Common Childhood Visual Problems
The three most common types of ocular problems in children are misaligned eyes (strabismus), lazy eye (amblyopia), and refractive errors (focusing problems).
Strabismus means eyes are pointed in different directions. After four months of age, all infants should have straight eyes. One eye may drift in or out, up or down. Strabismus may be present all of the time or intermittently and children are usually unaware of the problem. Strabismus interferes with the development of the coordinated use of both eyes together and can be treated with early intervention. If not treated, permanent muscle imbalance, progression to permanent loss of vision and loss of depth of perception may result.
Amblyopia, or lazy eye, is the development of poor vision in one or both eyes. It occurs in infancy into early childhood during visual development. In late childhood, visual loss due to amblyopia is no longer a substantial threat. The earlier amblyopia is detected, the easier it is to treat. If not treated, permanent visual loss, poor depth perception, progressive strabismus and/or double vision may result.
Patching and/or blurring (atropine) drops have been the go-to remedies for lazy eye. These treatments are often prescribed alongside corrective glasses. They work by limiting use of the stronger eye, forcing children to use and strengthen their weaker eye.
ESA now prescribes Luminopia, the first FDA approved digital therapy used for the treatment of amblyopia in children ages 4-7. Patients watch TV shows using a virtual reality headset one hour a day, 6 days a week. Over 700 hours of popular shows are available from PBS, Nickelodeon, Sesame Street, etc. making compliance with treatment easy. The software modifies images into treatment by rebalancing input to the brain and can be used as an alternative to eye patching. Basically the therapy encourages use of the weaker eye while also prodding patients’ brains to combine input from both eyes. Insurance coverage will be verified prior to the headset being prescribed. The headset is shipped to the patient and must be returned when treatment is completed.