Amblyopia Vs Strabismus : What Is The Difference

Ambylopyia and strabismus are two eye conditions that tend to affect a child’s eyes. An eye doctor can see evidence of these diseases once a patient grows older, but typically they start in childhood. There are some exceptions to this, so let’s take a look at the difference between amblyopia vs strabismus.

Amblyopia Vs Strabismus: The Relationship

The basic difference between these two words is that amblyopia is a medical term that refers to poor vision. On the other hand, strabismus refers to a problem with eye alignment, and you may notice the eyes moving in different directions.

They both have been called a “lazy eye” by people, but a true “lazy eye” is one that does not see as well as the other eye. In some cases of strabismus, both eyes may see well and they are not amblyopic at all. 

What Is Amblyopia?

Amblyopia happens when the brain and the eyes don’t work together properly. This can cause one eye to become weaker than the other. This problem usually starts in early childhood, and if it’s not treated early, it can cause permanent vision loss. 

Amblyopia Statistics

Amblyopia is the most common cause of vision problems in children. It affects about 2 to 3 out of every 100 kids. It’s important to understand amblyopia because early treatment can help children avoid serious long-term vision problems.

Types Of Amblyopia

There are three main types of amblyopia:

• Strabismic Amblyopia: This is the most common type of amblyopia. It occurs when one eye is misaligned, meaning the eyes don’t look in the same direction. The brain receives two different images, which causes confusion. To avoid seeing double, the brain ignores the image from the misaligned eye, leading to amblyopia.
• Refractive Amblyopia: This type happens when there is a difference in vision between the two eyes. For example, one eye might be nearsighted or farsighted, while the other eye has normal vision. The brain prefers the clearer image from the stronger eye and ignores the weaker one.
• Deprivation Amblyopia: This type is less common and happens when something blocks light from entering the eye, such as a cataract (a clouding of the eye’s lens). Because the eye doesn’t get clear images, the brain ignores the signals from that eye, leading to amblyopia.

Amblyopia usually affects only one eye, but it can sometimes affect both eyes. If it’s caught early, it can be treated effectively. 

What Is Strabismus?

Strabismus can happen in both children and adults, but it is often associated with amblyopia in children. As you read above, strabismus can cause ambylopia. 

Strabismus means that the eyes are not aligned correctly. Normally, both eyes should point in the same direction and work together to create a single image. In strabismus, one eye may point straight while the other eye looks in a different direction. This misalignment can be constant, or it can happen only sometimes.

Types Of Strabismus

There are different types of strabismus based on which direction the eyes are misaligned:

• Esotropia: One or both eyes turn inward toward the nose. This is the most common type of strabismus in children.
• Exotropia: One or both eyes turn outward, away from the nose.
• Hypertropia: One eye points upward while the other eye remains straight.
• Hypotropia: One eye points downward.

How Does Strabismus Cause Amblyopia?

Strabismus can cause amblyopia because the brain struggles to combine the two different images coming from the misaligned eyes. To fix this, the brain starts ignoring the image from the misaligned eye. The misaligned eye which is now being ignored or suppressed can develop amblyopia (poor vision)

Why Does Strabismus Happen?

Strabismus can occur for different reasons, such as problems with the eye muscles, nerve damage, or even because of a need for glasses. It can affect children and adults, though it’s more common in young children.

Comparing Amblyopia and Strabismus: How Are They Related?

Amblyopia and strabismus are related but are not the same thing. 

Strabismus refers to the misalignment of the eyes, while amblyopia happens when the brain favors one eye over the other. In many cases, strabismus can lead to amblyopia because the brain ignores the signals from the misaligned eye.

Can Amblyopia Happen Without Strabismus?

Yes, amblyopia can happen without strabismus. For example, in refractive amblyopia, the eyes are aligned correctly, but the brain still prefers one eye because it sees better than the other. This difference in vision causes amblyopia.

While strabismus can cause amblyopia, not all children with strabismus will develop amblyopia. 

