Posted on January 11, 2018
Generally speaking, LASIK is not known to correct lazy eye, or amblyopia. LASIK can correct a refractive error of the eye, that is, restore vision without glasses, in eyes that have useful vision. To better understand what LASIK can actually offer patients of lazy eye, we need to understand what is lazy eye, and also what is the relationship between LASIK and lazy eye.
What is lazy eye?
Lazy eye, called amblyopia by your doctor is a condition in which the brain begins to ignore the image from one eye, because it has had poor vision for a long time. This is especially true in terms of children, because the visual cortex (the part of the brain responsible for vision) does not mature completely until about nine years of age.
Amblyopia or lazy eye can be because of:
- Anisometropic amblyopia: or lazy eye due to very different refractive errors or a marked difference in the prescription from the two eyes. The brain suppresses the image from the eye with the higher prescription and uses the other eye only.
- Strabismic amblyopia: or lazy eye due to squint, that is improper alignment of the eyes. The brain suppresses the image from the deviating eye.
- Form deprivation amblyopia—commonly caused by a congenital cataract or any eye disease that results in poor vision as a newborn or infant.
As explained earlier, these conditions can only be corrected in children (before the age of 9- to 10-years-old), the vision loss remains permanent in adults.
What can LASIK do for patients with lazy eye or amblyopia?
It is traditionally believed that the vision loss due to amblyopia in adults can usually not be recovered. So no refractive surgery can offer vision that is significantly better than that with spectacles or contact lenses.
In case of anisometropic amblyopia or amblyopia due to very different powers of the two eyes, LASIK can offer some hope of vision correction. Very often, patients are unable to tolerate the high power glasses in one eye only, especially since it often leads to strain, double vision and headaches. Also, with very high power, the spectacle lenses are often heavy, and the glasses get skewed.
In this subgroup of patients, LASIK can improve vision only to the extent that the vision is corrected using spectacles and/ or contact lenses but not beyond. So, LASIK may be performed on the eye with a high prescription in cases of mild amblyopia to allow the weaker eye to be less dependent on glasses.
It is therefore important to remember that LASIK is only able to refine the vision in an amblyopic eye to the level it can achieve with the glasses prescription.
The best index of the benefits of laser eye surgery are therefore dependent on the best corrected visual acuity of the lazy eye, and your surgeon will counsel you about it. That said, there are several anecdotal reports of patients with lazy eyes who have had successful outcomes after LASIK, which has encouraged refractive surgeons to consider the surgery in these patients.
Changing opinions about LASIK in Amblyopia
It was generally believed that patients were not suitable candidates for LASIK. But there have been several reports of patients with nystagmus and higher refractive error who have improved several lines after undergoing LASIK, and so most refractive surgeons discuss the potential risks and benefits of LASIK with all of these patients as well.
What can LASIK offer me if I have a lazy eye?
What LASIK can definitely do for you, if other eligibility criteria are met, are the following:
- It can eliminate the need for glasses in both eyes.
- The vision in the lazy eye may continue to be blurred, as compared to the good eye, but the vision will definitely be as clear without glasses, as it was with glasses or contact lenses.
- The vision in the lazy MAY be better after surgery in terms of quality of vision and precision. The vision MAY also improve to beyond what it is with your prescription glasses and contact lenses.
- This can significantly improve your quality of life, if you are struggling with a very high prescription of glasses in one eye.
Should I discuss LASIK with my doctor if I have lazy eye?
Suffice to say, amblyopia or lazy eye is not a contraindication for LASIK or other refractive surgery, and your treating will discuss its potential risks and benefits with you thoroughly. After a comprehensive eye evaluation he or she will help you choose which procedure is best suited to your eyes and visual needs, and will also help you set realistic expectations from the surgery. The least that surgery for vision correction can offer patients with lazy eye is freedom from glasses, with a vision without glasses which is as good as with glasses.