An eye that diverges in gaze. A lazy eye is formally called
strabismus. A lazy eye (strabismus) can be due to esotropia (cross-eyed) or to exotropia
(wall-eyed). The danger of the condition is that the brain comes in time to rely
more on one eye than the other and that part of the brain circuitry connected to
the less-favored eye fails to develop properly, leading to amblyopia (blindness)
in that eye.
The classic treatment for a moderately lazy eye has long been an eyepatch, covering
the stronger eye with a patch, forcing the weaker eye to do enough work to catch
up. However, eyedrops can work as well as an eyepatch in correcting moderate lazy
eye and preventing the development of amblyopia. Atropine eyedrops are instilled
daily in the stronger (dominant) eye. The atropine works by blurring rather than
blocking vision in the stronger eye.
Severe strabismus may require surgery. The surgery is designed to increase or
decrease the tension of the small muscles outside the eye. (These muscles are called
the extraocular eye muscles. The six extraocular eye muscles move the eye in all
directions.) When strabismus surgery is needed, the sooner it is done, the better
the chance of the child achieving normal binocular vision.
Adults sometimes also need strabismus surgery. This can be done in a standard
manner, as in children. Or adjustable suture surgery may be done because scarring
from old eye surgery, inflammation from eye muscle disease, or neurological eye
weakness makes it difficult to gauge how much tension to take up or let out to straighten
the eyes. With adjustable suture surgery, it is possible to adjust the tension of
the muscles after the surgery.
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