wandering right eye

Lazy eye (amblyopia)

On this page, when to see a doctor, risk factors, complications.

Lazy eye (amblyopia) is reduced vision in one eye caused by abnormal visual development early in life. The weaker — or lazy — eye often wanders inward or outward.

Amblyopia generally develops from birth up to age 7 years. It is the leading cause of decreased vision among children. Rarely, lazy eye affects both eyes.

Early diagnosis and treatment can help prevent long-term problems with your child's vision. The eye with poorer vision can usually be corrected with glasses or contact lenses, or patching therapy.

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Signs and symptoms of lazy eye include:

• An eye that wanders inward or outward
• Eyes that appear to not work together
• Poor depth perception
• Squinting or shutting an eye
• Head tilting
• Abnormal results of vision screening tests

Sometimes lazy eye is not evident without an eye exam.

See your child's doctor if you notice his or her eye wandering after the first few weeks of life. A vision check is especially important if there's a family history of crossed eyes, childhood cataracts or other eye conditions.

For all children, a complete eye exam is recommended between ages 3 and 5.

Lazy eye develops because of abnormal visual experience early in life that changes the nerve pathways between a thin layer of tissue (retina) at the back of the eye and the brain. The weaker eye receives fewer visual signals. Eventually, the eyes' ability to work together decreases, and the brain suppresses or ignores input from the weaker eye.

Anything that blurs a child's vision or causes the eyes to cross or turn out can result in lazy eye. Common causes of the condition include:

• Muscle imbalance (strabismus amblyopia). The most common cause of lazy eye is an imbalance in the muscles that position the eyes. This imbalance can cause the eyes to cross in or turn out, and prevents them from working together.

Difference in sharpness of vision between the eyes (refractive amblyopia). A significant difference between the prescriptions in each eye — often due to farsightedness but sometimes to nearsightedness or an uneven surface curve of the eye (astigmatism) — can result in lazy eye.

Glasses or contact lenses are typically used to correct these refractive problems. In some children lazy eye is caused by a combination of strabismus and refractive problems.

• Deprivation. A problem with one eye — such as a cloudy area in the lens (cataract) — can prohibit clear vision in that eye. Deprivation amblyopia in infancy requires urgent treatment to prevent permanent vision loss. It's often the most severe type of amblyopia.

Factors associated with an increased risk of lazy eye include:

• Premature birth
• Small size at birth
• Family history of lazy eye
• Developmental disabilities

Untreated, lazy eye can cause permanent vision loss.

Aug 14, 2021

• Coats DK, et al. Amblyopia in children: Classification, screening, and evaluation. https://www.uptodate.com/contents/search. Accessed June 8, 2021.
• AskMayoExpert. Amblyopia. Mayo Clinic; 2021.
• Amblyopia. National Eye Institute. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/amblyopia-lazy-eye. Accessed June 8, 2021.
• Amblyopia preferred practice pattern. American Academy of Ophthalmology. https://www.aao.org/preferred-practice-pattern/amblyopia-ppp-2017. Accessed June 8, 2021.
• Coats DK, et al. Amblyopia in children: Management and outcome. https://www.uptodate.com/contents/search. Accessed June 8, 2021.
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Amblyopia (Lazy Eye)

At a glance: Amblyopia

Poor vision in 1 eye

Eye drops or wearing an eye patch

What is amblyopia?

Amblyopia (also called lazy eye) i s 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. Over time, the brain relies more and more on the other, stronger eye — while vision in the weaker eye gets worse.

It’s called “lazy eye” because the stronger eye works better. But people with amblyopia are not lazy, and they can’t control the way their eyes work.

Amblyopia starts in childhood, and it’s the most common cause of vision loss in kids. Up to 3 out of 100 children have it. The good news is that early treatment works well and usually prevents long-term vision problems.

What are the symptoms of amblyopia?

Symptoms of amblyopia can be hard to notice. Kids with amblyopia may have poor depth perception — they have trouble telling how near or far something is. Parents may also notice signs that their child is struggling to see clearly, like:

• Shutting 1 eye
• Tilting their head

In many cases, parents don’t know their child has amblyopia until a doctor diagnoses it during an eye exam. That’s why it’s important for all kids to get a vision screening at least once between ages 3 and 5.

Is my child at risk for amblyopia?

Some kids are born with amblyopia and others develop it later in childhood. The chances of having amblyopia are higher in kids who:

• Were born early (premature)
• Were smaller than average at birth
• Have a family history of amblyopia, childhood cataracts, or other eye conditions
• Have developmental disabilities

What causes amblyopia?

In many cases, doctors don’t know the cause of amblyopia. But sometimes, a different vision problem can lead to amblyopia.

Normally, the brain uses nerve signals from both eyes to see. But if an eye condition makes vision in 1 eye worse, the brain may try to work around it. It starts to “turn off” signals from the weaker eye and rely only on the stronger eye.

