The child seemed to be excited just as she had returned from school. Innocently though, she tells her mother “Mama, my teacher has asked you to take me to an eye doctor because my eye is lazy”. Alarmed, the mother looks at her dear one, notices the same sparkle in the eyes as in any other child, and starts wondering whether the child is just kidding! Well, children hardly ever lie. Just don't be lazy about a lazy eye. If not addressed appropriately and early enough, that eye may remain lazy throughout life!

Laziness of some sort or the other is quite human and universal. But less than 5% of people have lazy Eyes. What is a lazy eye?. All it means is that an eye that appears normal is actually not seeing fully well. Technically it is referred to as “Amblyopia” which means, “blunted sight”. That translates further as the otherwise normal eye has been blunted for some reasons, but given the right chance, would have had sharp vision. Needless to say sharp vision in each eye is the priceless possession that all of us adore and strive hard to retain throughout life.

A higher incidence of amblyopia has been associated with prematurity, low birth weight, spastic children and mental retardation. Maternal smoking and the use of drugs or alcohol during pregnancy are also associated with increased risk for amblyopia!

Causes
Many clinical conditions in early childhood result in amblyopia, the most common causes being squint and untreated and inequal errors of focussing. These two account for nearly 90% of all types of amblyopia. Other birth anomalies which can induce amblyopia include cataract, drooping eyelids, opaque cornea or even prolonged spasm of the eyelids. Although diverse, the causes of amblyopia have in common an inequality of visual information received by the two eyes, a decrease of visual input or a combination of both factors. The brain being highly choosy, it favors the eye with better performance at the cost of ignoring the less fortunate eye, which in turn ends up as a lazy eye. Hence it is necessary to treat amblyopia early in life before the brain establishes this perpetual “favoritism”. Moreover, if both the eyes fail to get good quality images, then both are liable to become lazy!

The goal of amblyopia treatment is to “normalize” visual functions of the lazy eye, and when this is not possible, to at least improve the eye functions to an optimal level, by employing different means of spectacles, patching, medications and even surgery. Like the detection, the treatment of a lazy eye is also equally challenging. The first step is to rule out any lurking disease in the lazy eye. The next step in to correct the significant refractive errors. The simplest tool is spectacles eventhough most parents (if not the affected child itself) object to starting the same for their child. The sense of urgency vis a vis the ‘critical period' once explained, then most families comply with spectacles. As the child is growing it may be necessary to check up the glasses at least every six months. Recourse to contact lenses in children are taken only in very rare conditions of high refractive error predominently in one eye. Despite the difficulties, the contact lenses in these children help regain vision to a great extent.

Thus, one cannot afford to be lazy about a lazy eye. Early detection and earlier treatment is the cornerstone for successful outcome. Treatment options are also simple and effective, eventhough needed for a long period. A qualified and professional perserverance on the part of the treating doctor and a convinced and committed parent instituting the treatment will together go a long way in reducing the menace of potentially reversible blindness due to a lazy eye.