LASIK laser eye surgery can only help improve lazy eye to the degree glasses or contacts do, although one study suggests LASIK may provide additional help to lazy eye patients. Good preschool vision screening is the best public health approach.
Amblyopia, or lazy eye, is the most common cause of vision loss in one eye in children. The term “lazy eye” is confusing because it suggests that the problem is in the eye whereas in reality the ultimate problem in “lazy eye” actually is in the visual part of the brain. During childhood development, the visual part of the brain needs visual stimulation to develop. Although experts argue as to when this is irreversible complete, it seems that by age 8 the brain becomes permanently hardwired. For this reason, it is important to make sure the brain is receiving good visual stimulation between birth and age 8.
There are three categories of problems that prevent good visual stimulation: 1) occlusion (such as a drooping eyelid or a childhood cataract) 2) strabismus (“crossed eyes”) and 3) large difference in prescription between the two eyes, forcing the brain to choose one eye to view through. Any of these problems limit good and equal visual input from both eyes. If these problems can be corrected early in a child’s life, then the visual system can develop more normally.
In adulthood, a lazy eye is characterized by its inability to see well even with glasses or contacts. Because it cannot see well with glasses or contacts, typically LASIK and PRK laser vision correction surgery will not be of any more help than the glasses or contacts. The medical terms for this situation is a “loss of correctability” and the loss refers to correction with glasses, contacts, or laser eye surgery. Many adults with lazy eye, however, only have a relative degree of amblyopia and can still get some measure of correction with glasses or contacts. For these patients, LASIK or PRK could also help to the same degree. However, one study did suggest that there may be some additional benefit to patients with lazy eye who have LASIK.
Because the visual limitations of amblyopia are life long, it is very important to screen young children for lazy eye. Last year, the American Academy of Pediatrics, the American Academy of Ophthalmology, and the American Association for Pediatric Ophthalmology and Strabismus, and the American Association of Certified Orthoptists jointly published an instrument-based pediatric vision screen policy statement outlining steps for amblyopia screening. It was recommended in this paper that screen start at 6 months of age. Today, unfortunately, half of children with amblyopia remain un-diagnosed before school age. Hopefully implementation of these new guidelines will help this.
See Also
Instrument-Based Pediatric Vision Screening Policy Statement
American Academy of Pediatrics statement on methods for appropriate vision screen in children.
Guidelines for Automated Preschool Vision Screening: A 10-Year, Evidence Based Update
A study from the American Association for Pediatric Ophthalmology and Strabismus reviewing guidelines for amblyopia (lazy eye) screening in children
Clearer Vision May Be In Sight for Amblyopic Patients
This study from EyeWorld showed there can be benefit in having LASIK in patients with lazy eye.
Research: LASIK May Be A Successful Treatment for Amblyopia
This study shows, contrary to mainstream thinking, that LASIK may help some adult patients with lazy eye.
Preferred Practice Patterns for Management of Amblyopia
American Academy of Ophthalmology “preferred practice patterns” for management of amblyopia.
Amblyopia
U.S. Department of Health and Human Services Guidelines for Amblyopia (Lazy Eye)