Some eye conditions that can lead to amblyopia are:

• Refractive errors. These include common vision problems like nearsightedness (having trouble seeing far away), farsightedness (having trouble seeing things up close), and astigmatism (which can cause blurry vision). Normally, these problems are easy to fix with glasses or contacts. But if they’re not treated, the brain may start to rely more on the eye with stronger vision.
• Strabismus . Usually, the eyes move together as a pair. But in kids with strabismus, the eyes don’t line up. One eye might drift in, out, up, or down.
• Cataract. This causes cloudiness in the lens of the eye, making things look blurry. While most cataracts happen in older people, babies and children can also develop cataracts.

How will my child’s doctor check for amblyopia?

As part of a normal vision screening , your child’s doctor will look for signs of amblyopia. All kids ages 3 to 5 need to have their vision checked at least once.

What’s the treatment for amblyopia?

If there’s a vision problem causing amblyopia, the doctor may treat that first. For example, doctors may recommend glasses or contacts (for kids who are nearsighted or farsighted) or surgery (for kids with cataract).

The next step is to re-train the brain and force it to use the weaker eye. The more the brain uses it, the stronger it gets. Treatments include:

Wearing an eye patch on the stronger eye. By covering up this eye with a stick-on eye patch (similar to a Band-Aid), the brain has to use the weaker eye to see. Some kids only need to wear the patch for 2 hours a day, while others may need to wear it whenever they're awake.

Putting special eye drops in the stronger eye. A once-a-day drop of the drug atropine can temporarily blur near vision, which forces the brain to use the other eye. For some kids, this treatment works as well as an eye patch, and some parents find it easier to use (for example, because young children may try to pull off eye patches).

After your child starts treatment, their vision may start to get better within a few weeks. But it will probably take months to get the best results. After that, your child may still need to use these treatments from time to time to stop amblyopia from coming back.

It’s important to start treating children with amblyopia early — the sooner the better. Kids who grow up without treatment may have lifelong vision problems. Amblyopia treatment is usually less effective in adults than in children.

Last updated: September 22, 2022

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Amblyopia (Lazy Eye)

Division of ophthalmology, what is amblyopia.

Amblyopia, also known as lazy eye or wandering eye, is a common vision problem in children. In most cases of amblyopia, your child’s brain ignores the signals coming from one eye, meaning the other eye is the only one being used.

Over time, the brain gets used to working with only one eye. The eye that’s being ignored by the brain doesn’t develop normal vision.

If treated while your child is young and the eyes are still developing, he has a good chance of overcoming amblyopia. The goal of treatment is to make your child’s brain use both eyes. Getting the eyes to work as a team becomes harder as your child grows. Early treatment is best; and treatment may not work at all if started after 7-10 years of age.

If left untreated, amblyopia may keep your child from developing normal vision.

Amblyopia affects 2-5 percent of children.

Amblyopia has three main causes:

• Strabismus , which occurs when a child’s eyes aren’t aligned (straight). The eyes don’t work together. This leads the brain to ignore one eye.
• Refractive error , or need for glasses. Children are especially at risk if one eye has larger need for glasses compared to other eye.
• Conditions that cause poor vision in one eye, like cataract or droopy eyelid (ptosis), which prompts the brain to ignore the blurry pictures seen by that eye.

Additional factors can place a child at a higher risk for amblyopia, including:

• A family history of amblyopia
• Prematurity
• Developmental delay
• Craniofacial disorders
• Certain genetic conditions, such as Down syndrome (trisomy 21) , 22q deletion syndrome , Williams syndrome and Noonan syndrome

Symptoms of amblyopia can vary from child to child, but may include:

• Squinting in one or both eyes
• Rubbing one eye (not just when tired)
• Holding items close to the eyes to see them
• A wandering or crossed eye (strabismus)

It’s important to note that some children display no symptoms of amblyopia. The child’s strong eye — and her brain — can compensate for the weaker eye, making it appear that the child has good vision.

Testing and diagnosis

Vision screening is the best way to detect presence of amblyopia or risk factors for developing amblyopia. Photoscreening, a type of vision screening that uses a special camera to determine how well a child can see, is often performed in conjunction with vision testing at pediatricians or schools.

The goal of treatment for amblyopia is to:

• Correct the problem that is causing amblyopia
• Make each eye see as well as it can, which often involves forcing the brain to use the “weak” eye
• Force the brain to use the signals from both eyes
• Make both eyes work together

Amblyopia is most often treated by blocking one eye to keep it from doing all the work. The brain can learn to accept signals from the eye that’s being ignored. Gradually, vision in this eye may improve.

Commonly used treatments include:

• An eye patch  is placed over the eye that’s being used. With this eye blocked, the brain is forced to start working with the eye it’s ignoring. The patch must be worn while your child is awake. Your child may not like wearing a patch. But remember that treatment will work only if your child wears the patch as often as instructed.
• Medicated (atropine) eye drops  can be used instead of a patch. Drops are put in the “good” eye, blurring near vision in that eye. This allows the eye that’s being ignored to start working with the brain. Eye drops may be an option for certain children who don’t like wearing a patch. But putting in eye drops can take practice.
• Eyeglasses can help correct focusing problems . They can also be prescribed to blur sight in the eye that’s being used. This forces the brain to work with the eye it’s ignoring. In some cases, sight in one eye is blocked by sticking a patch or a filter to the inside of an eyeglass lens. As vision improves, your child’s eyeglass prescription may change.

