November 30, 2017 - Lazy Eye (Amblyopia)
Hi everyone, it’s Dr. Sam. I’ve been getting a number of questions from parents who have kids that have been diagnosed with amblyopia – better known as lazy eye. The standard treatment offered is eye patching. So let’s talk about the research first.
There are a number of studies. One was done at Harvard and they found that the critical period of when you should be patching an eye is expanded, which means there is some plasticity in the brain where you can actually work with older children and adults to make improvements in lazy eye.
I would also quote the work of Dr. Martin Bernebomb in 1977. He did a number of studies with adults who were diagnosed with a lazy eye. He administered vision therapy, which is a form of physical therapy, and got very good results at improving binocular vision. There is also Dr. Sue Berry, who is a neurobiologist, who was diagnosed with strabismus as a child and had strabismus surgery. As an adult, she went through vision therapy and was able to get stereovision again.
In terms of my own clinical practice, I find that eye patching is traumatic, confusing, and ineffective. Whenever you patch an eye, what you’re telling the child is that the midline of their vision is not there anymore. So now the middle of the vision is only based on the eye that is not covered. Patching is very traumatic when it is offered to a child and they are told to wear it for 2-6 hours a day. There is no learning in it, it is a forcing of getting one eye to perhaps work better. But in the end, it doesn’t work and is not effective. The best way to improve amblyopia is two-fold.
- We know that the eye is part of the brain. The eye actually originates from brain tissue in fetal development at about 9 weeks old.
- In terms of vision therapy, which is the type of therapy I administer in my practice, I offer things like primitive survival reflex therapy, gross motor and fine motor therapy – which includes visual tracking, focusing, and coordination exercises.
If we do any eye patching, it is done actively while we perform a vision therapy exercise, but this is the only time I would use an eye patch. Overall, what a child needs to do is to learn to use both eyes together. They are never going to do that by using an eye patch.