Amblyopia

What is amblyopia? Amblyopia (also called lazy eye) is a type of poor vision that usually happens in just 1 eye but less commonly in both eyes. It develops when there’s a breakdown in how the brain and the eye work together, and the brain can’t recognize the sight from 1 eye.

In the late winter, when I was still very pregnant with Ori, I took Ezra to his 4 year pediatric checkup. He was actually a few months late to get this checkup, but neither Theo nor I had any concerns that we weren’t already aware of/managing (his asthma and his tonsils). So I was very surprised when the pediatrician mentioned that he failed his vision screen and she was going to refer him to an ophthalmologist. I almost laughed- he didn’t have any vision issues! Theo laughed, too. He said it was all just a ploy to get us to go see other doctors and pay ridiculous medical bills. He was joking, but also kind of not. So as soon as we got home from that appointment, Theo pulled out a variety of small animals and did a totally casual, unofficial vision test at home.

“Which animal am I holding up?” He asked Ezra, eager to prove the pediatric vision test wrong. When covering his right eye, Ezra got every single animal right.

“Pig, Sheep, Cow” he would say, to our eager nods. Then we covered up his left eye and tried the same test.

He got every single animal wrong.

Well, then.

We immediately followed through with a trip to the ophthalmologist. He confirmed what we kind of already knew: Ezra had 20/20 vision in his right eye, but was almost unable to see out of his left eye. He diagnosed him with amblyopia – what our parents/grandparents would have called “lazy eye”. Basically, one eye works perfectly fine and the other eye is not working well at all. The brain thinks it’s way too hard to work with this lazy eye- and basically fires it from doing it’s job and ghosts it. The brain completely stops communicating with the eye, which can lead to blindness and the vision in that eye can never be retrieved. Both the pediatrician and the eye doctor said that it’s easy to miss this diagnosis, because the one eye still works perfectly fine, and usually children aren’t even aware that they are only operating with one good eye.

Ezra immediately got glasses, hoping to make his eye stronger. He wore the glasses for about 6 weeks, and while we did see some improvement in his eye, the doctor recommended we start also patching his eye.

Four hours a day.

For 4 to 6 YEARS.

YEARS.

The doctor said it would take years.

So, for the past 5 months Ezra has been patching his eye every single day. Ok, there may have been one or two days that we forgot…but very faithfully he has been patching. He strongly dislikes it, but he knows that he needs to do it and so he does it. He usually asks every 20 minutes or so when he can take it off, but honestly we are just so proud of him for wearing it!

One of the hardest parts of patching for me as a Mom has been dealing with the comments! People- full grown adults, random strangers, friends that we know, other kids- will come up to Ezra and say

“What is WRONG with your eye?”

The poor kid just kind of blinks at them. As far as he is concerned, there is nothing *wrong* with his eye. And he doesn’t have the words to explain why he has to wear the patch. He wears it because he’s being told to wear it, ha. I try to answer gently, but sometimes I just wish that people would keep their comments to themselves, or think of something nice to say about it. Sigh.

Anyways- today Ezra had his follow-up appointment to check and see if patching is helping his eye develop that crucial communication with his brain.

Friends.

The doctor said that his vision/eye communication has improved SO MUCH that he doesn’t need to patch anymore!!!

I’m sorry, what?!?!

He just moved his timeline from 4 to 6 YEARS….to 6 MONTHS.

I am so blown away by this good news. And SO PROUD of my boy who didn’t want to do it, but did it anyways. He has more strength and determination and grit that most adults I know, and today I am SO PROUD of him!

We will continue to checkup and keep a close eye on Ezra and his vision, and will have another appointment in two months to see if he has continued to improve. These six months have been a lot of growing and learning. I am thankful for the resources we have and that we caught his amblyopia early enough to begin treating it so aggressively- and that he made such incredible progress in such a short amount of time!

Tips and Tricks

• Talk clearly and directly to the child about the problem + solution. It can be hard for them to understand, but don’t just sweep it under the rug. Make sure they know why they are patching and /or wearing glasses
• Order some fun patches! We got ours from Ohio Amblyope. The eye doctor gave us a referral code and they sent us 500 free eye patches and a fun eye patch poster to put the patches on when used
• The first patch we used was a reusable patch that could go directly onto Ezra’s glasses. Lots of people love this option, but it did not work for Ezra because he would consistently just take his glasses off, or lift or lower them in order to use his strong eye (remember, that is the one that is being covered).
• Be consistent. The doctor said that the main reason Ezra moved up his patching timeline so quickly was because he was so consistent about wearing his patch. As you can see from some of the above photos- he wore it EVERY DAY, no matter what! To church, to school, to play dates, he wore it the morning he had his tonsillectomy, and he even wore it to the water park! (He did take it off as soon as he was ready to go in the water). Of course, we missed a few days here and there, but overall we were extremely diligent to be consistent, and I think that really does pay off in the long run.
• Offer a reward! Patching is hard work- so we told Ezra once he finished his eye patch chart (think a sticker chart, but the stickers are the eye patches), he could pick a fun family outing. He picked mini golfing and is just about to earn a second reward.
• Make a day or a few hours where everyone in the family has to wear an eye patch! This makes it feel so much less isolating for the child who has to do it, and it helps everyone else have some more compassion and empathy when we experienced it, too.
• Remember to be patient and give grace if they are struggling. They could be struggling to see, or just struggling with a bad mood because they can’t actually see and have to work so much harder for something that most people just take for granted.
• Choose a consistent time of day to patch. We decided to do it first thing in the morning when he puts on his glasses. We also wanted it to be a time of day that he is using his eye, so that it gave him chances to truly strengthen that eye.
• Come up with some easy words or phrases to say to people who ask why he has a patch. Trying to get a four year old to say and explain “amblyopia” is probably more difficult than the actual patching! And saying “lazy eye” isn’t really PC anymore, as it makes it seem like a really detrimental condition. Instead, practice saying something like “Im making my eye stronger” or “it’s to help me see better when I take it off” are simple and to the point.

Recommended Eye Patch Products

Eye Patches to go on the glasses- reusable!

Fun Eye Patches- one time use

Eye Patch Reward Posters

Have you had experience with amblyopia? What else would you add?