Follow-up care

Once amblyopia improves, maintenance treatment may be needed to prevent vision from slipping. Maintenance treatment includes continued wearing of eyeglasses and/or wearing an eye patch for decreasing amounts of time during the day than was required during the treatment period.

Amblyopia can cause blindness, but fortunately it is the most reversible cause of blindness. Treatment is highly successful as long as children and families stick to the treatment plan.

Reviewed by Stefanie L. Davidson, MD

Providers Who Treat Amblyopia (Lazy Eye)

William Anninger, MD

Gil Binenbaum, MD, MSCE

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Ayesha Malik, OD

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Lazy Eye: Causes and Treatment

• Vision Problems
• Daily Management

If you or your child has a lazy eye ( amblyopia ), one eye is sending unclear images to the brain. while both eyes can be affected, usually amblyopia affects just one eye, with the brain relying on the stronger eye for visual information.

A lazy eye, which some people are born with, is the primary source of vision loss in kids, but adults with vision trouble in one of their eyes also can develop lazy eye later in life.

This article will discuss the causes of lazy eye, vision problems it causes, diagnosis, treatment, and management.

Illustration by Mira Norian for Verywell Health

How Do You Get Lazy Eye?

Lazy eye can develop anytime an eye is not functioning properly and fails to send sharp images to the brain. It is most common in young children. The condition affects up to 3 out of 100 children. Typically this happens in the following instances:

• If one eye over the other is much more nearsighted (able to see near objects more clearly than distant objects) or farsighted (able to see distant objects more clearly than near objects), the brain will begin to ignore the eye sending the fuzzier signals.
• In cases of strabismus , a condition in which the eyes focus on different images, such as if one eye wanders to the side instead of looking straight ahead, the brain will have to choose which eye to rely on for information. It then begins to ignore the other.
• If the normally clear lens (the structure that focuses light on the retina) develops a cataract (a clouding of the lens), after a while, the brain will tune out signals from the eye and will potentially never see normally.

These eye conditions are more likely to occur in some people than others. Those at risk for developing a lazy eye include children who were premature at birth or had a low birth weight and those who come from families where someone else has amblyopia.

Treatment: Can You "Fix" a Lazy Eye?

Effectively treating a lazy eye means first understanding what's causing it while aiming to correct the vision in the weaker eye. Treatment is particularly effective in children under the age 7 whose vision is still developing. Some treatments to consider include:

• Wear glasses to sharpen vision, particularly in the weaker eye.
• Put a patch over the stronger eye several hours a day to allow the brain to begin to rely on the weaker eye.
• Temporarily blur vision in the stronger eye with atropine drops .
• Surgically correct things interfering with vision, such as a drooping eyelid or a cataract .
• Watch videos wearing a virtual reality headset to strengthen the weaker eye (in children ages 4 to 7).
• Perform eye exercises to strengthen the weak eye .
• Undergo muscle surgery to allow the eyes to work better together.

Eye doctors, such as ophthalmologists, encourage early treatment. Seek treatment even if the lazy eye is not discovered until later or there is some other obstacle. Don't consider it to be too late.

Research suggests that even adults can potentially improve their vision. Although it was once believed that the vision center of the adult brain could not hold on to any new experiences or information, research has shown that this is not true, and it is possible to improve vision somewhat.

Identifying Lazy Eye

It helps to know the symptoms of lazy eye to be able to identify it in your child or yourself. Symptoms can be subtle and include:

• A tendency to shut one eye
• Tilting the head to see better
• Squinting to see more clearly
• Eyes that appear to be working on their own rather than together
• Eyes that are inwardly or outwardly turned
• Trouble with depth perception
• Decreased vision in one eye

Because signs in children may be subtle and difficult to discern, it's important to take children between the ages of 3 and 5 for regular vision screenings.

The cause of lazy eye will determine whether and when surgery is needed. For instance, if an infant has a dense cataract, surgery will need to be performed right away. But if the child is older and the cataract is just a small dot, the eye doctor may try other measures first, like patching the eye that doesn't have the cataract.

For children with strabismus (depending on their age), the eye surgeon may want to perform eye muscle surgery as early as possible. Those under age 4 tend to have better outcomes than older children.

While strabismus surgery typically ranges from $5,000 to $10,000 out of pocket, much of the cost usually is covered by insurance.

Vision Problems With Lazy Eye

If children with lazy eye are treated early enough (before age 5), they tend to recover fully, with no lingering vision problems. But if treatment is delayed, the child may have problems with depth perception . Those over age 10 may only recover some vision with treatment and may have some permanent vision loss in the affected eye.

