What are the treatment options for lazy eye (amblyopia)?

Photo of children with their teacher
PantherMedia / Cathy Yeulet
  • Lazy eye (amblyopia) in children can be treated with glasses, an eye patch or eye drops. The treatment will depend on factors like the type and severity of the problem.

In some children, only one eye focuses properly. This is a vision problem called lazy eye (medical term: amblyopia). It is caused when the two eyes send different images to the brain. This may happen if the child has a squint, or if one of their eyes is more nearsighted or farsighted than the other. The brain then mainly processes the information coming from the better eye, ignoring the other.

What are the treatment options?

The treatment for lazy eye will depend on things like how severe it is. The main treatment options are:

  • Glasses that can correct existing refractive errors (nearsightedness, farsightedness, blurred vision).
  • Occlusion therapy using an eye patch: Here the eye that sees better is covered up with a special patch for several hours a day. For children who wear glasses, the lens on that side can be covered. The aim of this treatment is to encourage the weaker eye to work harder. The word "occlusion" comes from the Latin word that means “to shut or close.”
  • Eye drops: Eye drops can be used to temporarily make it harder for the “good” eye to see properly, so the weaker eye has to take over and work harder. The drops contain medication such as atropine. This drug numbs the muscles in the stronger eye, making the lens of the eye unable to focus for a few hours.

In rare cases, lazy eye may be caused by a cloudy eye lens at birth (congenital cataract) or a droopy eyelid. That condition is then treated before the lazy eye is treated.

What does the treatment involve?

In children with a lazy eye, one eye is usually more nearsighted or farsighted than the other, or is affected by an astigmatism. That other vision problem is then corrected first using glasses. In some children, that’s enough to fix the lazy eye problem. But many children also need an eye patch or eye drops to effectively treat the lazy eye.

If the child's vision doesn't clearly improve in the lazy eye within twelve weeks despite wearing glasses, an eye patch or eye drops are used. This treatment typically takes a few months, during which regular eye tests aredone.

Eye patches should be worn for at least six hours each day. The eye drops are used once a day, just after getting up in the morning. Their effect also lasts for a few hours.

Research has shown that treating amblyopia with an eye patch or eye drops can improve vision in children. There was no difference between the two treatments in the studies.

How is lazy eye treated if it is caused by a squint?

If the lazy eye is caused by a squint, it is usually treated with an eye patch – together with glasses, if necessary. A lot of children who have a squint also have a refractive error. Research has found that treatment with glasses and eye patches improves the vision of children who have a squint.

Surgery is sometimes used if the squint is severe. This involves tightening or loosening eye muscles in order to change the position of the eyeball. The aim is to improve spatial vision (ability to judge how close or far away things are) and make the squint less noticeable to other people. The surgery doesn't improve the lazy eye problem itself, though, so it is typically only done after the lazy eye has been treated.

Are there side effects too?

Some people worry that covering the healthy eye could make it weaker because it's then used less during the treatment. But research in this area hasn’t found that to be true.

Eye patches may irritate some children’s skin. Eye drops can cause temporary sensitivity to light or a burning sensation. Sometimes a child might not be able to see properly with the healthy eye for a short while after treatment with eye drops. Eye drops may be particularly suitable for children who have problems wearing an eye patch.

Can amblyopia be treated later on?

Specialists recommend treating lazy eye as early as possible. For a long time, it was assumed that treatment would only be successful if it was started before the age of 7. But studies involving children and teenagers aged 7 to 17 suggest that later treatment can probably improve eyesight, too.

Can special exercises improve vision even more?

Sometimes children are encouraged to train their weaker eye by doing activities like drawing or making things while wearing the eye patch. Two studies have shown that this doesn't lead to a greater improvement in vision in most children. But it’s still not clear whether these activities help in certain children, such as those with severe vision problems.

How can I help my child?

Most children don't have any problems wearing their eye patch in everyday life. But some find it hard to wear it as much as they are supposed to. There are several reasons for this: While the "good" eye is covered by the patch, they can only see with their weaker eye. So they have worse vision during the treatment. This can lead to trouble playing or learning, and can be tiring too. They might also be teased about their eye patch in day care or at school.

Having to wear an eye patch for such a long time every day can be a real problem for some children. Parents use different strategies to try to help their child accept the patch. Some explain why it's important to wear the patch. Or they might explain the results of past eye tests to show their child that their vision really is improving. It might also be possible to talk with the doctor to see if or when you can shorten the time that the eye patch needs to be on.

Some parents have reported that doing things like putting eye patches on dolls or soft toys, or even wearing eye patches themselves, makes eye patches seem more normal to their children. Some parents praise their children or reward them with small gifts as an incentive. Other families manage better by not making a big deal out of wearing the eye patch.

Eye patches might look ugly or too plain. Some children prefer to cover up their glasses with something more interesting that they have chosen themselves. As with so many things, having the patch be part of a regular daily routine may also be important for the child. The good news is that in a few months’ time it will most likely be a thing of the past.

Gesellschaft für Neuropädiatrie (GNP). Visuelle Wahrnehmungsstörungen (Sk2 Leitlinie). AWMF-Registernr.: 022-020. April 2017.

Jefferis JM, Connor AJ, Clarke MP. Amblyopia. BMJ 2015; 351: h5811.

Li T, Qureshi R, Taylor K. Conventional occlusion versus pharmacologic penalization for amblyopia. Cochrane Database Syst Rev 2019; (8): CD006460.

Osborne DC, Greenhalgh KM, Evans MJ, Self JE. Atropine Penalization Versus Occlusion Therapies for Unilateral Amblyopia after the Critical Period of Visual Development: A Systematic Review. Ophthalmol Ther 2018; 7(2): 323-332.

Schmucker C, Kleijnen J, Grosselfinger R, Riemsma R, Antes G, Lange S et al. Effectiveness of early in comparison to late(r) treatment in children with amblyopia or its risk factors: a systematic review. Ophthalmic Epidemiol 2010; 17(1): 7-17.

Taylor K, Elliott S. Interventions for strabismic amblyopia. Cochrane Database Syst Rev 2014; (7): CD006461.

Taylor K, Powell C, Hatt SR, Stewart C. Interventions for unilateral and bilateral refractive amblyopia. Cochrane Database Syst Rev 2012; (4): CD005137.

West S, Williams C. Amblyopia in children (aged 7 years or less). BMJ Clin Evid 2016: pii: 0709.

Yazdani N, Sadeghi R, Momeni-Moghaddam H, Zarifmahmoudi L, Ehsaei A, Barrett BT. Part-time versus full-time occlusion therapy for treatment of amblyopia: A meta-analysis. J Curr Ophthalmol 2017; 29(2): 76-84.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

Comment on this page

What would you like to share with us?

We welcome any feedback and ideas. We will review, but not publish, your ratings and comments. Your information will of course be treated confidentially. Fields marked with an asterisk (*) are required fields.

Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?

Updated on June 4, 2020
Next planned update: 2023

Authors/Publishers:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

How we keep you informed

Follow us on Twitter or subscribe to our newsletter or newsfeed. You can find all of our films online on YouTube.