Lazy Eye and Vision Therapy

A lazy eye is the result of an underdeveloped visual system and vision therapy offers an effective treatment plan to strengthen the entire visual system to work together properly as a team.

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What is a lazy eye?

When a person has a lazy eye it means that there’s a decrease in vision in one eye and it’s not attributed to a disease, but rather to a lack of proper development of the visual system but rather to a lack of proper development of the visual system. A lazy eye, known medically as amblyopia, almost always manifests in one eye, while the other eye dominates and is relied on for good vision, however there are rare cases where both eyes could have amblyopia.

Patching

When there is a lazy eye, the visual system relies on the stronger eye and the brain ignores the visual input from the lazy eye, referred to as suppression. In order to strengthen the lazy eye, the accepted method for many years has been to use patching or special eye drops, referred to medically as occlusion therapy. The strategy is to shut off the visual ability of the strong eye in order to force the lazy eye to step up and strengthen it’s visual abilities.

Challenges of Patching

The patching method is logical and it directly targets treating the issue at hand by forcing the weak eye to strengthen. However, that being said, practically speaking there are certain challenges with this method. The main problem reported with patching is the issue of compliance. Many children do not want to walk around with a patch on their eye and can be bullied as it draws attention to an unusual appearance of wearing an eye patch. Moreover, the eye that they’re covering is the one that they depend on to see so they don’t want to cover it. A solution to these issues is to use an eye drop in the strong eye which then blurs the vision only in this eye, forcing the lazy eye to strengthen. However, these eye drops are medicated and come with drawbacks, including side effects such as light sensitivity and disorientation.

Once the patient finishes using occlusion therapy, there is another challenge that arises. The visual system has been used to having only one eye open and now it needs to relearn how to work together as a team with the brain working with both eyes. If you try covering one of your eyes for a few minutes, it takes a bit of readjusting to get used to looking with both eyes open again. Imagine this kind of adjustment for a person who is so used to only using one eye for so long. They went from only seeing from the dominant eye as they had a lazy eye which was suppressed and then the strong eye got covered, forcing the weak eye to strengthen on its own.

Additionally, it is thought that age is a contraindication for occlusion therapy, meaning that occlusion therapy is much less effective at an older age. However, there is research that supports that incorporating patching along with vision therapy yields successful results, no matter what age the patient is.

The approach using vision therapy is to incorporate eye patching along with various visual activities which strengthen the visual system as a whole, training the brain to work with both eyes together as a team.

Vision Therapy’s Role in Treating a Lazy Eye

Vision therapy uses a treatment approach which combines various methods in order to maximize the benefits that each has to offer. Vision therapy customizes each treatment plan to the individual patient’s needs and visual skills. A comprehensive eye exam is performed to understand the underlying cause of the amblyopia and the extent of the patient’s visual abilities. During therapy sessions, the patient will engage in various visual activities that have the purpose of training both eyes to work properly with the brain.

Binocularity

Our visual system consists of two eyes and therefore, visual skills cannot only be isolated as being considered for each eye individually, but rather it is also important to consider the strength of the visual skill when both eyes work together.

This applies to amblyopia because when treating a lazy eye, indeed it is important to strengthen the weaker eye so that the brain won’t keep suppressing it. However, if we end treatment there, then we are stopping short, only treating the lazy eye isolated on its own without training it to adjust to working alongside the other eye as part of a visual system.

This is where vision therapy becomes so essential. The treatment approach with vision therapy generally includes a form of occlusion (patching, drops, or virtual reality) in addition to training both eyes how to work together in order to achieve healthy binocularity.

Possible Treatment Tools

The treatment plan may include any of the following, often it’s a combination:

Glasses or contact lenses
Patching or blurring the strong eye using eye drops or virtual reality glasses
Visual activities to develop binocularity skills such as:
- Accommodation (the ability to focus up close)
- Eye tracking movements
- Eye-hand coordination
- Motor skills
- Visual spatial judgement
- Depth perception
- Reduce suppression of the lazy eye

There are all sorts of creative ways to incorporate these skills into various educational activities.