Keep in mind that the impairment in the eye can be mild, with vision in the 20/30 range, or severe, leaving the child legally blind in the eye with 20/200 vision.

Amblyopia Daily Management

In many cases, amblyopia is managed daily with treatments like using drops or patching the stronger eye for a period of time.

If patching is used, you'll initially be asked to cover the stronger eye for about two hours daily. The eye doctor will then monitor vision every six to 12 weeks. If there is not enough improvement, you or your child will be asked to wear the patch up to six hours daily.

Getting a child to keep a patch on can be challenging but is of utmost importance. Some strategies to try if a child resists include the following:

• Rewarding the child for using the patch with computer, device, or TV time
• Motivating them with stickers on a patching chart or diary for hours when the patch is worn

The use of atropine drops is an alternative to patching. Each day a drop is placed in the stronger eye to widen the pupil . It then forces the other eye to be used for close-up tasks like reading.

Also, each day you can encourage your child to perform eye exercises to strengthen the weaker eye, such as the following:

• Viewing dots
• Coloring within the lines
• Playing computer games
• Following an object like a lollipop stick
• Viewing stereograms (a two-dimensional image that can cause an optical illusion if viewed in a certain way)
• Eye relaxation

These can be fun exercises for your child and work to alleviate lazy eye.

Amblyopia (lazy eye) usually affects one eye. With this, the brain begins to rely on vision signals from the stronger eye and ignore those from the weaker, "lazy" one. Reasons why a lazy eye may develop include a cataract, which makes it difficult to see out of the eye; strabismus, in which the eyes are focusing on different points; and a difference in refractive error, in which one eye sees better than the other.

Treatment ranges from patching the stronger eye or blurring with drops, to surgery to remove any obstruction that may cause the vision to be unclear, such as a cataract or drooping lid.

National Eye Institute. Amblyopia (lazy eye) .

Stanford Medicine. Causes and risk factors for lazy eye .

National Health Service. Lazy eye .

American Academy of Ophthalmology. Amblyopia: what is lazy eye?

National Health Service. Orthoptic exercises young person .

American Academy of Ophthalmology. Amblyopia: types, diagnosis, treatment, and new perspectives .

Levi DM. Rethinking amblyopia 2020 . Vision Res . 2020;176:118-129. doi:10.1016/j.visres.2020.07.014

Mount Sinai. Amblyopia .

Boston Children's Hospital. Amblyopia .

Review of Optometry. Recommended strabismus surgery as early as possible.

NVision. The cost of strabismus surgery or correction.

Penn Medicine. Amblyopia (lazy eye).

American Academy of Ophthalmology. Amblyopia treatment modalities.

By Maxine Lipner Lipner is a New York-based freelance health and medical writer who covers ophthalmology and oncology.

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Amblyopia: What Is Lazy Eye?

Amblyopia is when vision in one or both eyes does not develop properly during childhood. It is sometimes called lazy eye. Amblyopia is a common problem in babies and young children.

A child’s vision develops in the first few years of life . It is important to diagnose and treat amblyopia as early as possible. Otherwise, a child with amblyopia will not develop normal, healthy vision.

What Is the Cause of Lazy Eye?

Amblyopia can develop from other eye and vision problems. Here are some conditions that may cause amblyopia in a child.

Strabismus  is when the eyes point in two different directions. One eye may be focused straight ahead while the other turns in, out, up, or down. To avoid seeing double , the child's brain may ignore the image from the eye that is not focused straight ahead. But this can keep that eye from developing properly.

Refractive errors

Having a refractive error means being nearsighted , farsighted , or having astigmatism (distorted or blurry vision ). A child may have a refractive error that is worse in one eye. That eye can "turn off," and vision will not develop properly. This can be difficult to tell since the child's vision seems fine when using both eyes.

Cloudiness in the normally clear parts of the eye

Some children are born with a cataract , where the eye's normally clear  lens is cloudy. This can keep vision from developing properly in that eye.

Droopy eyelid

Ptosis, or a droopy eyelid , can block vision in a child’s developing eye and lead to amblyopia.

Your child might not be aware of having better vision in one eye than the other. And you may not realize it either unless your child has  strabismus or another eye problem you can see.

Amblyopia Diagnosis

Ophthalmologists diagnose amblyopia by checking to see if vision differs between the two eyes. To check a baby's or young child's vision, the ophthalmologist may cover one of the child's eyes and watch how well they can follow a moving object. The doctor may also watch how the child reacts when one eye is covered. If one eye has amblyopia and the other is covered, the child may try to look above or below the patch, pull it off or cry.

The ophthalmologist will do a complete medical eye exam , looking for other eye problems that could be affecting vision.

Poor vision in one eye does not always mean a child has amblyopia. In some cases, wearing  glasses to correct a refractive error in one eye can improve vision.

When Should a Child's Vision Be Tested?

All children should have their vision checked by their pediatrician, family physician, or ophthalmologist at or before entering pre-K or kindergarten. If there is a family history of misaligned eyes, childhood cataracts or serious eye disease, an ophthalmologist should check their eyes when they are an infant.

