Lazy Eye (Amblyopia) Treatment in Singapore

A lazy eye, or amblyopia, is an eye that has not developed full sight even when glasses correct its prescription. The eye itself is usually healthy; what has not developed is the brain’s use of it, because something got in the way while vision was forming.

A squint is about where an eye points; a lazy eye is about how well it sees. A squint is visible, because one eye turns. A lazy eye usually looks completely normal. They are connected: a squint is one of the commonest causes of a lazy eye, because the brain starts ignoring the turned eye. A child can have one, the other, or both.

Anything that gives the brain a poorer picture from one eye while sight is developing: a squint, a big difference in prescription between the two eyes, a strong uncorrected prescription in both, or something blocking the view such as a droopy eyelid or a childhood cataract.

Usually you cannot, which is why screening matters. A child with one good eye sees well enough to read, play and pass unnoticed, and will not report a problem because the view has always looked that way. It is generally found when each eye is tested on its own. Covering one eye and getting an objection is sometimes the first clue at home.

Glasses first, which alone improve many lazy eyes, then giving the weaker eye work to do: a patch over the stronger eye for part of the day, or drops that blur the stronger eye where a patch is not tolerated. Any cause that blocks the view, such as a cataract or a droopy lid, is dealt with first.

Commonly a few hours a day rather than all day, for months rather than weeks, and it is reviewed at each visit as the vision changes. Two hours a day has been compared with six, so the number of hours is set for the child rather than fixed.

For moderate amblyopia the two have been compared directly and improved vision similarly. Drops are an alternative where a child will not keep a patch on, or where a patch is difficult at school.

Treatment is most effective while the visual system is still developing, which is why childhood is when it is treated. Improvement has been measured in older children and teenagers, including those not treated before, and it becomes harder with age. An adult with a lazy eye is still worth examining: the eye should be checked for any other cause, and the better eye looked after.

Sometimes. Where a difference in prescription is the cause, wearing the right glasses can improve the weaker eye over several months without anything else, which is why it is the first step and why the next review matters.

It can slip back after treatment stops, which is why patching or drops are usually reduced gradually rather than stopped outright, and why checks continue for a while afterwards.

Not for the lazy eye itself. Surgery is for a cause: straightening a squint, lifting a droopy eyelid, or removing a childhood cataract. The vision is then treated with glasses, patching or drops.

A first consultation with Dr Audrey Pang is $174.40 and a follow-up is $119.90, nett, at our Camden and Parkway East clinics. Glasses, patches and drops are charged separately, only where they are needed. Treatment is a series of reviews rather than one visit, because the hours are adjusted as the vision changes.

An eye specialist, usually one whose subspecialty is paediatric ophthalmology. At The Straits Eye Centre this is Dr Audrey Pang, Senior Consultant Eye Surgeon, who sees children at Camden and Parkway East.