A ‘lazy eye’ – your eye isn’t the problem

As I write this, I am reminded of something that I witnessed only minutes ago. I was walking through a pedestrian area of a normal town, turned a corner and saw a little Chinese boy of no more than two years of age balancing on top of a bollard with his arms out straight on either side and his dad helping him balance and stay safe. The image of the concentration on the child’s face and the unadulterated joy on his father’s, struck me as being utterly beautiful.

My point is that there is beauty to be seen every single day and it takes the most interesting and unlikely forms. We require a whole miracle of co-existing factors to see this beauty in life around us, one of which is vital, is good eyes. And eyes are the area where I want to show you that us parents have an opportunity to help our offspring see the beauty in the world.

I talk to a lot of people about their eyes and, on a daily basis, people who do not have a ‘lazy eye’ tell me that they have a ‘lazy eye’ and people who do indeed have a ‘lazy eye’ know absolutely nothing about it. We have all heard of it but many of us do not realise what it actually is.

Many of us think that an eye that turns in or out, or an eye with an eyelid that hangs lower than the other is lazy – no. A lazy eye is an eye that will not see well no matter what we do with it. It doesn’t matter what glasses we prescribe, what surgery is performed, what exercises are given, the eye will never see well.

The technical term for a ‘lazy eye’ is amblyopia, which it is a very common, quite complicated condition which is therefore very important for parents to understand. Firstly, a ‘lazy eye’ is a misnomer – the name in itself is deeply misleading. The eye is not where the problem is. The problem is in the primary visual cortex which is the portion of the brain that we use to actually perceive visual input.

The development of the primary visual cortex is in response to visual stimulus. This means that if an eye sees well, the brain is stimulated normally and it will develop normally. Equally, if for any reason an eye does not see well (even just for want of a spectacle lens), it fails to receive the normal stimulus and consequently the physical structure of the brain will be adversely affected. This development occurs within the first 8 years of life, after which the physical structure of the primary visual cortex is largely permanent. The result is permanent, untreatable vision loss.

To get amblyopia in both eyes is quite rare so usually the result is that the person has effectively, only one eye. As they have one good eye, they usually get through life pretty well and can see what they need to. The problem occurs where judgement of speed and distance is critical (sport, certain careers etc.) or when something happens to the good eye – then we are in trouble. I currently have a vivacious, fit, healthy sixty-year-old patient who has had a very common problem at the back of her good eye. Because the other eye is lazy, she will probably never drive again.

So what do we do about it? Well, it’s very simple. We make sure both our children’s eyes see well during the first eight years of life. Unfortunately, it is really quite difficult to tell if an eye sees well. Many parents I talk to tell me that they would know if their child had a problem with their eyes but I would strongly advise you that you possibly wouldn’t.

This is where your friendly local optometrist comes in. Take your child down to see them once a year, every year, from age three (or sooner if you notice a problem). It is all paid for by the NHS, whilst being quick, easy and actually quite good fun.

A simple thing like this can help you make sure the most precious things in your life are able to see the beauty in life, throughout their lives.

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