Treating Lazy Eye in Older Children

Many eye doctors believed until recently that if a child's vision was impaired because of a "lazy eye," the condition could not be corrected past the age of six or seven years. However, a study funded by the National Eye Institute, part of the National Institutes of Health, has found that amblyopia or "lazy eye" treatment can be effective in children age seven through 17. In fact, many of the 517 children studied at 49 eye centers showed improvement in their vision.

"Age alone should not determine whether or not to treat," said Michael Repka, M.D., a pediatric ophthalmologist at the Johns Hopkins Children's Center and a co-author of the study. Even teenagers benefit from treatment, said Repka.

Amblyopia is a common cause of vision loss in as many as 3% of children in the US. During infancy or childhood, the vision loss occurs when the brain favors one eye over the other. The other healthy eye does not receive brain input, limiting visual development. The most common causes of 'lazy eye" are nearsightedness, farsightedness, or a crossed or wandering eye (strabismus).

The reason vision in the amblyopic eye improves is due to the brain's plasticity, says Susan Cotter, O.D., a pediatric optometrist at the Southern California College of Optometry and co-author of the treatment study. Neuroplasticity means the brain can change with learning. By forcing the unused eye to work, the brain will process the sensory information and adapt. As a result, vision improves.

Children in the study were divided into two groups, randomly selected. One group wore only prescription classes. The other group either wore glasses and an eye patch or glasses, an eye patch and eye drops. The latter group was also instructed to read, draw, or do other close-up activities as well since "near-vision activities are visually stimulating," says Cotter.

The patch, eye drops and close-up work forced the test subjects to use their amblyopic eyes. Children wore the patch for two to six hours per day. Children 12 years and less also used eye drops.

However, "eye drops blur the eye all day which is why the teenagers wore only patches, which could be removed while driving," says Cotter.

If children in the study could read two more lines on the eye chart with the amblyopic eye, the treatment was considered successful.

According to the National Eye Institute, 53% of children in the study ages 7 through 12 who wore glasses and a patch for 2-6 hours per day, and did near-vision activities could read two or more lines on the eye chart after 24 weeks. But only 25% in this age group could do the same. Twenty-five per cent of children ages 13 through 17 who wore eye glasses and a patch had improved vision whereas 23% who wore only glasses improved. Of those children in this age group who had been previously treated for amblyopia, 47% who wore glasses and a patch and did close-up work had improved vision. On the other hand, only 20 % improved who were treated with only glasses.

"This study shows how important it is to screen children of all ages for amblyopia," said study co-chairman Richard W. Hertle, M.D., Children's Hospital of Pittsburgh.

If children also have strabismus and will undergo surgery to correct the eye muscle imbalance, they should be treated first for amblyopia, says Cotter. "Surgery doesn't help amblyopia. If the child has surgery and amblyopia still exists, one eye with 20/100 vision, for instance, will be blurry; consequently it will be difficult or impossible for the brain to fuse the two images together into one," says Cotter.

Atropine eye drops may serve to improve compliance because the child doesn't require monitoring. Adhesive patches are also used to increase compliance in young children as it is difficult for them to peek. "Children can't be monitored all day," says Cotter.

Although the adhesive patch is hypoallergenic, some children with sensitive skin experience irritation when the patch is removed. So some doctors allow their patients to switch to cloth patches. Cloth patches with side shields still block vision in the affected eye.

The number of hours that the children wore their patch was through self report. "This is a real world, treatment effectiveness study," says Cotter. "I do the same clinically."

A new study is planned to learn about the effects of near-vision activities on amblyopia.

Sources:

Article reviewed by
Susan Cotter, O.D.
Pediatric Optometrist
Southern California College of Optometry

Diana Clarke is a teacher and health educator. Her articles have appeared in newspapers and magazines, such as the San Jose Mercury News and the World of English.

---

Lunesta Personality Changes

Lunesta is a newly released sleeping pill. Marketed as a... Read More

A Closer Look at Lower Back Pain Relief

As many as 8 out of 10 adults will experience... Read More

Are You Suffering From Addiction?

Many researchers believe that addiction is a behavior that can... Read More

Stevens Johnson Syndrome Lawyer Says: Get Help

SJS is an allergic reaction to certain medications that can... Read More

Serzone Side Effects Lead to Serzone lawsuits

Serzone is a prescription medication that is given to patients... Read More

Another Cold Sore! Why Me?

An estimated 85 million Americans have acquired the herpes simplex... Read More

You Are Getting Very Sleepy....The Truth about Hypnosis

A hypnotic "trance" is not something that is foreign to... Read More

The Importance Of Using Electric Wheelchairs To Improve Mobility

No person likes to feel housebound and dependent on others.... Read More

The Medical Community Changes Its Mind

How many of us have taken aspirin or a similar... Read More

How to Find a Drug Rehab in Florida?

When you're in need, the quickest way is the best:... Read More

Defective Heart Defibrillators Recalled by Guidant Corporation

On June17, 2005 Guidant Corporation recalled close to 50,000 heart... Read More

Medical Collections

Although you make a patient feel better, there isn't usually... Read More

Toenail Fungus: Treatment and Prevention

A thick, yellowish nail with splotchy white areas is a... Read More

Cholesterol Prescription Medications Can Kill You

While there are numerous options for people to lower cholesterol... Read More

4 Reasons Why You Should Use Canadian Pharmacies

Let's face it: purchasing prescription drugs in the U.S. can... Read More

Naturopathic Medicine

Naturopathic Medicine is an holistic approach that relies on natural... Read More

7 Tips to Immediately Reduce Rotator Cuff Pain

1. Support the affected arm during activities of daily living.... Read More

How To Medically Treat Nail Fungus

Warning: This article is for information only and can not... Read More

?Foot Pain Relief At Last!?

"As an arthritis specialist, one area that I see people... Read More

An Introduction to Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a very common condition, but... Read More

Bextra Recall: Lawyer Says Help Is On The Way

By now, you have probably heard of the prescription drug... Read More

Zyprexa Side Effects are Deadly: Effects Include NMS

Zyprexa is a prescription drug that treats schizophrenia, acute mania... Read More

Eliminate Agonizing Hand Pain Quickly and Easily!

According to Dr. Nathan Wei, "The hand and wrist are... Read More

Kids and Medication Part II

In continuation of mood enhancement drugs for kids and adolescents,... Read More

A Compelling Look at Pain Relief

If your back aches when you're loading groceries in the... Read More

Physicians, Chiropractors and Physical Therapist Agree on a New Treatment for Low Back Pain

One of the most prevalent and difficult health conditions to... Read More

Is the Mexican Pharmacy safe to buy drugs online?

Are you frustrated with the high prices of prescription drugs?... Read More

Chronic Head, Facial, Or Neck Pain That Won?t Go Away - Could It Be TMJ?

I stumbled across TMJ when I needed treat a literal... Read More

10 Reasons To Buy Drugs From An Online Canadian Pharmacy

1. Online Canadian pharmacies offer overall best prices on Canadian... Read More

UltraCET: The Dynamic Duo Of Prescription Pain Control Medications

Remember the last time you stubbed your toe? OUCH! It's... Read More

The Last Line of Defense Against Medication Errors: What You Need to Know to Keep your Family Safe

This is a true story.Yesterday, I picked up a new... Read More

Lipitor Lawyer: Statin Drugs Cause Muscle Damage in 98%

Doctors have been encouraged to prescribe the cholesterol-lowering drugs called... Read More

Lunesta Side Effects

Before you decide to buy Lunesta, make sure you have... Read More