Have you been told this before? I can’t have surgery because I have a lazy eye
This is a common misconception from two standpoints. First of all, most people think that a “lazy eye” is an eye that crosses. The true definition of lazy eye or amblyopia is an eye that looks normal but cannot see 20/20 even with glasses. Lazy eye is a brain phenomenon where the eye cannot be corrected to 20/20, rather than a wandering eye (technically termed a
“strabismus” or muscle imbalance). I routinely treat patients with strabismus and with lazy eye. If the strabismus is corrected when glasses or contacts are worn—that is, farsighted patients whose eyes turn inward unless they are wearing glasses or contacts—then the strabismus will also be corrected with vision correction surgery. If the eye still crosses when glasses or contacts are worn, then the strabismus will persist after eye surgery. I will recommend to some patients with this situation to consider eye muscle surgery prior to vision correction surgery.
The second misconception with lazy eye (amblyopia) is that refractive surgery cannot be performed. I can and do routinely perform vision correction surgery on lazy eyes. The main issue with this situation is that I can never get the vision better after vision correction surgery than it was with the best pair of glasses or contacts. That is to say, if the patient was only correctable to 20/40, a patient could only expect a 20/40 outcome after LASIK or other procedure in that eye. The other issue is that while risks are very low, the patient with lazy eye is taking a risk on the eye with good corrected vision if they have both eyes corrected. If the lazy eye were so dense that the patient could not function if the lazy eye were their only eye, I would usually recommend against vision correction surgery except in unusual circumstances where the patient has a compelling reason to proceed with surgery. I once had a patient who had very dense lazy eye in one eye (which was legally blind, even with glasses) and a high nearsighted prescription in the fellow eye. He was an avid skier and swimmer who reluctantly had to give up these activities because he was contact lens-intolerant. Aware of his desire to return to these activities, I was willing to perform surgery on him with appropriate informed consent, and he was soon zooming down the slopes and zipping across the pool after successful eye surgery.
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