Far from lazy: Child’s dedication prevents eye damage

Saydee, 8, is happy that she can see better and ride in a car without feeling dizzy. After a visit to see pediatric ophthalmologist Naomie Warner, D.O., in the Eye Care Center at Mayo Clinic Health System last year, Saydee learned that she had lazy eye. She needed to wear an eye patch, in addition to her glasses, to help correct her vision.

Lazy eye, or amblyopia, is reduced vision in one eye caused by abnormal visual development early in life. The weaker, or lazy, eye often wanders inward or outward. Amblyopia generally develops from birth up to age 7. It is the leading cause of decreased vision in one eye among children.

Untreated, lazy eye can cause permanent vision loss, which affects 2.9% of adults according to mayoclinic.org. Dr. Warner says, "Vision loss can usually be treated, and often reversed, if caught early during childhood development before the age of 10."

Joyce Solie, Saydee's great aunt and guardian, also had a similar problem in her youth, which is what motivated her to bring in Saydee for an eye checkup. Unfortunately for Solie, she didn't get treatment soon enough when she was a child to reverse her lazy eye. She didn't want her niece to have the same outcome.

Solie was concerned for Saydee when she couldn't see clearly and started bumping into things around the house. She also noted that car rides weren't fun and often made Saydee sick when she would look out the window.

Dr. Warner diagnosed Saydee with a specific type of lazy eye called refractive anisometropia, where the sharpness in her vision between the two eyes is different. She was instructed to wear the patch in order to prevent her eyes from turning in a harmful direction.

"I had to wear patches over my left eye every day for three hours over four months, because my right eye was shaped like a lemon, but my left eye was shared like an orange," says Saydee. "Sometimes, I did not like to wear my patch, because it was uncomfortable, so I took it off. But then I had to wear it longer the next day."

Initially, Saydee was concerned about being teased at school. "My family and teachers helped me a lot with my patch. They reminded me to wear it and told the other kids why I had to wear the sticky patches over my eye." Saydee collected her colorful and patterned used patches and placed them as scales on a fish poster for her scrapbook.

"Fortunately, her condition was caught early enough that the eye actually hadn't started drifting outward or crossing inward," says Dr. Warner. "If Saydee wouldn't have been treated, she most likely would have had permanent decreased vision and an eventual eye turn that may or may not have needed surgery."

During one of her last visits, Saydee was excited to learn that she no longer needed to wear the eye patch. She says, "I was glad when Dr. Warner told me that, because I kept wearing the patches so much hat my eye got better faster than she thought it would."

Common causes of lazy eye

Anything that blurs a child's vision or causes the eyes to cross or turn out may result in lazy eye, including:

• Muscle imbalance (strabismus)
  he 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 tracking together in a coordinated way.
• Difference in sharpness of vision between the eyes (refractive anisometropia)
  A significant difference between the prescriptions in each eye — often due to farsightedness but sometimes to nearsightedness or an imperfection on the surface of the eye called astigmatism — can result in lazy eye. Glasses or contact lenses typically are used to correct these refractive problems.
• Deprivation
  Any problem with one eye — such as a cloudy area in the lens (cataract) — can deprive a child of clear vision in that eye. Deprivation amblyopia in infancy requires urgent treatment to prevent permanent vision loss. Deprivation amblyopia often results in the most severe amblyopia.