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Lazy eye treatment in Adults

Category : 
Author : Dr Deepak Garg

Introduction-What is lazy eye

Lazy eye, or Amblyopia, is a condition that causes poor vision ( visual acuity), usually in one eye. It affects about 3 out of every 100.

Lazy eye is the non-scientific term for amblyopia. The condition results from the poor development of eye teaming (or eyes working together).  The development must get affected during the critical period of first 7-8 years of life. This is a crucial functional vision skill that enables both eyes to work together and focus on the same point in space. When they don’t, it leads to one or both eyes not seeing clearly. 

Moreover, because the brain doesn’t develop the ability to see clearly in one or both eyes, the eyesight of a person with amblyopia cannot be improved with glasses alone. The part of the brain responsible for this function is the visual cortex.

Many people tend to confuse “lazy eye” with an eye turn (sometimes called “crossed eyes”). This typically occurs when one eye focuses on an object while the other points in another direction. An eye turn is actually a separate condition called “strabismus.” A person may have amblyopia with or without an eye turn and all patients with eye turn don't have a lazy eye.

Squint Before
Cross eyes or squint
Lazy eye patch
Patching the stronger eye

Why does lazy eye occur?

In most cases of amblyopia, one eye just isn’t seeing as clearly as the other. 

Lazy eye develops because of abnormal visual experience early in life ( critical period of the first 7-8 years of life) that changes the nerve pathways between a thin layer of tissue (retina) at the back of the eye and the brain. The weaker eye receives fewer visual signals. Eventually, the eyes' ability to work together decreases and the brain suppresses or ignores input from the weaker eye.

Anything that blurs a child's vision or causes the eyes to cross or turn out can result in a lazy eye.  Because of this blurry vision, the brain has suppressed (or turned off) the information in one eye. This negatively impacts the development of clear vision.

Normally, the brain receives two images at slightly different angles, and it combines them to produce a 3D image. This is called binocular vision. But that’s not the case with amblyopia.

The suppression of information from one eye negatively impacts the development of binocular vision. As a result, it seems like one eye does all the work of seeing. Thus, the other eye is characterized as “lazy.”

Causes of lazy eye?

Any eye condition and interfers with the child seeing with one or both eyes can lead to a lazy eye.

  1. Muscle imbalance (strabismus amblyopia). The most common cause of lazy eye is an imbalance in the muscles that position the eyes. This imbalance can cause the eyes to cross in or turn out, and prevents them from working together.
  2. The difference in sharpness of vision between the eyes (refractive amblyopia). A significant difference between the eye powers in each eye — often due to farsightedness but sometimes due to nearsightedness or an uneven surface curve of the eye (astigmatism) — can result in lazy eye. Glasses or contact lenses are typically used to correct these refractive problems. In some children lazy eye is caused by a combination of strabismus and refractive problems.
  3. Children can be born with cataracts. Its not a very common condition but does happen. If not treated at 6-10 weeks of age there is a risk of developing a lazy eye in the eye or eyes that had the cataract.

Lazy Eye in Adults: Symptoms

  1. Decreased visual filed - for eg when driving a car one may not see the car approaching from behind on one side till it almost overtakes you.
  2. Eye strain
  3. They may develop a squint also known as sensory exotropia

Traditional treatment of lazy eye?

Traditionally lazy eye is treated by something known as patching. We very simply cover the stronger eye so that the weaker eye is forced to function or see. This forced seeing would stimulate the affected visual centers of the brain. 

The issue with this form of treatment is that it does not focus on developing binocular vision.  With the patch visual development did happen but was thus limited by age.

Lazy eye patch
Treatment of Lazy eye / Amblyopia with a patch

Why the Misconception About Lazy Eye Correction for Adults?

For many decades, it has been thought that only children under the age of 9-10 could be successfully treated for amblyopia (lazy eye). In other words, lazy eye treatment was usually not provided to older children.  So far, traditional therapy of patching was not very effective beyond this age and thus this misconception.

Adult lazy eye treatment

For many years it was believed that amblyopia was only treatable in children, often those who are 10 years of age or younger. However, this isn’t necessarily the case. While every patient is different, many adults can see results from amblyopia treatment.

The visual system which consists of the brain, eyes, and visual pathways, can be retrained due to the brain’s plasticity.

For amblyopia, specifically, binocular vision needs to be retrained, as this is the root cause behind a lazy eye.

With poor binocular vision the two images that the eyes see cannot be combined into one single image, but due to the plasticity of the brain, this does not have to be permanent.

While treatment is most effective when it’s given at an early age, it is still possible at any age to retrain the visual system, restore binocular vision, and correct amblyopia.

Lazy eye treatment in adults

There are a few treatment options for treating adults with lazy eyes. At Eye Solutons we have experience with two treatments that have shown very promising results. Here we will talk about the first one

  1. Revital Vision
  2. OrthoK

RevitalVision

Revital is Vision training software program, clinically and scientifically proven to improve vision in adult amblyopia, eye diseases and vision impairments.

How does it work?

Human’s quality of vision depends on 2 factors:

  • Eye’s image capturing
  • Brain’s image processing

Traditionally we have focused on correcting the eyes/ bending lights. On the other hand RevitalVision focuses solely on the brain’s visual processing.

Blurred vision from the eyes can be improved by enhancing the brain’s visual processing. Using Gabor patches with patented stimulation technique, Revital facilitates neural connections at the cortical level, to stimulate specific neurons in the visual cortex and create new neural connections at the synapse level for long-lasting vision improvement.

What are studies showing?

  • Revital is the only FDA approved treatment for amblyopia beyond 9 years of age.
  • Clinical studies demonstrated that the vision improvement gained with 20 hours of RevitalVision in adults was equivalent to 500 hours of patching in children.
  • The average improvement experienced in RevitalVision's amblyopia treatment for adults is a 2.5-line advancement on the eye chart & 100% in contrast sensitivity.

Treatment Criteria

  1. Age 9 and up
  2. BCVA 6/9-6/30
  3. Eye deviation upto 8 prisms
  4. Patient can wear the best corrected glasses
  5. Patient motivated to comply with the training tasks
  6. Stable VIsion

Contraindications

  1. Unstable vision
  2. Diplopia or double vision
  3. Epilepsy and chronic migraines
  4. Severe untreated attention disorder
  5. Squint more than 8 prisms.

Revital at Eye Solutions

Eye Solutions has been offering Revitalvision to their patients for some time now.  We have noticed significant improvement in patients who we did not expect much improvement and this was like a last ditch effort.

Process of availing this treatment at Eye Solutions

If you have amblyopia and are above 9 years of age and are interested to know more click below and we will call you.

The entire process of availing of this treatment at Eye Solutions can be done online.

Prerequesites of availling this treatment online is to have a detailed eye examination with your local opthalmologist and share that report with us.

Steps

  1. Take appointment to know more about RevitalVision
  2. When ready you will be given a demo of how to use the software
  3. You will receive login and password for RevitalVision
  4. 5 training sessions after you login
  5. 60 sessions of exercises available for treating Amblyopia

Frequently asked questions?

How much will my vision improve with Revital?

The average improvement is more than 2.5 lines on the eye chart, and 100% in contrast sensitivity. This means that if you could read from 10 meters before the program, you would be able to read from a distance of 17 meters after the program. However, the amount of improvement varies between individuals.

How long do the results of Revital last?

Just like learning to walk, riding a bicycle and learning to swim have long-lasting effects, so does RevitalVision. You should note that while the improved neural-vision skill is long-lasting, RevitalVision has no effect on the progression of your eye disease.

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