Most doctors test vision as part of a child's medical exam. If they see any sign of eye problems, they may send a child to an ophthalmologist for further tests.

Amblyopia Treatment

Amblyopia is usually corrected by making the child use their weaker eye . This is often done by putting a patch over the child’s stronger eye. In some cases,  eye drops can be used to blur vision in the stronger eye. Or the child may wear eyeglasses with a lens that blurs vision in that eye.

It generally takes several weeks to several months for vision to get stronger in the weaker eye. Once the child has better vision in that eye, they may need to wear an eye patch part-time for a few years. This helps keep their vision strong. Remember to keep all appointments with the child’s ophthalmologist who will carefully monitor your child’s vision.

How to Choose and Use an Eye Patch

An eye patch should be comfortable, yet remain firmly in place. It should also not allow the child to peek around its edges. Most drug stores have a variety of sizes and types of eye patches. Decorated fun patches are available online. Do not use the black eye patches with elastic bands or ties (such as a pirate-type patches). These are too easy for a child to remove or peek around. To wear the patch, simply attach it to the skin around your child’s eye.

If your child wears glasses, there are patches designed to attach to the lens. These may be good for children who are used to wearing a patch, but they are not as good for a child new to treatment. This is because the patch can slip or the child may learn to peek around it. If your child wears glasses and is not used to patching, it is best to attach the patch directly around the stronger eye underneath the glasses.

Keep Your Child from Taking Off the Eye Patch

Children do not like to have their stronger eye patched or blurred. However, you need to help your child do what is best for them. Otherwise, treatment will not work.

Try distracting the child or having them do something that keeps their attention. Or reward the child with a treat for wearing the patch.

It can take a while for your child to get used to wearing a patch. Over time, this should get easier for them and you. Remember that strengthening the weaker eye is the only way to develop healthy, normal vision.

If your child still takes off the patch, as a last resort, you might cover his or her hands with gloves, mittens, or socks.

Teach Your Child About the Eye Patch

Pre-school or school-age children might not want to wear an eye patch or use blurring eye drops. To help, parents should explain how important these treatments are to be able to see well. And reassure them that lots of children wear eye patches for the same reason.

Consider having a very young child practice putting an eye patch on a doll. Or let the child decorate his or her patch with crayons or markers.

Explain the amblyopia treatment to the child’s teacher. Ask the teacher to compliment the child on being so good about wearing the patch. Children thrive on positive feedback from their teachers.

Things to consider with patching treatment:

• In very rare instances it is possible to overuse the patch or blurring eye drops. This can affect vision in the stronger eye. Be sure to keep the child’s appointments with the ophthalmologist so that vision in both eyes can be closely monitored.
• The skin near your child’s eye patch can get irritated. To help, try a different size or type of patch, and angle the patch differently each day.
• Your child may initially be clumsy when wearing a patch. Try to keep an eye on your child when they are climbing stairs or being active.

Surgery to Correct Causes of Amblyopia

In some cases, the ophthalmologist will recommend surgery to correct certain eye problems causing amblyopia. After surgery, the child may need to keep wearing a patch or otherwise cover the stronger eye until their vision improves.

It is possible to prevent vision loss from amblyopia. For best results, amblyopia should be treated before a child reaches 7 or 8 years old. Many children do not like to have their stronger eye patched or blurred. However, you need to help your child do what is best for them.

Treating Amblyopia Using New Technology

A new treatment for amblyopia uses a virtual reality (VR) headset to help improve vision in children aged 4 to 7. A child watches videos wearing the headset, which helps them use their weaker eye. To learn more, ask your child’s ophthalmologist.

Treating Amblyopia for Better Lifelong Vision

When a child has amblyopia, it is important to make vision stronger in the weak eye. Even if eye problems causing amblyopia are corrected with glasses or surgery, the amblyopia itself must be treated. If not, the child may have lifelong vision problems.

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Wandering Eye

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A wandering eye is a type of eye condition known as strabismus or tropia, and it may be caused by damage to the retina or muscles that control the eye, stroke or brain injury, or an uncorrected refractive error like farsightedness. With a wandering eye, one eye deviates or wanders in a different direction when looking at an object.

What Causes a Wandering Eye?

The eyes contain muscles to which they are attached to, and these muscles receive signals from the brain that direct eye movement. Normally, the eyes work together so that they focus in the same direction at the same time. However, with a wandering eye, there is poor eye muscle control and one eye turns away from the object that the person is attempting to hone in on—either up, down, in or out. The eye that turns may do so all the time, or it may only do so at certain times, such as when the person is fatigued, sick or has overworked the eyes as a result of prolonged reading or staring at a computer. There are other cases where the eyes may alternate turning.

Because the eyes are misaligned, the brain receives a different image from each eye. While the brain will learn to ignore the image it gets from the wandering eye, if left untreated, lazy eye or amblyopia can present. This is characterized by a permanent reduction of vision in the traveling eye, and can lead to poor depth perception.