Can Strabismus Happen Without Ambylopia?

Yes. Strabismus, especially in older people can happen without amblyopia. This is more likely in older adults. When examined, these adults may have intermittent strabismus or constant strabismus but the visual acuity in each eye is still very good. 

Strabismus Vs Amblyopia: Detection And Treatment

Detecting amblyopia and strabismus early is critical because the brain’s visual development happens mostly during the first few years of life. 

Detection Of Amblyopia Or Strabismus

Both of these eye problems are usually diagnosed by an eye doctor after a parent or a pediatrician suspects that the child is having visual disturbances. A parent may say that they feel that their child eye is turning in or out. Or a parent may say that they feel that the child does not see well and has some functional vision problems.

Formal screenings by the pediatrician and an eye doctor are very important. There is effective treatment available for both conditions but the earlier treatment is started the more likely that it is for it to be successful. 

Routine eye exams are important in children just to make sure that there is nothing bad going on. In the absence of visual problems, it is a healthy idea to have a baseline eye exam with an eye doctor for your child around the age of 4 or 5. This is when the child can usually read letters off the chart and can provide a good exam. 

Of course if there is any history of ocular misalignment that the parent has noticed from simple observation, or a family history of vision impairment, being extra cautious is the best way to preserve vision long term. 

Stay on top of regular pediatric exams as well as regular eye exams to ensure good long term eye health. 

Treatment Of Amblyopia And Strabismus

The treatment for amblyopia depends on the type of amblyopia the patient has. The treatment for strabismus may be part of treating amblyopia or it may be a separate case all together if the person has no amblyopia. 

Glasses

For children with refractive amblyopia, glasses are needed to correct vision problems which can be nearsightedness, astigmatism or farsightedness. Wearing glasses helps the brain get clear signals from both eyes. In addition to glasses, eye patching may be used as well over the good eye.

Eye Patching

If one eye is weaker, doctors often recommend covering the stronger eye with a patch. This forces the brain to use the weaker eye, which helps improve its strength over time. Patching is often used in combination with glasses.

Atropine Eye Drops

Instead of patching, some doctors prescribe atropine drops. These eye drops blur the vision in the stronger eye, which makes the brain rely more on the weaker eye. This may be an option in children who do not use the patch or take the patch off. 

Surgery

Surgery may be needed to correct strabismus, especially if the eye muscles are the problem causing the amblyopia. Surgery can help align the eyes so that they work together properly.

The earlier these treatments are started, the better the chance of improving vision. In some cases, children who get treatment early can have normal or nearly normal vision as adults.

Long-Term Outcomes: Amblyopia VS Strabismus 

If amblyopia and strabismus are treated early, many children can grow up with normal or almost normal vision. However, if these conditions are not treated in time, they can lead to permanent vision problems.

Depth Perception

Adults with untreated amblyopia can have poor depth perception and may have trouble doing tasks that require sharp vision, such as driving or reading. Even though vision in the stronger eye is usually good, the brain still ignores the weaker eye, which can make everyday activities more difficult.

Double Vision

Strabismus in adults can cause problems like double vision and poor eye coordination. In some cases, strabismus surgery can help align the eyes. In addition to eye muscle surgery, prism glasses can also be an option.

Even if treatment doesn’t fully restore vision, it can still improve quality of life by helping people with amblyopia and strabismus see better.

Amblyopia And Strabismus: Summary

Amblyopia and strabismus are some of the most vision problems in children. Both of these can lead to long-term issues if not treated early. Amblyopia happens when the brain favors one eye over the other and there is a decrease in vision in one eye. Rarely you can have amblyopia affect both eyes. Amblyopia can be caused by strabismus, which means that the eye muscles are not working in alignment. Strabismus is a term that refers specifically to a problem with the eye muscles and parents may notice an eye turn. 

Both conditions can be treated effectively with glasses, eye patches, surgery, or vision therapy if caught early. Early detection is key to preventing permanent vision loss, and managing these conditions can help children grow into adults with healthy vision.