Ever wonder what lazy eye means? What is amblyopia? How do you get it? How do you treat it? This presentation will walk you through this functional vision problem so you can understand what lazy eye is and how you can be successfully treated by your developmental optometrist no matter your age.

1. What is Lazy Eye?
Dominick M. Maino, OD, MEd, FAAO, FCOVD-A
Professor of Pediatrics/Binocular Vision
Illinois Eye Institute/Illinois College of Optometry
Optometrist, Lyons Family Eye Care

2. What is Lazy Eye?
Lazy eye is also called Amblyopia
and is characterized by reduced
vision in one or both eyes.
It is often associated with many
other vision problems as well.

3. What is Lazy Eye?
Amblyopia is a binocular
vision (two eyed), brain
problem. (Most doctors
forget this.)
This vision loss is not
caused by a disease.

4. What is Lazy Eye?
If this is not caused
by a disease, what
does cause lazy
eye?

5. What is Lazy Eye?
In order for lazy eye to be
diagnosed, you need
various amblyogenic
factors present and you
must rule out the existence
of any ocular disease.

6. What is Lazy Eye?
What are these
amblyogenic
factors?

7. What is Lazy Eye?
Amblyogenic factors include:
High refractive error in one or
both eyes and/or a
constant eye turn.

8. What is Lazy Eye?
What is refractive error?
Nearsightedness (myopia)
Farsightedness (hyperopia)
Astigmatism

9. What is Lazy Eye?
Nearsightedness
(myopia) makes it
hard to see far
away. You usually
need a very high
amount of
nearsightedness to
cause amblyopia.

10. What is Lazy Eye?
Nearsightedness is
usually what is
discovered by most
vision screenings.
Vision screenings
often miss other
vision problems.

11. What is Lazy Eye?
Farsightedness
(hyperopia) usually
causes problems with
near vision. It is often
missed during vision
screenings and it takes a
relatively small amount
to cause lazy eye.

12. What is Lazy Eye?
Farsightedness
(hyperopia) is often
associated with blur at
near, headaches,
eyestrain, asthenopia
and reading problems.

13. What is Lazy Eye?
Astigmatism causes your
vision to be blurry no matter
where you look and depending
upon the type of astigmatism
present, even a small amount
can cause amblyopia.

14. What is Deprivational Amblyopia?
Deprivational Amblyopia is caused
by a congenital cataract or other
blockage of light getting to the back
of the eye and is a pathological
cause of non-functional amblyopia.
This type of amblyopia is not being
discussed today.

15. What is Lazy Eye?
Another cause of a functional vision
loss is a constant strabismus. This
is an eye turned inward, outward, up
or down. It must be a constant eye
turn to cause amblyopia.

16. What is Lazy Eye?
Strabismus
Exotropia: an outward eye turn
Esotropia: an inward eye turn
Hypertropia: a vertical eye turn

17. At What Age Can You Treat
Lazy Eye?
Despite what you may hear from those who
have not kept up with the latest research,
Lazy Eye can be treated AT ANY AGE!
Children, Adults and Seniors
may all benefit from treatment.

18. How Do You Treat
Lazy Eye?
Treatment always starts with the best
prescription glasses possible. This
prescription may change over time as the
functional vision loss improves.

19. How Do You Treat
Lazy Eye?
If wearing the glasses improves the vision
in the amblyopic eye, the doctor will often
suggest a change in the prescription or
continued wearing of the glasses before
other treatment options are considered.

20. How Do You Treat
Lazy Eye?
If wearing glasses does not continue to
improve the vision in the amblyopic eye,
your doctor may suggest patching the
better seeing eye. Usually patching 2
hours/day while doing hand-eye activities
at home will improve how the patient sees.

21. How Do You Treat
Lazy Eye?
If this does not improve the vision in the
lazy eye, your doctor may suggest
additional hours of patching and additional
home vision therapy.

22. How Do You Treat
Lazy Eye?
There are times when some
children will not wear their eye
patch. If this happens the doctor
may recommend using atropine in
the better seeing eye. This blurs
the better seeing eye at near and
forces the amblyopic eye to be
used. Usually 1 drop in the amblyopic eye on Saturday and Sunday
works as well as 1 drop daily.

23. How Do You Treat Lazy Eye?
Next comes optometric vision therapy.
Vision therapy is a doctor-supervised, non-surgical, customized program of
therapeutic procedures designed to prevent, remediate, and/or enhance
vision problems and/or improve visual skills.
Vision therapy can include the use of lenses, prisms, filters, computerized
procedures and non-computerized instrumentation. The goal of vision
therapy is to treat vision problems that cannot usually be treated
successfully with eyeglasses, contact lenses and/or surgery alone, and help
individuals of all ages achieve single, clear, comfortable binocular (two-eyed)
vision using the scientific principles of neuroplasticity.

24. Amblyopia Treatment Summary
Diagnostic
Evaluation
• Full eye
examination
(with dilation
cycloplegic
refraction)
• Visual
efficiency
assessment
• Specialized
testing
Glasses
• Full time
wear
• Rx may
change as
vision
improves
Patching
• Patch better
seeing eye
• As little as 2
hrs/day may
work well
• May
recommend
hand-eye
activities
also
Eye
Drops
• Atropine is
used if child
will not wear
patch
• 1 drop on
Sat & Sun
works as
well as 1
drop daily
Vision
Therapy
• In office
• Out of office
• A treatment
prescribed by
your
optometrist
and
individualized
for the each
patient

25. Amblyopia FAQs
Where do I find a doctor that treats amblyopia and provides
vision therapy?
In Chicago go to Lyons Family Eye Care (LFEC).
To find a doctor close to you go to the
College of Optometrists in Vision Development,
Optometric Extension Program Foundation and
American Optometric Association websites.