A wandering eye can be classified by the direction the eye turns:

• Inward (esotropia)
• Outward (exotropia)
• Downward (hypotropia)
• Upward (hypertropia)

It may also be classified in other ways:

• Alternating (the eye that turns alternates from left to right)
• Unilateral (always involves the same eye)
• Constant or intermittent (the regularity with which it occurs)

Testing and Treatment

To determine the classification, and in order to develop a treatment plan for a wandering eye, an optometrist will look at a number of factors to understand the cause of the condition, as well as how the eyes move and focus. This may include:

• Looking at the patient’s  family history
• Reviewing the patient’s  medical history
• Observing the external and internal structures  of the turned eye
• Refraction  – a string of lenses are put in front of the patient’s eyes and a handheld instrument with a light source is waved pass. This is done to gauge how the eyes focus and can conclude the lens power needed to correct refractive errors like nearsightedness, astigmatism and farsightedness.
• Visual acuity  – reading letters on distance or near reading charts to measure and estimate the amount of visual impairment
• Focusing and alignment testing   to determine how well your eyes move, focus and work together.

Information gathered from these assessments will help your optometrist devise a treatment plan, which could consist of vision therapy, eyeglasses, prism or eye muscle surgery. If treated early, a wandering eye can be corrected and vision can be restored.

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A lazy eye (amblyopia) is when the vision in 1 eye does not develop properly. Rarely, both eyes can be affected.

Check if you have a lazy eye

A lazy eye does not always cause symptoms and is often first diagnosed during an eye test.

The main symptoms include:

• shutting 1 eye or squinting when looking at things
• eyes pointing in different directions (a squint )
• not being able to follow an object or person with your eyes
• tilting your head when looking at something
• having tired eyes and rubbing your eyes a lot
• difficulty catching or throwing
• tripping or falling over a lot
• blinking a lot

Many children do not notice anything wrong with their vision.

You can check a younger child's eyes by covering each eye with your hand, 1 at a time. They may complain if you cover their good eye.

Older children may say they're not able to see as well with 1 eye and may have problems with reading, writing and drawing.

Non-urgent advice: Go to an opticians if:

• you're worried about your or your child's vision
• you have not had an eye test for 2 years

What happens during an eye test

To check if you or your child have a lazy eye, an eye test specialist called an optometrist will usually do an eye test.

You'll be asked to look at lights or read letters while different lenses are placed in front of your eyes.

To check the health of your eyes, you or your child may be given eye drops so the optometrist can see the back of your eye more clearly.

If you or your child needs glasses, you'll be given a prescription. You can take this to any optician.

Find out more about eye tests for children

NHS eye tests

NHS eye tests are free for some people, including:

• children aged under 18, or under 19 and in full-time education
• people who have diabetes or glaucoma
• people on some benefits, including Universal Credit

Find out more about free NHS eye tests

Treatments for a lazy eye

How lazy eye is treated depends on what's causing it.

Treatment for a lazy eye aims to improve vision in the weaker eye.

This may include:

• wearing glasses to correct your vision
• wearing an eye patch over the stronger eye for a few hours a day for several months – these are usually worn with glasses
• using eye drops to temporarily blur vision in the stronger eye

Treatment should ideally start before the age of 7, when vision is still developing.

If lazy eye is caused by cataracts or a drooping eyelid, you may need surgery.

You may also need to have surgery if you have a squint. This will straighten the eyes and allow them to work together better, but does not improve your vision.

Some people are entitled to a voucher to help towards the cost of glasses or contact lenses, including:

• if you're on some benefits, including Universal Credit

If you do not have a voucher, you'll have to pay for glasses or contact lenses.

Find out more about NHS optical vouchers

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Can you answer some questions about eye tests for children to help us improve our information?

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Page last reviewed: 04 January 2023 Next review due: 04 January 2026

5 treatments to fix a lazy eye, according to an eye doctor

• You can fix a lazy eye by blurring the vision in your stronger eye, which forces you to develop the vision in your weaker eye.
• This can be done by wearing an eye patch, getting special corrective glasses, using medicated eye drops, adding a Bangerter filter to glasses, or even surgery.
• A lazy eye is usually caused by an uncorrected vision problem, an eye misalignment, or by something blocking your vision, like a droopy eyelid or scar in front of the eye. 

Amblyopia, more commonly referred to as a lazy eye, is a relatively common condition. It occurs in about 3% of children and involves one eye being weaker and having poorer vision than the other eye. 

Although there's some stigma surrounding the term "lazy eye," it's important to note that a lazy eye is not a reflection of character. It doesn't mean that you're lazy — it is an uncontrollable health issue with your eyes — and it can be treated with a number of methods. 

Without treatment, the eye will become even weaker, which is why it's so important to fix a lazy eye. Here's what you need to know about what causes a lazy eye and how to effectively treat it. 

What is a lazy eye?

