Discover Vision Centers has an extensive history in the development of LASIK and providing life-changing outcomes for patients. Patients often ask if LASIK is an option for those with amblyopia and if LASIK surgery can fix lazy eye. Correcting a lazy eye in an adult requires an understanding of the underlying cause.
Amblyopia is the medical term for a lazy eye, and it occurs when the eyes do not work in concert with each other. The two main causes for amblyopia are either an eye misalignment or a significant difference in the power between the eyes known as anisometropia. Alternatively, if there is an eye turn strabismus the brain will turn off the signal from one eye to avoid double vision. In the case of differing powers, the brain will choose the image that is most clear. In either scenario, the neural pathway from the back of the eye to the brain is underutilized, which leads to underdeveloped vision.
When discussing LASIK surgery for amblyopia, setting proper expectations is important. Approximately 2–3% of the population can be affected, and there are different types of amblyopia to consider. Early intervention in the first decade of life will lead to the best outcomes. The neural pathway from each eye to the brain requires an equal signal for the best development in early childhood. Understanding the root problem helps answer the question of whether LASIK can fix a lazy eye. In the case of anisometropia, LASIK vision correction can balance out the refractive error between the eyes, but final vision is dependent on what the neural pathway will support.
Amblyopia (lazy eye) is a disorder of vision in which the brain fails to fully process input from one eye and over time favors the other eye; it results in decreased vision in the offending eye. The eye, internally and externally, will appear otherwise normal. Amblyopia is the most common cause of decreased vision in a single eye among children and younger adults. Importantly, if amblyopia has developed, LASIK or refractive surgery cannot restore the lost vision, but it can resolve the refractive error so the person can have optimal performance without glasses or contact lenses.
Strabismus amblyopia is the most common cause of amblyopia. To avoid double vision created by misaligned eyes, the brain ignores the visual input from the misaligned eye, which leads to amblyopia in that eye.
Refractive amblyopia is a common type of lazy eye. It occurs when a child is born with a high refractive error (diminished acuity or blurriness) in one eye compared to the other eye. Externally and internally, the eyes will appear normal, and the eyes will be aligned.
Deprivation amblyopia is the least common form of amblyopia. It is typically the most severe form of amblyopia, and it often causes the worst vision in comparison to other types of amblyopia. Deprivation amblyopia occurs when the visual axis is obstructed. Causes of stimulus deprivation include eyelid ptosis, corneal opacities, cataracts, and vitreous hemorrhage, among others.
There are several types of amblyopia. Depending on the type of amblyopia, a different approach may need to be taken to address a patient’s specific issue. As we mentioned earlier, the sooner the unequal signal that each eye is sending to the brain is realized, the more treatable it is, and better long-term outcomes may be achieved. Fixing a lazy eye in adults has less success than in children.
Strabismus amblyopia: This subtype of amblyopia is induced by an imbalance of the eye’s extraocular muscles, resulting in an eye misalignment. LASIK cannot address this directly; however, in many cases, once surgical repair of the muscles is completed, the refractive error can be corrected with LASIK.
Refractive amblyopia: For this type of lazy eye, LASIK can play a key role. When there is a significant difference in refractive error between the two eyes, LASIK can correct this error and put the eyes on an equal plane. With the eyes corrected, the neural pathway will determine the final vision of the amblyopic eye.
Deprivation amblyopia: The most common types of eye diseases that cause deprivation amblyopia are congenital cataracts, corneal opacity, or an eyelid that anatomically covers the eye. In all cases, light is not able to get to the retina properly, and with a reduced signal to the brain, the neural pathway is underdeveloped. LASIK is not the first solution, but it may be considered after the underlying problem is addressed.
Will LASIK fix lazy eye? With refractive amblyopia, the goal is to make the eyes see on the same plane and give equal input to the brain. In this case, LASIK can be considered a treatment to aid in the correction of lazy eye. If there is a significant refractive error between the eyes, this can often make it difficult to tolerate a pair of glasses. The magnification from the glasses correction will be different between the eyes, and it can place unequal image sizes on the retina. Symptoms will often include blurred vision, headaches, eyestrain, or dizziness. This is not the case with LASIK, as it places the correction directly on the eye. In these cases, LASIK will fix the root cause and may be recommended as lazy eye treatment.
The best candidates for LASIK eye surgery in patients with lazy eye are those whose amblyopia is due to anisometropia asymmetric refraction between the two eyes. This large difference in prescription between the two eyes can be made more equal with laser vision correction. There are varying degrees of best corrected vision in amblyopic eyes before surgery. For example, one person’s best vision with correction in the lazy eye may be 20/40 vision, while another may only achieve vision of 20/400. The surgical outcome should be able to match the preoperative best correction. LASIK can correct eyes with myopia, hyperopia, and astigmatism.
Poor vision is the primary finding in lazy eye. A full ocular health examination must be done to rule out other causes of decreased vision, but in most cases the internal evaluation of an amblyopic (lazy) eye will appear normal. The most common causes of lazy eye are either strabismus (misalignment of the eyes) or anisometropia (a large difference in the prescriptions between the eyes). After excluding other ocular pathology, coupled with strabismus or anisometropia, a diagnosis of amblyopia can be made.
Treatments can include the following:
Discover Vision has been helping patients in the Kansas City metro area and beyond correct their vision with LASIK for more than twenty-five years. We have helped tens of thousands of patients with many types of prescriptions, including those with amblyopia, see clearly without their glasses and contact lenses.
Discover Vision’s laser vision correction surgeons and refractive specialists include Dr. John Doane and Dr. Randy Jackson. Dr. Doane and Dr. Jackson are both fellowship-trained in cornea and refractive surgery.
Discover Vision Centers has been serving the Kansas City community for over 50 years. Dr. John Doane has been performing laser vision correction since 1995. He has been ranked among the top 5% of Laser vision surgeons in the country. Our Refractive Team has performed over 45,000 vision correction procedures and has been instrumental in pioneering the latest solutions in Vision Correction and advanced microsurgery. For more information on SMILE, call 816.283.EYES.
Dr. Randy T. Jackson is a board certified ophthalmologist who specializes in refractive surgery, including SMILE, LASIK Laser Vision Correction, Photorefractive Keratectomy (PRK), Full Focus® Vision Correction and cataract surgery. For more information on SMILE, call 816.283.EYES.
LASIK will not make lazy eye worse. LASIK will correct the prescription required by the eye, but final acuity is determined by the degree of vision the neural pathway can support.
Lazy eye can be treated with vision therapy at any age; however, the visual system has more plasticity when a person is younger, which makes therapy more successful in children.
If you are curious about cost, the best place to start is with a free LASIK consultation to determine if you are a candidate for surgery. LASIK consultations are performed virtually or in-office. During your consultation, our team will discuss pricing and financing options available through CareCredit (subject to credit approval).
