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7 Silent Signs Your Child Might Have Lazy Eye

Lazy eye affects about two to three out of every 100 children in the United States, and it's not as easy to notice as you'd think.

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What is lazy eye?

Amblyopia, or lazy eye, is when vision in one or both eyes doesn’t develop the way it should. A person with lazy eye typically has decreased vision in one eye from lack of use, says Paul J. Lederer, MD, a developmental optometrist in private practice in the Chicago suburbs. There are few, if any, signs of amblyopia, which often makes it difficult to detect. Strabismus is the form of lazy eye that is easiest to identify. It happens when the eye drifts or wanders inward or outward constantly or intermittently. Parents are often able to spot strabismus because they can see that their child’s eyes are misaligned. Lazy eye typically affects only one eye, but can sometimes affect both. Eye doctors recommend children get their vision screened as early as six months old to detect any issues. “After about the age of four months or so, if the eye is not lining up properly, it’s not normal. It should be looked at,” says David Epley, MD, owner of Children’s Eye Care in Kirkland, Washington.

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They turn their head when watching TV

Dr. Epley says if you notice your child repeatedly turning his or her head when watching television, it could be a lazy eye symptom. Kids with lazy eye have one eye that is dominant, and they rely on that eye to see better. They will often turn their heads to use their dominant eye when engaging in activities such as watching television.

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They repetitively squint, rubs, or cover one eye

Closing one eye when out in the sunshine, looking far away, or repeatedly squinting or narrowing both eyes together could be signs of amblyopia, says Dr. Epley. Repeatedly rubbing one eye or covering one eye with a hand could also be signs that one eye is weaker than the other, and the child is making adjustments to try to improve their vision.

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They are having trouble with math

Slight misalignment of the eyes can cause double vision or blur a page in a book, says Dr. Epley. Sometimes, strabismus can cause the eyes to separate objects and put the image on the wrong line. “Math is a problem, because the numbers are stacked on different levels, and it’s hard for the brain to transition from one level to the next,” says Dr. Epley. “Trying to refocus the stronger of the two eyes creates a distraction and takes away from a child’s comprehension of the task at hand as well as her accuracy.”

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They have delays in reading

When children enter school and begin reading, those with a lazy eye often become fatigued while reading. The lazy eye causes children to lose their place when reading, skip or re-read little words, misread and substitute the little words, and add words into sentences. “They start to avoid those things because they don’t think those things are fun, especially when the print gets smaller,” says Dr. Lederer. “It takes a lot more energy for them to maintain their concentration on the page for a sustained period.”

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They have difficulty with fine motor skills

Lazy eye symptoms include difficulty with fine motor skills, such as writing. Dr. Epley says the lazy eye can affect depth perception, making it difficult to stay on one line when writing. If you notice your child writing above or below the line, it could be a sign her eyes are not working together properly.

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They have a hard time paying attention

A lazy eye can cause people to look like they have an attention problem, says Dr. Lederer. Lazy eye causes children to have difficulty maintaining focus during tasks that require visual attention for long periods of time. If you notice your child’s attention straying while reading or performing other visually-oriented tasks, it could be a sign their vision needs to be tested.

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They have difficulty playing sports

Dr. Lederer says a lazy eye can interfere with a child’s ability to judge space and depth, which can make playing sports a challenge. “You need both eyes to judge where things are in space,” says Dr. Lederer. “When you don’t have those two points of view, you can’t tell how far something is from you or how far you are from it.” For example, kids with a lazy eye might misjudge stairs and trip over them or get hit by swing as it’s swinging back and forth because they have difficulty judging where the object is in space.

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Lazy eye treatments

In many cases, kids with amblyopia will wear a patch over the stronger eye to force the weaker eye to gain strength. Glasses correct the vision imbalance between the eyes, and patching forces the brain to use the weaker eye, says Dr. Epley. Treatments for strabismus depend on whether the eye drifts inward or outward and whether the drift is constant or intermittent. “If it’s intermittent, you can capitalize on when the eyes are straight to improve on that control of the straightness by either using glasses or exercises and therapy,” says Dr. Epley. If the eyes cross inward, surgery is a more common treatment because it’s more difficult to do exercises that teach the eyes to pull apart than it is to teach them to pull closer together.

If you notice signs of lazy eye, it’s best to consult with an eye doctor who can properly diagnose and recommend treatment options for your individual case. Next, check out these secrets your eye doctor won’t tell you.

Sources
  • Paul J. Lederer, MD, a developmental optometrist in private practice in the Chicago suburbs
  • David Epley, MD, owner of Children's Eye Care in Kirkland, Washington