26. Amblyopia FAQs
What credentials should my doctor have so I know he/she
will provide the best care?
Your doctor should have one or more of the following:
Completed a residency in pediatrics, binocular vision and vision
therapy
Fellowship and/or membership in the College of Optometrists in Vision
Development
Membership in the Optometric Extension Program Foundation
Diplomate in Pediatrics/Binocular Vision from the American Academy
of Optometry

27. Amblyopia FAQs
Does vision therapy work for amblyopia?
Yes! The College of Optometrists in Vision Development and the
Optometric Extension Program Foundation have many articles
supporting vision therapy for the treatment of amblyopia and other
functional vision problems. The American Optometric Association also
has Clinical Guidelines for amblyopia that include vision therapy as
well. The National Institutes of Health National Eye Institute sponsored
PEDIG clinical trials that support the interventions noted in this
presentation about amblyopia. PUBMED lists hundreds of articles that
clearly show amblyopia can be treated at any age.

28. Amblyopia FAQs
Tell me more about vision therapy
There are 4 phases to vision therapy
Glasses
Patching
Eye Drops
This was
previously
described
Monocular
• Hand-eye
• Focusing
• Eye
movement
Biocular
• Same as
noted in
monocular
phase and
antisuppression
Binocular
• Same as
noted
previously
plus
convergence
and
divergence
therapy
Integration
&
Stabilization
• Hand-eye, eye
movement,
focusing,
convergence
and divergence
therapy done
simultaneously

29. Amblyopia FAQs
Tell me more about the vision therapy program
Functional optometrists will use computer programs,
lenses, prisms, and other specialized equipment during the
therapy both in office and for you to use at home.

30. Amblyopia FAQs
Tell me about home vision therapy
Home vision therapy can vary from doctor to
doctor. I recommend a minimum of 20 to 30
minutes per day, 5 days per week. Some doctors
do not prescribe home vision therapy, but I find
that the in office therapy program progresses at a
faster rate of speed if home therapy is conducted.

31. Amblyopia FAQs
What does vision therapy cost?
This will vary from office to office but is
comparable in cost to occupational, physical,
and/or speech/language therapy. Some offices
charge for each individual visit while others have
a “program” similar to that of having braces
applied by your dentist.

32. Amblyopia FAQs
Does insurance cover the cost of vision therapy?
Yes. No. Maybe. Some time ago most insurance
would have picked up about 80% of the cost. Then
my impression was that the insurance companies
just seemed to stop reimbursement for therapy. Now
they are once again picking up some of the cost.
Know your insurance policy. Do not take “NO” for an
answer. Your doctor’s office will usually assist you
when it comes to insurance, but it is ultimately your
responsibility.

33. Amblyopia FAQs
Where do I learn more about treatment, especially
from a parent’s or patient’s point of view?
Go to:
Parents Active in Vision Education
Vision Therapy Parents Unite!
Vision Therapy Changed My Life
Convergence Deficiency/Insufficiency
Living with Diplopia

34. Amblyopia FAQs
Amblyopia InfoGraphic

35. Amblyopia FAQs
Amblyopia InfoGraphic

36. Amblyopia FAQs
Amblyopia InfoGraphic
(Courtesy of VisionHelp.com)

37. Amblyopia FAQs
Where can I get additional information on pediatrics,
binocular vision, vision therapy, children wearing
glasses and more?
MainosMemos
VisionHelp blog
COVD blog
Discovering Vision Therapy blog
Wow Vision Therapy blog
SOVOTO
Little Four Eyes

38. Amblyopia FAQs
Reading List
Fixing My Gaze: A Scientists Journey into Seeing in 3 Dimensions
By Susan Barry, PhD
Eyes For Learning: Preventing and Curing Vision-Related Problems
By Antonia Orfield
When Your Child Struggles: The Myths of 20/20 Vision
By David Cook, OD
The Suddenly Successful Student: A Parents’ and Teachers’ Guide to Learning & Behavior
Problems: How Behavioral Optometry Helps
By Hazel Dawkins, E. Edelman, O.D. & C. Forkiotis, O.D.
Suddenly Successful: How Behavioral Optometry Helps You Overcome Learning, Health &
Behavior Problems
By Hazel Dawkins, E. Edelman, O.D. & C. Forkiotis, O.D.
Thinking Goes To School
By Hans G Furth, Harry Wachs, O.D.
Your Child’s Vision
By Richard Kavner, O.D.
See Vision Therapy Rocks
for more resources

39. Amblyopia FAQs
Where can I get additional help?
Call or email us at Lyons Family Eye Care.
Lyons Family Eye Care
3250 N. Lincoln Ave.
Chicago, IL 60657
Click here to view a map of our location
Phone Number: 773-935-2020
Email: info@lyonsfamilyeyecare.com
“LIKE” us at Vision Therapy at Lyons Family Eye Care
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40. About Dominick M. Maino, OD, MEd, FAAO, FCOVD-A