Dr. King:
Hi, and welcome to Days Of Our Eyes. I’m Dr. King.
Dr. Cha:
And I’m Dr. Cha.
Dr. King:
In today’s video, we’ll be talking about amblyopia, also known as lazy eye. What is it? Can’t it be fixed? Keep watching and find out
What is amblyopia. Well, a lot of people use the term lazy eye. But we know lazy eye can mean a couple different things. We throw, we throw strabismus, we throw lazy eye, and we throw amblyopia around. And we get, we get what we mean. Lazy eye is a generic term that can mean either one. So it’s not really an eye term at all. Amblyopia is an eye that does not correct to 20/20 vision. It doesn’t see as well as its fellow eye. Strabismus is a mechanical misalignment of the eyes, usually due to muscular factors or nerve factors. It doesn’t correct as well as its fellow eye. Most commonly we find it in children. You know, because their vision is still developing. Vision develops from the time we’re born all the way up to age 10.
Dr. Cha:
And that’s when the neurons and the brains make those connections with their eyes and how, how they’re saying the image to, or sending the information to the brain and make sense of all that information. We want to catch it early because that’s when the brain is the most, you know, malleable, most adaptive, most flexible.
Dr. King:
So anytime in there that connection can become interrupted and generate amblyopia. The most common things I see for amblyopia is refractive error. One eye is more farsighted or nearsighted than the other, Strabismus.
Dr. Cha:
Eye turn.
Dr. King:
An Eyeturn, yeah.
Dr. Cha:
Amblyopia can develop in patients that might have been born with a cataract or some other reason why their eye doesn’t see clearly. If, especially if something is kind of in the way or maybe even like what we call a Blepharoptosis, where the eyelid even droops down past, you know, the pupil, the black part of your eye. It doesn’t get as much good information into the eye compared to the other good eye, you know, in comparison. And that’s how amblyopic can develop.
Dr. King:
Anything that interrupts that connection from the eye through the vision pathway to the vision center in the brain that will cause amblyopia. So really think of it as not just an eye problem, but a neuro-eye problem. Amblyopia definitely can affect quality of vision. It has a direct effect on binocular vision, depth perception, judging distances. The good news is the human brain is amazing and it can actually adapt and adopt things like shadow and size, shape cues to help make up for that. Do people with amblyopia see straight or do they see double generally? No. They, they see straight, they don’t see double. They’re relying on the dominant eye. And the brain can, what we call suppress the amblyopic eye.
Dr. Cha:
Yeah. I find it when I’m laying on the couch and watching tv. only one eye’s really looking and you don’t even notice your brain turning of the other eye offer suppressing it. And that’s what Dr. King is talking about. Our brain does a really good job, one to make sure or try to make sure that we have a clear image out of one or both eyes. And if we’re getting two clear images, they wanna make it a single image, right? If the brain can’t really do that automatically, if the eyes are, you know, not cooperating, so to speak, then it will turn one off. Cuz that’ll, that’s easier than trying to coordinate them together. Right? Just turns one of the eyes off and then uses the good eye. It’s dominant eye to do the heavy lifting.
Dr. King:
The brain doesn’t like discord, so it will find a way to make things function, right? As best as it can.
Dr. Cha:
What are the steps we take to, you know, help these patients?
Dr. King:
First thing, just make sure that their vision is corrected optimally. If you have one eye that is a little nearsighted and one eye that’s a lot nearsighted or whatever, you’ve gotta correct it. You have to focus the vision in the eye first. Glasses, contacts, whatever it takes to get them corrected optimally. Next, we want to get the brain to accept the image coming from the amblyopic eye. So we want to stimulate the brain to pay attention to it. And that can be accomplished in many ways. In the old days, we relied very heavily on patching. We would cover the good eye to try and stimulate the pathway from the lazy eye to the brain. I’m using the term lazy eye, the amblyopic eye, sorry. Even doctors do that.
Dr. Cha:
Like waking it up. Yeah.
Dr. King:
Yeah. We try and wake it up. But nowadays we’re doing other techniques. There’s drop therapy to try and minimally blur the other eye, vision therapy, which is, this falls into, I have a great deal of respect for these folks. There are doctors that dedicate their whole practice to creating binocular vision. They’ll actually do eye exercises to achieve more binocular function without just patching one eye. Remember, we’re trying to get the brain to use two eyes together. So we don’t really wanna cut off that other eye.
Dr. Cha:
Especially our vision therapy colleagues, they really isolate what part of the patient’s vision needs to be helped. You can think of it like physical therapy or occupational therapy, they focus on different muscle groups or different, you know, bones and joints and structures, and they cater different exercises or different regimens to treat that or to strengthen what’s weak, right? The lazy eye. They’re really good at really customized treatment regimens for our patients. And then we have the one big one.
Dr. King:
If there’s an eye alignment problem, if we have a muscle problem where the eyes aren’t pointed in the same direction, then we of course have to do strabismus surgery to get those eyes working together. It’s time for the MythBuster. You’re the freshest one outta school, I wanna know what you were taught.
Dr. Cha:
Neuroplasticity or the ability for the brain to adapt and make new connections. Persist even when we’re adults. Think about traumatic brain injuries, right? It’s a long recovery process, but with the right and persistent amount of therapy and management, people can recover a good amount of their function back to their brain. Again, this is more of a, a brain condition or issue, not an eye issue all the time, but assuming that, you know, the eyes are sound, you know, you have the right glasses, you have, you have the surgery, you know, to align things or get the cataract out of the way, whatever have you. Vision therapy again can isolate even for adults, you know, to bring the eyes back into alignment, to, you know, kind of strengthen those muscles that haven’t been used in their adolescence that they can maybe start utilizing. Now, there are more reserved kind of visual potentials for, you know, the, our older patients that have amblyopia, we can’t always promise them 2020. We are promising the world, right? Well, but we’re not God. We’re, we’re just, we’re we’re humble doctors. We try to be.
Dr. King:
That myth goes way back. There was a time that things were taught that, you know, past age eight or 10, it’s set for life and you’re not gonna make any, any headway. And all the way back when dinosaurs were roaming the earth and I was in school, they were busting that myth. It’s a slower process in adults, in kids. The beauty is if we can catch ’em early, A, they’re gonna improve faster. And B, it’s gonna be less inhibition in their learning, their schooling, their intellectual development. So we wanna catch it early so these kids can stay caught up. It’s not a disability so much as their eyes are working against them instead of for them as adults, it can still be improved. It just takes patience and a lot of skills. We are busting that myth.
Dr. Cha:
If you found this information is video helpful, please do us a huge favor and give us a thumbs up. Subscribe.
Dr. King:
And if you have any questions about amblyopia, drop ’em in the comments box below. We’ll be happy to answer ’em for you.
Dr. Cha:
And try to check out our Days Of Our Eyes content, and find some up there even. We have a video about dry eye. Hopefully we find it helpful. Thanks for tuning in.
Dr. King:
See you next time.