Amblyopia is commonly known as lazy eye. This should not be confused with squints. Amblyopia is poor vision in an eye that did not develop normal sight during early childhood.

After the age of 4 years, the development of the part of the brain that processes vision is almost complete. If the brain has not received clear images from the weak eye, it would be difficult to improve the vision in this eye after the brain is completely developed. The eye is then said to be amblyopic or lazy.

Successful treatment depends on how severe the amblyopia is and the age of the child when treatment begins. If the problem is detected early, successful treatment is possible and treatment time is shorter. If it is detected after the age of 4, the success rate would be very low.

Since the child is usually too young to complain of poor vision, this detection requires early checking of the vision by the family doctor, paediatrician or ophthalmologist before 3 years of age.

To correct amblyopia, the child must be forced to use the lazy eye. This is usually done by patching, or covering the good eye often for weeks or months. If the child also requires spectacles, he must wear it all the time.

The basis of patching is to allow the amblyopic eye to be used more often than the other eye so that it gets a chance to develop normal vision. The recovery of vision is better if patching is done at a very early age, preferably before 4 years old.

When first applying the child's patch, you may like to explain the reason to the child, or demonstrate on a doll. If the child is schooling, explain the treatment to the teacher so that she can encourage the child to perform his usual tasks with the patch on. She can also discourage classmates from teasing.

Treatment may take weeks to years. The younger the age treatment is started, the faster the recovery. The vision sometimes worsens after recovery so the child must be reviewed regularly.

1. Sore skin

2. If the child wants to remove the patch,

•	Use mittens or socks on the hands so that he cannot peel off the patch
•	Use empty paper towel roll over the hands and elbows so that they cannot bend their arms to peel the patch off.

3. Older children refusing to wear the patch to school

Spectacles should fit comfortably on the face and ears. Different sized spectacles are available, even for babies.

A good frame should have a comfortable support at the nose and behind the ears. Sometimes a back strap may be required to prevent the child from pulling the spectacles off.

The child should be encouraged to put on his spectacles as much as possible throughout his waking hours if he is being treated for amblyopia. If he is old enough, he can help to pick the colour of the frames. He should never be made to full ugly with his spectacles on.

This is a general guide. If in doubt, please consult your doctor.