Amblyopia: The Hidden Eye Problem

March 18, 2015

Glasses 3Before J left the NICU, a pediatric ophthalmologist cleared him of any vision problems caused by being on oxygen for 10 weeks or from being so premature. His vision developed normally, and by the time he was a toddler, my husband and I were pleasantly surprised by how good his vision was. He would point to a dot in the sky and call it a bird, while we just about needed binoculars to see it.

As it turned out, his vision was excellent…in his left eye.

We moved just before J’s 4th birthday, but we traveled back to his pediatrician one last time for his annual check-up. That decision probably saved his vision for the rest of his life. Our pediatrician was partnering with a large research hospital in the testing of a hand-held vision machine that was able to check a child’s vision within seconds. It didn’t work at all on our baby, but our pediatrician said that they were finding it to be very effective for toddlers and older children.

When the nurse checked J’s vision, the machine said that he had a large difference in the vision between his eyes and that he likely had amblyopia, or a lazy eye.

We were shocked.

We took J to a pediatric ophthalmologist, who told us that most children with J’s type of amblyopia have it for years before it is caught. Structural problems with the eye can cause it to cross, which is the more obvious form of amblyopia. But, J’s condition was caused by uneven eye development. Babies have very limited vision, and over the course of their first years, their eyes develop, expanding their vision. J’s eyes developed at very different rates. Both eyes are structurally healthy, and both eyes are capable of seeing objects at a great distance. However, J’s right eye was so weak in its ability to focus on close objects that his brain began to ignore the signal from the weaker eye. Over time, the brain continues to ignore the weak eye to the point that the condition is irreversible, usually at about age 9. The older the child, the harder the condition is to treat.

What is amazing to me is that we caught J’s condition at all! I had no reason to question his vision, we had absolutely no history of amblyopia in our family, and J had been cleared from vision issues caused by his prematurity. Even the pediatric ophthalmologist said we were very lucky to have found the problem before J struggled with reading, which is a red flag for most children with his specific condition.

I believe J’s eye condition was related to his unusual brain development. He was born at 26 weeks, and I’ve noticed a number of quirks that I believe have to do with a baby being born so early. J is very left-side dominant, another anomaly in our family, and I don’t think that it is a coincidence that his right eye developed so far behind his left one because it mirrors exactly how he learned to hold objects, to crawl, and to walk. The right side of his body was always behind his left.

Glasses 4Amblyopia is very common, affecting as many as 20% of children. I want to encourage my fellow preemie parents to have your toddler’s eyes checked. I had a false sense of security because J’s eyes were healthy when we left the NICU, but the truth is that as our kids grow, it is especially important for us to monitor all aspects of their development. They can’t express vision problems to us, and it is so much better to be safe than sorry.

Within days of his wearing glasses, we noticed an improvement in J’s vision, and we hope that because his condition was caught early, he may eventually have normal vision in both eyes. That is just another blessing to add to our many, many blessings!