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1616 Cornwall Ave. #105

Bellingham, WA 98225

Phone: 360-393-4479  

Fax: 360-746-8661

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Our Eye Clinic is proud to serve patients living throughout Whatcom and Skagit Counties as well as the students enrolled at Western Washington University (WWU), Bellingham Technical College (BTC), and Whatcom Community College

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AMBLYOPIA - AKA 'LAZY EYE'

Amblyopia is compared to a baby wearing a cast on a limb for years.  If the eye is not used, vision does not develop properly. 

You are not born with 20/20 eyesight. 

You don't have color vision, you don't have depth perception. 

 

When things move, you don't have any clue where they are, and what they are.

 

Just after birth, you might differentiate see light vs. dark and mother's face.

 

Through the first few years (but especially during the first 3-6 months) of 

life, you are learning to see and make sense of what your eyes are bringing to you.  This is why you will hear the common mantra from a Behavioral Optometrist, that "vision is learned."  

Amblyopia, often termed lazy eye is a dysfunction that occurs during the period while someone's eyesight and vision is still developing.  

It is not commonly due to an eye disease or something structurally wrong with your eyes.  

So how does it get that way and what is it really?

WHAT IS AMBLYOPIA?

The word Amblyopia is broken down to the parts 'ambly' which equals dull, dim, and 'opia' which means eye / optics.  It occurs most often in a developing child around the ages of birth to 3 years old.  After that age, if your child doesn't have Amblyopia, it's unlikely that it will occur.

Many people mistake the term and call it 'lazy eye' but it usually doesn't have much to do with the eyeball itself.  In order to truly understand Amblyopia, try to think of it as a problem in the visual pathways of the brain.  

DOWNLOAD OUR FREE E REPORT TO SEE OUR EXACT APPROACH TO TREATING AMBLYOPIA.

The visual pathways are in the brain and they receive input not only from the eyeballs but other areas of the brain. That usually makes sense.

Here's the tricky part for most people to understand.

 

The eyes receive input back from the brain.  So there's messages coming into the brain from the eyes, and messages going from the brain back to the eyes.  Constantly. Even when your eyes are shut. 

 

 

WHAT CAUSES AMBLYOPIA?

By knowing that the messages are going both ways - from the eyes to the brain - and from the brain back to the eyes, you can start to realize how complex Amblyopia can be.  It can be caused by optical problems in the eyes, like Farsightedness, Astigmatism but it could also be caused by early childhood events affecting brain processing.  

The main causes of Amblyopia are below.

  • High farsightedness in one eye but not in the other (Anisometropia).  This is called "Refractive Amblyopia"  because it's due to the optics of the eye.  One eye refracts light so differently than the other, the brain gets clear information from one side only.  As a result, the information from the farsighted eye gets "suppressed". Then a vicious cycle occurs. As it gets suppressed more, it might function worse through lack of use (similar to a limb being in a cast).

  • Strabismus.  If you have one eye that is not lined up with the other, then this is called Strabismus.  When this begins in early childhood, the brain starts to suppress the information it receives from the eye that is turning in or out (similar to the suppression that occurs in the case of Refractive Amblyopia).

  • Being deprived of visual information in early critical periods of life.  This is called Deprivation Amblyopia.  This is kind of heartbreaking to think about, but consider that there are places in the world which place infants in orphanages with very little stimulation.  They might just stay alone in their crib all day without opportunities to get out, see other environments and move around.  If a child isn't exposed enough to movements, depth, color, shapes, sounds, touch etc. it could cause Amblyopia (along with other developmental delays). 

Another possible reason would be if your eyelid muscles aren't working enough to keep an eye open (Congenital Ptosis), then you could develop Deprivation Amblyopia in the eye behind the closed lid.  Finally, the excessive use of eye patching in an attempt to strengthen one eye could backfire by causing the patched eye to become deprived.  This was more common when eye care professionals used to tell parents of children under the age of two to patch all day every day.  Amblyopia is also more common to premature babies as well. 

  • Genetics. These visual dysfunctions can also be inherited. 

Let's take the cast off.  Taking the cast off might be the equivalent of putting some glasses on.  That's a good start. 

But then what do you do?  How do you accelerate the development of the arm?

You might be tempted to cast the other arm (or tie it behind your back for a few hours a day to force the weaker arm to start working again).  

Another valid idea.  

DOWNLOAD OUR FREE E REPORT TO SEE OUR EXACT APPROACH TO TREATING AMBLYOPIA.

 

The problem with using this concept in Amblyopia is that the eyes and the visual system do not work like arms.  To function, adequately, the eyes are supposed to focus, aim and move to the same place at the same time.  Arms don't require this sort of synchronicity.  Additionally, the brain need practice integrating the message from the two eyes at the same time.

This is why it is rare to see us at Northwest Vision Development Center to prescribe eye patch treatment for Amblyopia.  It is generally not our first choice in treating Amblyopia. In 20, 30, 40 years, we predict that we may look back on the days of patching, scratch our heads and wonder... "What were we thinking?"

In our office we most often treat Amblyopia with a combination of spectacle lens correction, contact lenses, prisms, and or vision therapy.  

The glasses (if the child needs them) are required to correct optical problems in the eyes.  The vision therapy works via one on one activities designed to train the person to see better and see with both eyes simultaneously.  

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