Strabismus/Amblyopia (Lazy Eye)

Strabismus occurs when one eye does not align with the spot a person is looking at. This misalignment can take different forms:

• Exotropia: the eye turns outward
• Esotropia: the eye turns inward
• Hypertropia: the eye turns upward or downward

Strabismus can appear at birth or develop later in life due to infections, trauma, diabetes, tumors, or other conditions. When the eyes are not aligned, a person may experience:

• Double vision (common if the condition develops after age 6)
• Suppression of one eye to avoid double vision
• Loss of depth perception (3D vision)
• Poor binocular coordination (eye teaming)

Amblyopia—often called “lazy eye”—happens when one or both eyes do not develop clear vision. Causes include strabismus, unequal or high prescriptions, astigmatism, nutritional deficiencies, or early developmental issues such as congenital cataracts. Even with glasses, the affected eye(s) cannot achieve 20/20 vision.

Amblyopia usually develops between birth and age 7 and is the leading cause of permanent vision loss in people under 40—more than all eye diseases and trauma combined. About 5% of children are affected, and parents may not notice it without a professional eye exam. This is why infants should have their first eye evaluation between 6–12 months of age with a pediatric or behavioral optometrist.
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Why Early Treatment Matters

Both amblyopia and strabismus respond best to early detection and treatment. While it was once believed treatment was ineffective after age 6, research now shows excellent results are possible at any age with proper care.

​​​​​​​Surgery may straighten the eyes cosmetically, but it rarely restores normal binocular vision and comes with the risks of anesthesia. The most effective long-term solution is vision therapy, which retrains the eyes and brain to work together. With therapy, both clarity of vision and eye coordination can improve dramatically.