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What is Lazy Eye ?

What is Lazy Eye ?Amblyopia, also known as lazy eye, means that one eye sees less than the other.

Its cause is an anomaly that usually occurs in the visual function of the eye during childhood. It can cause a shift in the weak eye to the right or left. Rarely, it can occur in both eyes. Often corrected with treatment with glasses, contact lenses, and one eye closure

What are the Causes of Lazy Eye (Amblyopia)?
Lazy eye is a disorder that is often encountered in childhood between the ages of 3-5. It can be corrected if detected at an early stage. In amblyopia; It occurs when one eye sees less than the other, or when both eyes see less.
In this disorder that occurs in childhood, the weak eye receives less stimuli than the other, and over time, the brain begins to neglect the image from the eye with low vision. Any condition that prevents vision in childhood can lead to lazy eye. At the beginning of these; imbalance in the eye muscles, droopy eyelids, differences in visual clarity between the eyes, cataracts and hereditary genetic anomalies.
In lazy eye caused by imbalance in the eye muscles, since the position of the eyes is also affected in straight gaze, inward or outward shift of the eye occurs; this makes it impossible for the eyes to work together. Over time, the brain starts to ignore the image coming from the gliding eye, and this results in the emergence of gliding eye amblyopia.
If the difference in the refractive error between the two eyes is more than 1.5 degrees, the possibility of developing lazy eye is high in the eye with a higher refractive error. Likewise, if there is a congenital high-grade refractive error in both eyes, especially if it was not detected between the ages of 3 and 5 and glasses were not used; There is a possibility of laziness in both eyes. This condition is called refractive anisometropia amblyopia. When visual impairment is detected in a child, the use of contact lenses or glasses can prevent the progression of amblyopia. In some cases, both eye muscle imbalance and visual disturbances can be observed together in children.
Although less common, a cataract-like condition that affects vision in the eye can also lead to amblyopia. This is a condition that requires immediate treatment and can lead to vision loss if it progresses. Therefore, when any defect in the child's vision is noticed, it is necessary to consult an ophthalmologist immediately to prevent further problems.

What are the Symptoms of Lazy Eye?
Since lazy eye appears in childhood between the ages of 3 and 6, it can be difficult to recognize the symptoms. The most common symptoms are:
• The child has difficulty in describing how far or close objects are (impaired depth perception)
• Strabismus or closure in one eye
• Squinting
• Constantly turning the head in the same direction while watching or reading something
In cases where children cannot express themselves, it is important for the family to monitor the child carefully. in child; When a condition such as inability to move the eyes together, problems in hand-eye coordination or strabismus (gliding of the eye) is detected, an ophthalmologist should be consulted immediately and treatment should be started in order to prevent permanent visual impairment.

Who is at Risk?
lazy eye; It is more common in babies born prematurely or small, in children with amblyopia and developmental disorders in other family members.

How is Amblyopia Diagnosed?
In diseases that develop in childhood, especially before the speaking period, it is difficult for children to describe their own discomfort; They try to overcome the discomfort by developing some methods of their own. For this reason, families need to be sensitive and careful about behavioral changes in children.
Since there is no pain or pain sensation in lazy eye, children may not be able to express this discomfort. families; in case they see any signs of hand-eye coordination problems in their children, seeing near or far (too close to the TV, the book, avoiding reading, indifference to lessons in school age, the need to turn their head to one side while reading or watching something, etc.). It is useful to consult an ophthalmologist without looking for other symptoms such as strabismus or gliding in the eyes.
The diagnosis of lazy eye is made by eye examination. In the examination, it is checked whether there is any shift in the eyes, any visual impairment in one or both eyes. In some cases, a drop can be used to enlarge the pupil; This drop causes blurred vision. However, the drop loses its effect within three to four hours and this turbidity disappears.
In eye examination in children before speaking age;
• In the eye examination of children before the speaking age, it is checked whether there are situations that prevent the visual axis and whether the child can follow an object with both eyes in a coordinated manner.
• Autorefractometer or skiascopy measurement is made at the age of 1, and it is determined whether there is a high degree of refractive error. In older children, visual function tests are done with letters or pictures.
How is Lazy Eye Treatment Performed?
Since lazy eye can lead to vision loss depending on the cause, its treatment should be started immediately. This disease also causes reluctance to school in children, difficulty in adapting, etc. can cause problems such as For this reason, it is important to intervene without losing time, to prevent problems that may arise in the development and education of the child.
Visual function can be completely normalized in children who start treatment between the ages of 3-6. After this age, known as brain plasticity; learning and re-development of the brain in children, since irreversible conduction disorders occur in the nerve transmission between the eye and the brain, the child may not fully regain eye health. Treatment varies according to the level and cause of lazy eye.

Use of Glasses or Contact Lenses
The most important element in the treatment of amblyopia is to correct the primary eye pathology that causes amblyopia. The use of glasses is a part of the treatment in lazy eye caused by visual disorders.
Lazy eye, which is caused by the inability to see near or far, such as astigmatism, myopia or hyperopia, or because the eye refracts light differently than normal, can be resolved in this way.
In this method applied to stimulate the weak eye; An eye patch is placed on the healthy eye and it is aimed that the child learns to see with the weak eye. These bands, which are used for 2-6 hours a day, serve to equalize the visual function in the eyes.

closure treatment age,

Use of Eye Drops
As in eye closure treatment; By instilling a drop that enlarges the pupil in the healthy eye, the visual focusing function of the eye is temporarily reduced and the child continues to see with the weak eye. With this drop, which is used 2-3 days a week, it is aimed to operate the weak eye without using an eye patch. In some cases, eye drops can cause some reversible side effects, such as sensitivity to light. Therefore, it can be considered as an alternative treatment for children who cannot adapt to the sealing tape.
Surgical Operation
If the child has a lazy eye caused by cataracts or droopy eyelids, surgical operation may be required. In addition, surgical intervention can be applied if the strabismus in the eye cannot be removed with the use of glasses.
Activity Therapies
in children; Activity treatments such as painting, puzzles or computer games to focus the eye on the same point for a long time are also applied. These treatments are used in addition to glasses, lenses or eye closure treatments; It is intended to activate the weak eye.
After the treatment for amblyopia is started, improvement begins after a few weeks, depending on the condition of the laziness. However, this disease has a risk of recurrence even if it is successfully treated. Therefore, children diagnosed with amblyopia should be followed up regularly until a certain age.

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