A lazy eye is when there is poor vision in one eye, and vision relies on the stronger "good" eye. It is the result of a problem with the connection between the eye and the brain. A lazy eye usually develops early in life. When the vision in one eye is abnormal, neural connections, or brain signals, won't be properly stimulated, and the signals that are sent to the brain will create a blurred image, says Jill Rotruck, MD , an ophthalmologist and assistant professor of Ophthalmology and Visual Sciences at the Yale School of Medicine.

There are three main causes of a lazy eye , Rotruck says. They are:

• Uncorrected refractive error . This is when there is an uncorrected vision problem, such as nearsightedness, farsightedness, or astigmatism.
• Strabismus . This is when the eyes are misaligned. 
• Stimulus deprivation . This is when something is blocking the vision. 

Amblyopia itself doesn't result in a change in appearance to the eye, says Rotruck. If the lazy eye is caused by an uncorrected refractive error, both eyes may appear normal.

However, in the case of strabismus, the eyes may be misaligned, with one eye wandering inward or outward. Additionally, if the amblyopia is caused by something blocking the vision, this will be visible, such as a droopy eyelid, scar in front of the eye, or cloudiness of the eye's lens. 

How to fix a lazy eye

Depending on the individual's situation, there are various ways to fix a lazy eye. While the methods are very different, they mainly have the same goal, which is to address the underlying cause and force use of the weaker eye. 

Some examples of treatment include:

1. Corrective glasses 

One way to correct a lazy eye is by using glasses that deliberately blur the image that the stronger eye sees. This is usually done by using an incorrect glasses prescription, known as optical penalization.

By blurring the image that the stronger eye sees, Rotruck says the brain will be forced to pay attention to the weaker eye, and strengthen the connection between the brain and the weaker eye. Contact lenses can be used in the same way, however, if the patient is a very young child, it's much more likely for glasses to be used. 

According to the American Academy of Ophthalmology, corrective glasses are a very common first-line treatment for amblyopia. This method is highly effective for amblyopia. A 2006 study showed that there was a significant improvement in 77% of participants. Furthermore, the condition was fully resolved in 27% of participants. 

2. Eye patches

Rather than blur the vision in the stronger eye, an eye patch takes away the vision in the stronger eye completely, which will also strengthen the weaker lazy eye by strengthening the connection between the brain and the weaker eye. Rotruck says treatment will vary from wearing the patch for two to six hours a day, to all day in some cases. 

This treatment has been shown to be effective. A 2006 study found that 2 hours of daily patching resulted in a modest improvement of moderate to severe amblyopia. 

3. Medicated eye drops

The most common form of medicated eye drops for lazy eyes is atropine drops . Rotruck says these work by preventing the stronger eye from focusing, which causes blurred vision. This involves putting the eye drops in the stronger eye, which forces the patient to use the weaker eye more, says Rotruck. These drops are typically prescribed to be used two days a week. 

Two 2009 studies found that weekend atropine eye drop was effective in improving severe amblyopia over the course of 18 weeks. 

4. Bangerter filter

A Bangerter filter is another way to blur the better-seeing eye's vision. This is a special type of filter that is put on the lens of the glasses of the better eye, making the view through the lens hazy, says Rotruck.

This forces the lazy eye to be used more. The filter will be used until the patient's eye doctor determines that the treatment is no longer needed. According to the American Academy of Ophthalmology, this method is not as popular as the others.

A 2009 study found that using a Bangerter filter along with corrective lenses works more quickly than using corrective lenses alone.

In some cases, surgery is necessary for amblyopia if the cause is stimulus deprivation, meaning something getting in the way of the vision such as a droopy eyelid, cataracts, or scarring.

"Clearing the obstruction will allow clear signals to reach the brain and the brain to learn how to see normally out of each eye," says Rotruck. 

Insider's takeaway

Ultimately, the best treatment for a lazy eye will be determined by the patient's doctor. The doctor will decide which method to use and how long to use it for. Some patients will see improvement within weeks, but in other cases, it can take months or longer to fully treat amblyopia.

Related articles from Health Reference:

• The 4 best vitamins for eye health and which foods — besides carrots — may improve vision
• Shingles in the eye is dangerous and can cause blindness — here's how to prevent it
• How to put in eye drops correctly, in 2 different ways
• 3 ways you can treat pink eye without a doctor's appointment
• Do eye drops expire? Yes, and they expire more quickly once you open them

• Main content

Pediatric Eye Care

Wandering Eye / Exotropia

Intermittent exotropia (eye wandering).

Intermittent exotropia, also called wandering eye, is a type of strabismus (eye misalignment) in which the eyes drift out (exotropia) from time to time. This is a relatively common type of strabismus in both children and adults. The amount of deviation varies widely from person-to-person.

Parents may begin to notice their child's eye turns out, especially when the child is tired, daydreaming, or sick. Parents may also notice their child closes or squints one eye when outside in bright sunshine.

The treatment for intermittent exotropia can range from observation, conservative management, to surgery. We typically choose to observe the child when:

• There is only a small to moderate deviation
• If they can control it well so the eye drifts less than half of their waking hours,
• So long as their ability to use their eyes together (stereoacuity) is good.

