What would you recommend for amblyopic eyes?

Patient's Query

Hello doctor,

I am a 19 year old male and I have some questions about my eyesight. I have amblyopia and strabismus. When I was born, I was almost blind in my left eye around 20/200. My eye doctor made me wear glasses and patch my right eye until I was about 6. As I absolutely hated the patching I was not compliant and I still have a lazy eye. My right eye is nearsighted and my left eye is farsighted. I have worn glasses full time. I do not remember the diopters for each eye. My right eye over the years has increased in nearsightedness and my left eye is getting weaker because my brain ignores it. My right eye is corrected to 20/20 and my left eye is corrected to 20/40. My eye doctor says that I am one-eyed and surgery would only be cosmetic. I have been doing some research and I have found that through different eye exercises and patching one can improve eyesight in adulthood. My biggest concern is that if I should engage in these exercises. When I cover my right eye the left one immediately goes to the center and when I look up it goes up and left. I am worried because I am both near and farsightedness and if both eyes are used, I will get double vision. I hate being only able to use one eye at a time and I want to strengthen my left eye. What would you recommend? Should I engage in these exercises or just accept the fact that I will be monocular for the rest of my life? I look forward to your reply. I thank you in advance.

Answer

Dr. Asif Manzoor

Ophthalmology (Eye Care)

Hi,

Welcome to icliniq.com.

You have explained everything very well.

Whenever there is a difference in refractive status of more than 1 diopter between two eyes, there is a chance of amblyopia (lazy eye) when the brain starts ignoring the blurry eye.

I think your eye doctor has done a great job that you got 20/40 in worse eye and that is a good vision. But, still might not have normal stereopsis (depth perception) and perfect alignment of the eyes.

Initially, it was said that patching is only beneficial in younger age till 8 to 12 years of age. Now, there are ongoing trial on the benefits of patching and exercise in adults and they say they are getting promising results. But, final results are still awaited.

You can try and see what happens. Because, you got nothing to lose now as your right eye is normal. You can try if you want to take a chance.

The second thing you mentioned is that your left eye gets central when you cover the right eye and that show your vision in the left eye is good.

Surgery can be done to align your eyes and that will give you cosmetic correction. But, there is always some chance that lazy eye can get deviated over the years.

For possibility of double vision after surgery, your doctor can test with post-operative diplopia test using a prism that wherever there are chances of diplopia or not after surgery. Also, that gives a safe range for correction where there is no double vision.