Some children may also oppose to covering the good eye as this is their preferred and dominant eye.  

Head tilting

Kids with amblyopia sometimes tilt their head when looking at things to help with focus. 

Vision‑related discomfort

Children with lazy eye may have tired eyes, or blink and rub them a lot. They may also complain of headaches too. 

Coordination issues

Many children with lazy eye struggle with hand‑eye coordination (for example, catching a ball). Because they struggle to judge depth, they may also trip over things or bump into obstacles more often. 

Book an eye test

What causes lazy eye (amblyopia)? 

Lazy eye (amblyopia) tends to show up in the early years, and can be picked up during an eye test. That’s why we recommend getting childrens eyes checked around age three or four before they start school
 
A child’s vision and eyes continue developing until they’re about seven or eight years old. This is the optimal window for any amblyopia treatment. There are four main causes of lazy eye. 

1. Sight problems

Lazy eye is often caused by refractive errors that affect vision. One eye may be very short sighted or long sighted. This means that the eyes have to strain to get a clear image. 

2. A squint

A squint or strabismus is when your eyes don't line up (while one eye looks forward, the other eye may look to one side, upwards or downwards). If a squint goes untreated, the child may develop a lazy eye. People with squints often notice they have double vision or blurred vision. 

3. Vision deprivation

Any condition that obstructs or blocks vision in one eye. Although fairly rare in children, conditions like congenital cataracts can lead to lazy eye.

4. Ptosis (dropping eyelid)

Ptosis is when the upper eyelid hangs over the eye blocking light entering that eye. This can partially or completely block the child's vision in that eye leading to amblyopia. 

How is lazy eye diagnosed? 

Lazy eye can be diagnosed with a routine eye test. And, up to the age of 16, all children's eye test are free in our stores. 
 
When your child turns four, makes sure you take them for a B4 School Check (it's the 12th core contact in the Well Child Tamariki Ora Programme), which often take place at Plunket centres or community centres. The nurse will check your child for signs of lazy eye among other things.  
 
Learn more about children's eye tests

Here are some of the lazy eye tests that can help diagnose the issue. 

Home eye cover test

If you think your child might have a lazy eye, show them something interesting and cover one eye at a time. If they struggle or try to move your hand when the stronger eye is covered, it could be amblyopia. 

A comprehensive eye test

The best way to diagnose lazy eye is with a comprehensive eye examination. Our optometrists will perform tests to check for and diagnose lazy eye 
 
Book an eye test

Visual acuity test

Guided by an optometrist, your child will read letters, pictures or symbols on a chart, covering one eye at a time, to check if there’s a difference in how well each eye sees. 
 
Book an eye test

Strabismus checks

There are a few tests the optometrist can use to check for strabismus ('squint'). These tests help to see if the child's eyes are aligned. 
 
Learn more about strabismus (squint)

How is lazy eye treated? 

There are a few different treatments available for lazy eye. The optometrist, or eye specialist at the hospital, will decide how to fix a lazy eye, depending on what's causing the amblyopia, how severe it is, as well as the needs and demands of the child. For example, some kids really don't get on with eye patches. 

Corrective glasses

If the lazy eye is caused by a refractive problem such as astigmatism or short‑sightedness, prescription glasses can really help.  

Wearing an eye patch

An eye patch is placed over the normal eye (often, it's just for a couple of hours per day but can be more). This forces the lazy eye to work harder. Over a few weeks or months, this helps train the eye to work more effectively. 

Amblyopia eye drops

If the child refuses to wear an eye patch, the optometrist, or eye specialist at the hospital, might recommend using an eye drop called Atropine 1%. This is dropped in the healthy eye, and blurs the vision in that eye for a few days. This then forces the brain to use information from the lazy eye. 

Lazy eye surgery

In some situations, the optometrist will recommend lazy eye surgery. If it's caused by a cataract, the child will have this removed while under anaesthetic. If the lazy eye is caused by ptosis (droopy eyelid) or problems with the eye muscles, surgeons can also correct these issues. 

Lazy eye exercises

Certain exercises can help to train the lazy eye by making it focus on things. Your optometrist will show you how to do them. These can include pencil push‑ups (focusing on an object moving near and far) or object tracking. These might be done while the normal eye is covered. 

New methods

In the past decade or so, a variety of new treatments for lazy eye have been tested using VR‑style headsets. You wear a headset, and each eye sees a slightly different thing while you play video games. The headsets can be set up to train the lazy eye to work harder. These lazy eye treatments are promising, but they aren't available everywhere just yet. 

Treating lazy eye in adults 

For many years, people thought lazy eye was only something that could be treated in children. However, recent research has shown that lazy eye treatment for adults can still be effective. 
 
For example, one study asked adults with lazy eye to wear an eye patch for 2 hours a day for 24 weeks, and their vision improved significantly by the end.