We may choose some conservative management like alternatively patching either eye when there is no amblyopia (lazy eye) in young children, or putting them in glasses that are purposely over-powered to encourage the eyes to come together in children until about age 10 or 11.

We can perform eye muscle surgery to make the eye easier to control at any age and may recommend surgery if:

• The deviation becomes large
• The child begins to lose the ability to use their eyes together (stereoacuity)
• The child experiences a psychosocial impact like being picked on at school

If you think your child or you have intermittent exotropia, we recommend they be seen by a pediatric ophthalmologist for an evaluation.

To schedule an appointment, call (509) 456-0107

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Clinic Hours : 7 am to 5 pm

Optical hours : 8 am to 5 pm, surgery center hours : 7 am to 5 pm, stay home if you are sick.

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Please prepare for at least two hours for routine or medical eye exams. Sometimes it takes a little longer to give each patient quality care, and we hope you understand.

Any Questions?

Someone is available to answer your questions Monday through Friday, 7 AM to 5 PM, at 509-456-0107.

Adult Strabismus

• • A condition in which eyes wander to one side, cross, or are higher or lower than the other
• • Symptoms include double vision, which can start suddenly or gradually
• • Treatment includes placing prisms or opaque films in eyeglasses; surgery is also an option
• • Involves ophthalmology
• Strabismus Surgery
• Strabismus (crossed eyes)

What are the symptoms of adult strabismus?

What are the most common types of strabismus, what causes adult strabismus, how is strabismus diagnosed, what are the treatment options for adult strabismus, what makes yale medicine’s approach to treating adult strabismus unique.

People who see second lines of print while they're working at their computer or see a car heading down their lane while they're driving may be suffering from strabismus, says  Martha Howard, MD , a surgeon at the Yale Medicine Pediatric Ophthalmology & Strabismus Program . "It can be very frightening,” says Dr. Howard.

Strabismus is a condition in which the eyes are not aligned. It affects people’s ability to function and can even cause them to lose their independence. Fortunately, in many situations, it’s also very treatable. Yale Medicine offers an array of strabismus specialists who have a deep knowledge of conditions, treatment and procedures.

An adult with strabismus will experience double vision. The onset can be sudden or gradual, says Dr. Howard. The distortion may occur only sometimes or in specific circumstances.

Strabismus may be intermittent at first and then become constant. “It may only happen when you look in a particular direction,” says Dr. Howard. “For some people, it may occur only when they are looking to one side."

Many times, the appearance will be obvious to outside observers. “But sometimes only family members or friends will notice that the eyes are not aligned,” Dr. Howard says.

Children with strabismus don’t see the second image because their brains suppress it. Adult brains don’t have that ability.

An estimated 4 percent of adults in the United States will experience strabismus in their lifetimes. The condition can be further described by the direction of the misalignment.

• Esotropia, the eyes cross inward
• Exotropia, one or both of the eyes look outward
• Hypertropia, one eye moves up out of alignment
• Hypotropia, one eye moves down out of alignment

Some adults with strabismus were born with the condition. It may have first appeared when they were children, but corrected itself as they matured. The risk of adult strabismus increases with age, so the condition can reappear when a person gets older.

“Unfortunately, as we age, our eye muscles do not function as well as they did in the past,” says Dr. Howard. “We call that decompensation.”

Such other health problems as circulation or neurological problems can lead to strabismus. Mini-strokes, diabetes and hypertension can impair the circulation to the muscle or to the nerves that control them. “Damage to different cranial nerves can cause strabismus and double vision,” Dr. Howard says.

Strabismus can occur in people with a history of thyroid disease, even if the thyroid blood levels are in control. Tumors in the brain stem or in the eye can cause strabismus as can trauma.

Diagnosing strabismus starts with a simple test: covering and uncovering each eye.

“When either eye is covered, the double vision resolves,” says Dr. Howard. “That’s a distinguishing feature. If you cover an eye and the double vision remains, that’s not strabismus.”

The ophthalmologist will perform a complete exam and check a patient’s ocular motility, which describes how well the eyes move in various directions. The physician will also measure the misalignment with prisms. “From that information, we can identify what kind of strabismus the patient has,” she says.

“In some situations, the double vision will resolve with time,” says Dr. Howard.

In some patients, strabismus can be improved by placing prisms in their glasses. In other cases, one eye must be covered with an opaque film over one lens of a person's glasses to eliminate the second image.

Surgery can play a significant role in improving the symptoms of strabismus. When necessary, surgery is usually performed with local anesthesia in an outpatient setting. However, general anesthesia is possible as well.

“I often use adjustable sutures,” says Dr. Howard. This allows post-surgery fine-tuning with topical (eye drop) anesthetics.

We have the only program for strabismus in southern New England located within an academic medical center. We are experts in diagnosing and treating strabismus disorders in adults. Our ophthalmologists understand the available options to improve symptoms of strabismus, including surgery if prisms become unwieldy.