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LAZY EYE STUDY

There is encouraging news tonight for many older children who suffer from lazy eye. Treatments for lazy eye that were previously thought to benefit only children younger than seven have now been shown to help even older teens.

Lazy eye, or what’s commonly referred to as amblyopia, is seen in 3% of all children in the US. Previously, patients of lazy eye were told there was nothing that could be done to help them if they were too old. Now, there is something that can be done, and it has immediate results.
“I could barely read one line.” Tyler Kovaks certainly isn’t a lazy kid, but he, like millions of other children, suffers from lazy eye. The medical term is amblyopia. It is a condition resulting in poor vision in an otherwise healthy eye due to unequal or abnormal visual input while the brain is developing in infancy and childhood.
As a result while the eye can see fine, the messages don’t get sent to the brain through the nerves.
The most common causes of amblyopia are crossed or wandering eyes or significant differences in refractive error between the eyes, such as one eye having worse near or farsightedness than the other. Previously, many eye care professionals thought that treating amblyopia in older children would be of little benefit.
Dr. Robert Cykiert, staff ophthalmologist at NYU Medical Center, says, “Until recently we thought age ten was the absolute limit for treating amblyopia, and even ten was kind of late. Treatment under age 7 or 8 was thought to be most beneficial.”
Now, surprising results from a nationwide clinical trial show that many children age 7 through 17 with lazy eye, or amblyopia, may benefit from treatments that are more commonly used on younger children.
In this study, two basic approaches used in younger children were tested in older children as well. In one approach the children were just given eye glasses, while in the other approach they were given glasses plus eye patches to wear over the good eye, or were given eye drops that worsens visions to use in the good eye.
Dr. Richard Hertle, the lead researcher at Children’s Hospital of Pittsburgh, says, “What this does is it allows the eye that has amblyopia to be used alone. This also allows the portion of the brain that’s responsible for connecting to that eye to be stimulated alone on a daily basis.”
The goal was to see an eye chart better by two lines. Using the patch or drops, more than half of those in the 7-12 age group achieved this. 25% in the older 13-17 year old age group met the goal.
Dr. Cykiert says, “It’s very significant. Now we’ve learned that you can actually treat amblyopia above that age and so you can improve people’s vision for the rest of their lives just from a few extra years of treatment.”
But this shouldn’t be a license to not take the disease seriously and address it as early as possible.
“The message from this study should not be that children can wait till the age of ten before receiving treatment for amblyopia. The earlier you treat amblyopia the better the results are,” says Dr. Cykiert.
Most children, including those who responded to lazy eye treatment, are left with some visual impairment, in other words they don’t get to “20/20” vision. But they do have significant improvements.
It is also not known whether vision improvement will be sustained in these children who have lazy eye, once treatment is discontinued. A follow up study will help determine whether the problem can recur in kids who did respond to treatment, and whether the lazy eye treatment must be continued.

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