Common Questions

What is vision therapy and how does it relate to a lazy eye?

Vision therapy is an approach to treatment based on the fundamentals of developmental optometry. We are not born with all the necessary visual skills to achieve a high quality of life. Visual skills are developed and learnt over time, mostly during childhood. Sometimes people require assistance in developing all sorts of life skills and visual skills are no different. Vision therapy’s approach to vision is so much more than 20/20 vision. It focuses on our entire visual system and how our brain works with both eyes together to be the strongest team it can be. By using various visual activities, we can train our brain and eyes to work together properly and to develop the visual skills we need to function in our daily life. If someone has a lazy eye, one eye is dominant and the other eye is weaker, nicknamed as the ‘lazy eye’. Vision therapy ends the competition between both eyes, of having one eye being the stronger one while the other trails behind as the weaker one. This treatment trains both eyes to work together with the brain to optimize the visual system.

What are the risk factors of having a lazy eye?

Family history of amblyopia Premature birth Born at a small size Developmental delay It is estimated that 3% of children have lazy eye/amblyopia.

What is a vision therapist?

To put it simply, a vision therapist is a person under the supervision of an optometrist who conducts therapeutic activities to help a person who suffers from a visual disorder.

Summary

If you or a loved one have a lazy eye or you have a risk factor for amblyopia, such as having a family history or a premature birth, please schedule an appointment for a developmental eye exam at our office. Our staff have extensive experience diagnosing and effectively treating a lazy eye. To schedule a developmental eye exam, please call (562) 925-6591. Patients with developmental vision issues visit our clinic from all over California, and we are proud to be a leading provider of developmental vision services for patients from Bellflower, Long Beach, Lakewood, and Los Angeles.

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Testimonials

I haven't actually used the optometrist side, so my review is limited to the vision therapy offered. This office was recommended by my occupational therapist for the treatment of my double vision following a stroke.

Claire A.

Love this location. I had a brain injury accident from day one one. All the team make you feel you still important and hope in the horizon after when the medical system fell you miserably. Dr. Ikeda very professional and very understanding about your issue. Two tombs up.

Jim K.

My husband and I were immediately impressed with Dr Ikeda. I was hit by a car while cycling which caused broken bones and three brain injuries. The brain injuries caused double vision. Dr. Ikeda examined my eyes and got me started on vision therapy with his occupational therapist who specializes in vision therapy. She (Chris) is absolutely great. I am impressed with the array of tools used to help recover my binocular vision. I am doing things I never thought were possible (balance boards etc). Chris pushes me and keeps me motivated. I really enjoy my sessions with her. The office staff is always friendly and they have a wonderful appointment reminder tool that makes it easy to keep my calendar up to date. I am happy the rehab center at Little Co. of Mary recommended them!!

Teresa S.

The Vision Therapy is handled in a separate office through a different door from the shared waiting room. Chris, the vision therapist, has a wide and varied assortment of tools, equipment and resources to best evaluate and treat most vision issues. After just a few visits, my double vision became easier to control, using exercises developed during the therapy process. It was time well-spent.

Joe M.

I have been coming here since I can remember. I love it here. The staff is so amazing and nice. They explain everything they gonna do and never make you feel rushed. Dr. Ikeda has always been my doctor and I would never want another one. He is the doctor for my whole family and is always asking how everyone is doing. I am also so crazy about picking out my frames and have to try so many and each person who helps me take the time and lets me try them all on. I would never want to go anywhere else! I definitely would recommend this office to anyone looking for a great eye doctor.

Kayla W.

This is not for the eye exam but for the frames selection portion. I brought my prescription from Kaiser here with my VSP insurance. The reception staff was very polite and professional. Manny helped me to pick out frames and explain my coverage. Very helpful and patient not like the individual at the other place I rated here on Yelp. I was running late and he still helped me and was not bothered at all. I am so glad I came here ..........very pleased.

Very professional staff and pleasant.