Strabismus and amblyopia are two of the most common conditions diagnosed during childhood eye exams in Edmonton, and both are among the most treatable when caught early. The challenge is that parents often do not recognize the signs, and children almost never complain, because they have no comparison for what normal vision looks and feels like.
Understanding what these conditions actually are, what causes them, and what treatment involves helps parents respond quickly when something does not look right.
What Is Strabismus?
Strabismus is a condition where the two eyes do not point in the same direction at the same time. One eye may turn inward (esotropia), outward (exotropia), upward (hypertropia), or downward. The misalignment can be constant or intermittent, and it may affect only one eye or alternate between both.
Strabismus occurs when the muscles controlling eye movement are not properly coordinated, or when the brain has difficulty aligning both eyes on the same point. It is not a phase children grow out of without treatment. Left untreated, strabismus almost always leads to amblyopia in the eye that the brain begins to ignore.
What Is Amblyopia?
Amblyopia, commonly called lazy eye, is reduced vision in one eye that occurs because the brain, overwhelmed by conflicting signals from misaligned or unequal eyes, begins to suppress the input from the weaker eye. Over time, the visual cortex stops developing properly for that eye. Even with perfect glasses correction, the suppressed eye does not see as clearly as the other because the brain has learned not to rely on it.
Amblyopia is the most common cause of vision impairment in children in Canada. It cannot be detected through a standard school vision screening. Only a comprehensive children’s eye exam in Edmonton with careful testing of each eye individually reveals the difference in visual acuity between the two eyes.
Causes of Strabismus and Amblyopia
Refractive amblyopia occurs when there is a significant prescription difference between the two eyes. The brain favours the clearer eye and suppresses the blurrier one, and the turned eye may look perfectly straight while the amblyopia develops silently. This is the form most commonly missed by parents because there is no obvious physical sign.
Strabismic amblyopia develops when strabismus is present and the brain suppresses the turned eye to avoid double vision. Deprivation amblyopia occurs when something blocks light from reaching the eye during critical early development, such as a congenital cataract. Family history plays a role in both conditions. Children with a parent or sibling who had strabismus or amblyopia should be examined earlier and monitored more closely.
Signs to Watch for in Edmonton Children
Some of these signs are subtle, which is why professional examination matters even when nothing seems obviously wrong.
- One eye that turns in, out, up, or down, even occasionally or only when the child is tired
- Covering or closing one eye in bright light or when trying to see something clearly
- Tilting or turning the head consistently during visual tasks
- Squinting or apparent difficulty judging distances, like misjudging steps or reaching for objects slightly off target
- A family history of crossed eyes or lazy eye in parents or siblings
Because children with amblyopia usually do not know their vision is reduced in one eye, screening for these signs requires active parental attention and annual professional examination. If you notice any of the above, book an appointment with an Edmonton optometrist rather than waiting for the next scheduled exam.
What Treatment Looks Like
Prescription glasses are often the first intervention and the most important one. Many cases of strabismus and refractive amblyopia respond significantly to accurate glasses correction alone. When the prescription difference between the eyes is corrected with lenses, the suppressed eye begins to re-engage. We carry a full range of prescription glasses in Edmonton for children in durable, child-appropriate frames.
Patching therapy involves covering the stronger eye with a patch for a prescribed number of hours per day, forcing the brain to use the weaker eye and stimulating its visual development. Most children adapt to patching more readily than parents expect, particularly when started young. Atropine drops are an alternative to patching for some children, temporarily blurring the stronger eye to achieve the same effect.
Vision therapy is a structured program of exercises that improves eye coordination, focusing, and binocular vision function. It is particularly useful for convergence insufficiency and some forms of intermittent strabismus. In cases where the muscle imbalance does not respond to optical and patching treatment, surgical correction of the eye muscles may be recommended. Your optometrist will refer to an ophthalmologist when surgery is indicated.
Questions Edmonton Parents Ask About Strabismus and Amblyopia
Q: My child’s eyes only turn occasionally. Should I still be concerned?
Yes. Intermittent strabismus that only appears when a child is tired or focused on something nearby still needs professional evaluation. Occasional misalignment means the visual system is struggling to maintain coordination, and without intervention, it can become more frequent and lead to amblyopia. An eye turn that appears even some of the time is worth booking an appointment for.
Q: My child passed a school vision screening. Can they still have amblyopia?
Yes. School screenings test distance visual acuity in both eyes together. They do not test each eye individually at near, and they are not designed to detect amblyopia. A child with amblyopia in one eye can compensate with the better eye during a screening and achieve a result that appears normal. A comprehensive pediatric eye exam tests each eye separately and specifically checks for the kind of acuity reduction that indicates amblyopia.
Q: Is seven years old too late to treat amblyopia?
No. While the visual system is most responsive to treatment before age seven, meaningful improvement is possible through the early teen years in many cases. The younger the child is when treatment begins, the better and faster the typical response, but older children should not be told treatment is pointless. An honest assessment from an Edmonton optometrist will tell you what improvement is realistic for your child’s age and the severity of the amblyopia.
Q: How long does patching therapy last?
The duration depends on the child’s age, the severity of the amblyopia, and how well the eye responds to treatment. Some children show significant improvement within a few months. Others require a year or more of ongoing patching to achieve and maintain the best possible vision in the affected eye. Your optometrist will monitor progress at regular intervals and adjust the treatment plan based on what the exams show.
Q: Will my child need glasses forever because of amblyopia?
Not necessarily. Some children with amblyopia caused by a prescription difference between the eyes can eventually reduce or stop wearing glasses once the visual system has fully developed and the amblyopia has resolved. Others continue to need glasses for prescription management alone. Your child’s long-term glasses requirement depends on the underlying cause of the amblyopia and how much their prescription changes as they grow.
Book a Children’s Eye Exam in Edmonton
All eye exams for patients under 19 are covered by Alberta Health Care at no cost. Eyes On Optometry provides pediatric eye care in a calm, unhurried environment with optometrists experienced in assessing children of all ages, from infants through to teenagers. Early detection and treatment of strabismus and amblyopia makes a real and lasting difference to your child’s vision.
Contact us to book your child’s appointment in Edmonton today. If you are also wondering whether your child might need glasses, our guide on signs your child may need glasses covers what to watch for at home.