We’ve all heard the term “lazy eye,” but what does it mean? Every day, we see patients here at SightMD.
Some have a lazy eye or other conditions like ptosis or strabismus. Keep reading to learn more about these conditions!
“Lazy eye” isn’t the right term
A lazy eye is a generic term that implies someone’s eyes don’t look right. It is a diagnosis that brings many patients to seek treatment with a pediatric ophthalmologist.
The truth is that it is not a medical term. Ptosis, or eyelid drooping, strabismus or ocular misalignment, amblyopia, and pseudostrabismus are a few potential diagnoses when a “lazy eye” is being diagnosed. The diagnosis and treatment encompass much of what a pediatric ophthalmologist does.
Amblyopia is a term that means that for some reason, developmentally, one eye has not developed at the same rate as the other, resulting in worse vision. This can be due to ptosis, strabismus, refractive error, or even a cataract.
Treatment of one of the causes of a “lazy eye,” can help treat amblyopia. Ptosis means that one or both of the eyelids are droopy. The main concern of a baby having ptosis is that if it covers the pupil, it can cause severe amblyopia.
The treatment, if the lid is covering the pupil, involves emergent surgery to correct the lid position. If the lid isn’t covered, surgery can wait.
The pupil should be assessed to see if a syndrome called Horner’s Syndrome is present.
Strabismus is a misalignment of the eyes. Esotropia means that the eyes cross. Exotropia means the eyes turn out and a hypertropia means that one eye is higher than the other.
As a child, the two basic types of esotropia are accommodative esotropia and non-accommodative esotropia. The difference is that accommodative esotropic patients are corrected with glasses and non-accommodative is corrected with surgery.
The majority of children with esotropia can be treated with glasses. If a vision difference remains, once the alignment is corrected, a child may need to patch the good eye to ensure adequate visual development of the weaker eye.
Patients with an exotropia typically have normal vision in each eye, unless the exotropia is constant and occurs all the time. If an exotropia is under good control, it can be observed. Surgery and/or exercises can help treat an exotropia.
A hypertropia is a bit more complicated. This happens more frequently in the setting of systemic disease, cranial nerve palsies, or complicated strabismus such as Brown Syndrome.
Pseudostrabismus means that for some reason, the eyes look misaligned but they are absolutely fine. Usually, this is found in babies with a broad nasal bridge.
The inner portion of the nose obscures the white part of the eye, or sclera so that the eyes look crossed. There is no treatment for pseudostrabismus.
In time, the babies’ eyes look straighter. It is often confusing to differentiate between the types of “lazy eye.” Although pediatricians screen for amblyopia, oftentimes parents can help diagnose a problem.
If you or your pediatrician is concerned, you should bring in your child for a consultation. Our pediatric ophthalmologist, Dr. Michelle Liebert has offices in Smithtown, Deer Park, and Riverhead. We also have pediatric ophthalmologists available at our Bayshore, West Islip, and Rockville Centre locations.
Need to schedule an appointment at SightMD? There are over 30 different SightMD locations in the Long Island area to choose from, so contact us to schedule one today!