Children's Eye Problems
Two of the most significant children's eye problems are strabismus and amblyopia.
Both conditions tend to occur very early in life, and early detection of amblyopia, in particular, is very important because long-standing cases tend to be more difficult to treat successfully.
Strabismus is misalignment of the eyes. It can be constant or intermittent, and it can affect just one eye (unilateral strabismus) or both eyes (alternating strabismus).
The direction of the misaligned eye can be inward, causing "crossed eyes" (also called esotropia) or outward, resulting in a "wall-eyed" appearance (also called exotropia).
Studies suggest approximately 2 to 5 percent of children in the United States have strabismus.
Usually, the only effective treatment for misaligned eyes is strabismus surgery. In this type of eye surgery, the surgeon alters the location of one or more of the six extraocular muscles that attach to the exterior of the eye and control its position and movement.
The success rate of strabismus surgery depends on the degree of misalignment of the eye and the direction of the turned eye (in, out, up or down) in relation to the straight eye. Often, more than one strabismus surgery is needed to achieve perfect eye alignment.
Vision therapy is a supervised program of eye exercises and other activities that sometimes is used to treat strabismus non-surgically. The goal of vision therapy, like strabismus surgery, is to produce clear, comfortable binocular vision and normal depth perception.
Generally, vision therapy by itself is used only to treat limited amounts of intermittent strabismus. For large, constant eye turns, strabismus surgery or eye alignment surgery combined with vision therapy usually is needed for a successful outcome.
Amblyopia is reduced visual acuity in an otherwise healthy and physically normal eye. The condition occurs when the two eyes are not used equally, causing one eye to become the dominant (clear) eye and the other eye fails to develop normal vision.
Amblyopia (also called "lazy eye") can be caused by unequal amounts of nearsightedness, farsightedness and/or astigmatism in the two eyes. This type of amblyopia is called refractive or anisometropic amblyopia.
Amblyopia also can be caused by strabismus (strabismic amblyopia).
Studies suggest approximately 1 to 5 percent of American children have amblyopia.
Often, amblyopia can be successfully treated with eyeglasses or contact lenses and patching (occluding) the dominant eye, which forces the amblyopic eye to be used more so good vision can develop in the weaker eye.
In some cases, a program of vision therapy is recommended along with patching to stimulate improvement in the sensitivity of the eye with amblyopia. Some vision therapy techniques for amblyopia are computer-based and can be performed at home.