Can LASIK Fix Lazy Eye?

LASIK will not fix lazy eye. While LASIK can correct certain conditions that contribute to lazy eye, other treatments are needed to address the disorder. 

What Is Lazy Eye?

Amblyopia or lazy eye usually happens in one eye and sometimes in both eyes. It occurs when the brain and eye do not work together as they should. 

Generally, the person will see better in only one of their eyes. The vision in the lazy eye gets worse over time and leads to blindness if not medically treated.

Therefore, lazy eye refers to the fact that one of the eyes works better and is stronger. This condition, which is the most frequent cause of vision loss in children, begins in childhood. Often, an eye patch and eyeglasses are used to treat the problem.

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Lazy Eye Symptoms

Also, the problem is not uncommon, as up to 3 out of every 10 children experience this optical condition. Children with lazy eye exhibit the following symptoms:

• Squinting
• Shutting one of their eyes
• Tilting the head to see better

Medical professionals encourage eye exams for children between the ages of 3 and 5, so the problem can be diagnosed and treated early.

Children Who Are at Greater Risk

The risks increase for amblyopia for children who have developmental disabilities, were premature or smaller than average size at birth, or have a family history of lazy eye or childhood eye conditions, such as cataracts. 

Causes of Amblyopia

Doctors do not know what causes lazy eye. However, certain vision difficulties tend to trigger the condition. These conditions may include the following:

Refractive Errors

Nearsightedness, farsightedness, and astigmatism may lead to lazy eye if these issues are not corrected with eyeglasses or contact lenses.

Strabismus

This vision difficulty occurs when the eyes are not lined up or when one eye drifts in, out, up, or down.

Cataracts

A cataract causes the natural lens to become cloudy, making objects look blurry. While this condition mainly affects older people, cataracts may also appear in infants and children.

Anisometropia

Anisometropia may also lead to amblyopia. Anisometropia is a vision problem where the eyes do not have the same refractive power, thus making vision blurry. The eye with better vision then receives signals from the brain, while the other eye is ignored.

Treating Lazy Eye Without Surgery

When caught early, lazy eye is usually treated with prescription lenses, patching the strong eye, or software-based technology.

Eyeglass & Contact Lens Prescriptions

In less severe cases, lazy eye is treated with prescription eyeglasses or contact lenses. These may be all that is needed to improve the condition.

Eye Patching

Patching is commonly and successfully used to treat more severe cases of lazy eye. However, practitioners often worry about compliance, which is required for the therapy to work.

Digital Therapeutics

Today’s innovations in technology are being tested to treat children with amblyopia. Computer-based therapy may be used instead of eyeglasses to treat the condition. For example, software-based dichoptic therapy is designed to rebalance the optical stimuli of the two eyes. This can potentially lessen suppressive interactions in the eye’s cortex. 

Luminopia One is a type of this therapy. The digital application makes use of cinematic contact in real time to rebalance visual input. 

One study of this treatment involved children from 4 to 7 years old who had mild strabismus or anisometropia, both of which contributed to the patient’s vision issues. The research revealed that using this form of therapy led to better treatment compliance and results.

Surgical Treatment for Lazy Eye

When surgery is suggested for lazy eye, it has to do with the underlying reason for the condition. Therefore, surgery is often performed when a patient is diagnosed with anisometropia or strabismus.

Treating Strabismus With Surgery

Surgery specifically for lazy eye is not available. Often, strabismus, which causes one or both eyes to wander, is confused with lazy eye. Amblyopia merely makes it difficult to see well. The eyes do not wander like they do in patients with strabismus.

If strabismus or an eye misalignment has caused the patient to develop lazy eye, eye muscle surgery can assist in improving vision and the patient’s appearance.

If an adult asks about “lazy eye surgery,” they’re really asking about strabismus surgery — a procedure to correct misalignment of the eyes, or crossed eyes. This condition, which causes 

double vision in adults, can be corrected by either tightening or loosening the muscles of the eye.

