Amblyopia(lazy eye) is a condition in which one eye does not function properly.
Therefore, the brain only works with the better-seeing eye and ignores images from the weaker eye.
Its symptoms include unequal vision in the eyes and impaired depth perception.
Verywell / Brianna Gilmartin
This results in permanently decreased vision in the ambylopic eye that is not correctable with glasses or contact lenses.
Non-surgical interventions are more common than surgery for managing the causes of amblyopia.
However, when appropriate, surgery can help to correct some of the causes in children.
These can include strabismus (crossed eyes), cataracts, refractive errors, and a droopy eyelid.
This article discusses when surgery is an option for amblyopia.
It also covers the purpose of surgery, what to expect, and recovery.
When Is Surgery an Option for Amblyopia?
Surgery may be an option for certain eye conditions that cause amblyopia.
However, surgery doesn’t treat amblyopia itself.
The most common treatments for amblyopia are wearing glasses or an eye patch.
Vision correction might reverse amblyopia, especially if done at a young age.
However, most cases of refractive correction in children can be treated with glasses and occasionally contacts.
Surgery is generally reserved for children withanisometropicamblyopia who do not respond to standard treatment.
Anisometropic means that there is a large difference in prescription between the two eyes.
That’s because PRK doesn’t have certain risks that LASIK has.
With PRK, the ophthalmologist uses a laser to shape the cornea.
This helps improve how the light focuses on the retina to correct vision.
StrabismusStrabismus, or crossed eyes, can sometimes cause amblyopia.
In strabismus, your eyes are pointed in two different directions.
For instance, one eye may be focused straight ahead, while the other is turned to the inside.
Eye muscle surgerymay be recommended for treating strabismus.
This surgery is performed on the muscles to realign the eye.
In a resection procedure, the eye muscle has a section removed to make it shorter and stronger.
CataractsCataractsare a clouding of the eye’s lens.
It not only affects adults, but it can occasionally affect children, too.
It may be something they’re born with or something they develop in childhood.
Without treatment for cataracts, vision distortion can lead to amblyopia.
That’s because children’s eyes and brains are still developing in their ability to process vision.
In this case, the first step to resolving amblyopia iscataract surgery.
The procedure involves removing the cloudy lens in your eye and replacing it with an artificial lens.
Afterward, most children need ongoing treatment to help improve the connections between the brain and eyes.
In some cases, it can cause amblyopia, since one eye can see better than the other.
Ptosissurgery involves tightening the levator muscle, which lifts the eyelid.
It might also involve attaching the eyelid to other muscles that can help lift it.
Health issues like a bleeding disorder, inflammatory disease, or immune dysfunction can increase your risk of complications.
You and your healthcare provider will have to weigh the risks and benefits of surgery in your case.
Problems that may occur due to surgery include:
These complications might require immediate intervention.
Blurry vision, decreased vision, or blindness are potential rare and unforeseen complications in any ophthalmic surgery.
In fact, many people with amblyopia do not complain about vision difficulties or eye movement issues.
Often, amblyopia is diagnosed with a routine eye examination, such as arefraction test.
Addressing amblyopia as early as possible is important.
Early treatment can prevent permanent vision loss later in life.
Many times, a lens prescription (refractive correction) will restore proper eye alignment.
Surgery may be necessary to correct structural defects in the eye.
However, even with surgery, follow-up treatment is typically needed to correct amblyopia.
This involves strengthening your weaker eye by increasing its use.
One example is patching.
Specific testing might be needed to evaluate issues likecongenital cataracts.
There are several types of laser eye surgeries, such aslaser-assisted surgery for cataracts.
LASIK or PRK surgery both use lasers to correct refractive issues.
Additionally, pre-operative testing includes anesthesia preparation.
It may also include a test for COVID-19.
These ophthalmic surgeries are generally outpatient procedures, meaning you will go home on the same day.
What to Wear
You or your child can wear anything comfortable for the procedure appointment.
All surgeries done in an operating room under some level of sedation require fluid and food restriction before surgery.
Depending on the age of the child, the number of fasting hours may vary.
The surgical or anesthesia team will provide specific instructions.
Medications
Typically, blood thinners and anti-inflammatory medications must be stopped for several days before surgery.
Additionally, use of lubricating eye drops or antibiotic ointment may be needed for several days before the surgery.
This can prevent eye muscle weakness or diminished vision from worsening in your weaker eye.
You will be asked to show identification and insurance information.
Same-day testing may include CBC, electrolyte tests, and aurine test.
If an infection is detected, the surgery may need to be rescheduled.
Vital signs, including temperature, blood pressure, pulse, and breathing rate will be monitored.
Typically, oxygen saturation will be checked with apulse oximeteras well.
An intravenous (IV, in a vein) line will be placed in the arm or hand.
The ophthalmologist andanesthesiologistmay come to do a pre-operative check shortly before surgery.
Then, when it is time for surgery, you will go to the operating room or procedure suite.
Before the Surgery
Preparation includes getting the eye ready for an incision and administering anesthesia.
Sometimes, an antibiotic ointment is applied to the eye prior to surgery.
Pain medication will be given as needed.
Use of the bathroom without assistance will be permitted.
The nurse will ensure that small amounts of food and drink are tolerated.
A prescription for pain medication and possibly an antibiotic will also be written.
Protecting the eye from contamination is important after eye muscle surgery.
And you may need to avoid exertionafter cataract surgery.
If you are unsure about your recovery period instructions, be sure to call your surgeon’s office.
Keep your eye clean and dry for several weeks after your procedure.
You might be given a prescription for antibiotics or other medications.
Be sure to take them as directed.
You might experience mild pain, discomfort, or swelling for a few days.
Your healthcare provider will give you a timeline for when you might restart these types of activities.
Excessive sunlight or bright lights can interfere with healing.
You will need to wear sunglasses to protect your eyes from excessive light after you stop wearing a patch.
Sometimes, physical therapy is needed for your eyes.
This can include eye movement exercises to strengthen weakened muscles.
That said, you might still have some vision defects after surgery.
Your vision might be different than it was before.
Your healthcare provider might give you a new prescription for eyeglasses several weeks or months after you heal.
You may also need use prescription eye drops to help strengthen your weaker eye.
(Children may need to wear a patch.)
After surgery, you will need to have regular eye examinations.
After any punch in of eye surgery, dry eyes can be a problem.
Using eye drops for lubrication can help prevent this problem.
And you might need future surgery if you develop another surgically correctable eye problem at a later date.
It’s typically treated with non-surgical methods, including wearing a patch over the stronger eye.
Sometimes the cause of amblyopia can be treated with surgery, but only in children.
Examples include strabismus, cataracts, refractive errors, and droopy eyelid.
A Word From Verywell
Surgical treatment for the causes of amblyopia includes a variety of methods.
But if surgery is recommended by your ophthalmologist, the outcome can improve your quality of life.
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