Lazy eye (amblyopia)

What to do if you're concerned about lazy eye?

If you or a child you care for have signs of a lazy eye, book in to see an optometrist  There are some simple tests they can do to figure out what's going on and prescribe an effective treatment plan.  

Book an eye test

Symptoms of lazy eye 

The symptoms of lazy eye aren't always obvious ‑ particularly in younger children who cannot speak or express themselves fully yet. If a child has had a lazy eye since they were very young, they often don't realise they're having 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 ignored. 
 
Here are some of the more common symptoms of lazy eye. 

Strabismus ('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 with a hand

Some children tend to cover their lazy eye with one hand to help with focusing ‑. Some children may also oppose to covering the good eye as this is their preferred and dominant eye.

Head postures

You might notice your child will tilt their head when looking at things to help with focus. 

Vision‑related discomfort

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

Coordination problems

Many children with lazy eye struggle with hand‑eye coordination (for example, catching a ball). Because they struggle to judge depth perception, 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 their 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. Refractive errors

A refractive error is when vision is blurry in one or both eyes. 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 (strabismus)

A squint or strabismus is when your eyes don't line up. While one eye looks forward, the other eye looks to one side, upwards or downwards. If left untreated, it will lead to amblyopia.  

3. Sight 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 (a cloudy area on the lens).  

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? 

Optometrists can diagnose lazy eye with a routine eye test. At Specsavers, all our eye tests are bulk billed under Medicare, so you won't have to pay anything for children's eye test.

In some Australian states, eye screening is made available at all preschools, while in other states coverage is less comprehensive. Certain non‑profit campaigns such as the Lions Eye Health Program also offer free eye tests across Australia ‑ you can see if they're doing kids' eye tests near you on their website. We'd recommend getting their eyes checked for the first time when they're three or four years old. 
Learn more about children's eye tests
 
Here are some of the eye tests that can help diagnose lazy eye. 

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. 

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

Tests for squints

There are a few tests the optometrist can use to check for squint or strabismus. 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.  

Eye patch for amblyopia

An eye patch is placed over the normal eye. This forces the lazy eye to work harder. Over a few weeks or months, this helps train the eye to work more effectively. To begin with, your child will wear the patch for a couple of hours per day, but they may need to wear it for up to six hours at a time. 

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

Sometimes, the optometrist will recommend surgery for amblyopia. 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 binocular 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 treatments aren't available everywhere just yet. 

Treating lazy eye in adults 

For many years, it was generally believed that adults couldn't be treated for lazy eye. However, recent research has shown this isn't necessarily true. 
 
For example, one study asked adults with lazy eye to wear an eye patch for 2 hours a day for 24 weeks. By the end of the study, all the participants' vision had improved significantly.