A patient may undergo one of two types of strabismus procedures:

1. Recession Surgery

This surgery involves detaching and then reattaching the eye muscle from the front part of the eye to a weaker location. This causes the muscle to become looser and reduces the resting tension placed on the muscle.

2. Resection Surgery

This procedure entails removing part of the eye muscle to strengthen it.

Alignment surgery is the third most common eye surgery in the U.S., with 1.2 million procedures performed annually.

These surgeries have a high success rate, and complications are rare.

Risks & Side Effects

The outpatient surgery does not require an overnight hospital stay. Children who receive the treatment can often return to school after resting for a few days. Most adults return to work the same week.

After-surgery side effects, which are temporary, include redness, soreness, pain, and double vision. 

Correcting Anisometropia With Surgery

You can use LASEK surgery to treat myopic anisometropia and amblyopia. Patching on the dominant eye may also support the therapy. 

LASEK and LASIK surgeries are similar, and both are used to correct refractive errors. The main difference between the two processes involves how the corneal flap is created during the reshaping process. 

During LASEK, the surgeon makes a substantially thinner flap than what is done during a LASIK procedure. However, the healing rate is faster for LASIK patients, as the procedure is less invasive.

LASIK has also been used to treat anisometropic amblyopia. About 165 children have received excimer laser refractive surgery in published studies.

Outcomes Using Laser Surgery

One study showed poor initial visual acuity or the presence of a major astigmatism resulted in poorer surgical outcomes. Also, children who are over 6 years old experienced poorer results. 

Otherwise, using LASIK to correct an underlying refractive error, such as anisometropic, has a high success rate. One study revealed that LASIK is an effective procedure for the correction of anisometropia that involves highly myopic (nearsighted) or hypermetropic (farsighted) patients. 

Researchers recommend LASIK surgery for anisometropic amblyopic patients who have not experienced success with eyeglasses or contact lenses. Further studies are needed to assess success with respect to the depth of amblyopia, response to traditional treatments, and age.

The Bottom Line

If you want to treat lazy eye successfully, you need to make sure your child is properly diagnosed and under a doctor’s care. 

Most parents do not catch the problem until they take their child to an eye doctor. That is why it is important to schedule an appointment for your child when they are between 3 and 5 years old. Early diagnosis and treatment will help to preserve and strengthen vision and avoid future deterioration.

References

1. Amblyopia (Lazy Eye). (September 2022). National Eye Institute.

2. Anisometropia. (May 2018). American Association for Pediatric Amblyopia and Strabismus.

3. Amblyopia. (July 2022). EyeWiki, American Academy of Ophthalmology.

4. At-Home Dichoptic Therapy Effective Amblyopia Intervention. (December 2021). Review of Optometry.

5. Luminopia One Amblyopia Vision Improvement Study. (September 2018). ClinicalTrials.gov.

6. Lazy Eye Surgery Facts. (May 2017). American Academy of Ophthalmology.

7. What Is Adult Strabismus? (September 2022). American Academy of Ophthalmology.

8. Strabismus Surgery. (January 2022). American Association for Pediatric Amblyopia and Strabismus.

9. [Refractive Surgery in Children with Myopic Anisometropia and Amblyopia in Comparison with Conventional Treatment by Contact Lenses]. (Spring 2016). Czech and Slovak Ophthalmology.

10. Excimer Laser Treatment for Pediatric Anisometropia. (May 2006). American Academy of Ophthalmology.

11. Risk Factors for Treatment Failure of Anisometropic Amblyopia. (October 2004). JAAPOS.

12. The Visual Outcome of Anisometropic Amblyopia After Laser-Assisted in-Situ Keratomileusis Surgery. (February 2014). Journal of the Egyptian Ophthalmological Society.

13. The Effect of Lasik Surgery on Myopic Anisometropes’ Sensory Eye Dominance. (June 2017). Scientific Reports.