Lazy eye and strabismus surgery are popular topics that are often misunderstood and can be confused.

Amblyopia, or lazy eye, is when an eye has poor vision because it’s not working in coordination with the brain. It can happen in both eyes but usually happens in only one eye. The brain then favors the better-seeing eye. Sometimes this causes the weaker (“lazy”) eye to wander outward, inward, upward or downward. When an eye wanders, that condition is called strabismus.

Amblyopia usually develops in early childhood and is the leading cause of vision loss in children. Early vision screening by a pediatrician, family doctor or an ophthalmologist is important in detecting children with amblyopia as young as possible. A number of eye diseases can contribute to the development of amblyopia.

Amblyopia treatment should be started as early as possible because:

• over time the amblyopic “lazy” eye could become permanently blind;
• depth perception (3-D vision) could be lost; and
• if the other, better-seeing, eye becomes diseased or injured, the amblyopic “lazy” eye cannot replace the loss in vision.

Amblyopia and strabismus are commonly confused. When most people think of “lazy eye” they are actually thinking of wandering or misaligned eyes, which is strabismus. “Lazy eye” is amblyopia — poor vision in one or both eyes. This poor vision (amblyopia) can lead to eye misalignment (strabismus). Strabismus is more commonly referred to as crossed eyes, wandering eyes, or drifting eyes. If for some reason one eye of a child has decreased vision, the brain will not use that eye and it becomes lazy from lack of use. That is amblyopia — the eye is lazy from lack of use. If one eye happens to be looking somewhere other than the other eye, that is strabismus.

Lazy eye (amblyopia) cannot be treated with surgery. It can only be treated when the patient is a child. The younger it is detected and treated the better. In fact, after age 6 the success rate of treatment goes way down. Glasses and eye patches are the most common treatments for amblyopia, or lazy eye.

“Lazy eye surgery” does not exist. This comes from the fact that strabismus (wandering of one or both eyes) is often confused with the eyes being “lazy.” Lazy eyes with amblyopia just do not see well, it DOES NOT mean they wander or drift.

Strabismus, or eye misalignment, CAN be treated with surgery on the eye muscles. This surgery can be performed on both adults and children. Eye muscle surgery can improve not only the cosmetic appearance of the eyes but also visual function.

When most people ask about “lazy eye surgery,” they are really talking about strabismus surgery, or surgery to correct misalignment of the eyes.

If you are considering eye muscle surgery, here are the key facts to know:

• The surgery works by either loosening or tightening the eye muscles. This changes the alignment of the eyes relative to each other.
• The are two main types of surgery:
  • Recession is when an eye muscle is detached and then reattached further away from the front of the eye to weaken the muscle.
  • Resection is when a portion of an eye muscle is removed to make the muscle stronger.
• Approximately 1.2 million eye alignment surgeries are performed each year, making it the third most common eye surgery in the United States.
• Eye muscle surgery has a high success rate and serious complications are extremely rare.
• It is a one-day procedure that usually does not require staying overnight in the hospital.
• Children can return to school after a few days of rest. Most adults can return to work within a week.
• Pain, soreness, redness, and double vision are the most common side effects of eye muscle surgery. These are usually temporary.

Whether you are looking into this “lazy eye surgery” for yourself or your child, a vital first step is to discuss your goals and expectations for the surgery with your ophthalmologist.