Strabismus & Amblyopia

Have you or your child been diagnosed with crossed eyes, lazy eyes, or wandering eyes?

What are strabismus and amblyopia?

Different - but related conditions.

Strabismus and amblyopia are different—but related—conditions that can affect vision, especially in children.

Strabismus is when the eyes are not aligned and point in different directions. This can lead to reduced visual input from one or both eyes, may cause double vision, and can affect a person’s ability to perceive depth. Strabismus may be where the eyes point inward in relation to each other (esotropia), outward in relation to each other (exotropia), or in rare cases in upward or downward directions (vertical strabismus).

Amblyopia is when there is a delay in the development of visual acuity (how fine or detailed the eye is able to see) in one eye—and in some cases, both eyes. Amblyopia can be caused by strabismus, but it can also be caused by other factors, such as a difference in prescription (refractive error) between the two eyes, or something that blocks the visual axis in one eye.

Treatment depends on the cause. Many forms of strabismus can be improved with a combination of glasses and/or vision therapy. Amblyopia may also be treated with a combination of glasses, vision therapy, or other methods to help improve visual skills in the non-dominant eye. Early treatment is important to help prevent long-term vision problems, though treatment can be helpful at any age.

The initial evaluation.

The initial evaluation is a comprehensive office visit where we take a close look at how the eyes and brain are working together. During this visit, we assess overall eye health, visual clarity, eye alignment, and how well both eyes function as a team. We measure visual acuity, check for any need for new or adjusted glasses prescriptions, and evaluate the specific features of strabismus or amblyopia that may be present. Using this information, we create an individualized treatment plan based on well-established clinical methods and current evidence, with realistic expectations for improvement. We recommend planning for about an hour and a half of testing and discussion.

This visit is billed to major medical insurance if you plan to use it. We do keep a card on file, since a no-show or same-day cancellation (after 7:00 AM on the day of your appointment) will result in a fee. If you’re using insurance, please double-check ahead of time that we’re in-network with your plan. You’re also welcome to self-pay for the visit if that’s easier. Please note that late cancellation fees still apply, even if the issue is related to insurance.

Depending on the findings, we may recommend monitoring with follow-up visits or moving forward with a structured vision therapy program. There are many ways to treat amblyopia and strabismus, and the plan needs to make sense for each individual patient.

How glasses treat amblyopia and strabismus.

Glasses are often an important first step in treating both amblyopia and strabismus because they correct the visual input the brain receives from each eye. When the eyes experience blur or when focusing requires excessive effort, the brain may begin to adapt in ways that disrupt the brain’s ability to use the eyes together—contributing to amblyopia or strabismus. By correcting refractive errors such as nearsightedness, farsightedness, or astigmatism, glasses help the eyes provide clearer, more balanced images to the brain. In some cases of strabismus, specific lenses which correct imbalances between focus points, image sizes, and visual positions can also reduce eye turning by decreasing the effort needed to focus or by helping the eyes align more comfortably. While glasses alone may not fully resolve amblyopia or strabismus, research shows they can significantly improve visual acuity and eye alignment and are often a critical foundation for additional treatments like vision therapy.

How is vision therapy used to treat strabismus and amblyopia?

Vision therapy is a type of sensory treatment that is used to improve visual skills and abilities. It is often used to treat any condition in which benefits from improving how the brain uses information from the eyes.

Vision therapy typically involves a series of exercises and activities that are designed to improve eye alignment, coordination, and focusing. These activities may include the use of special lenses, filters, and prisms, including free space, instrument based, and sensory based procedures.

The goal of vision therapy for strabismus is to improve eye alignment and coordination, and to help the brain learn to use both eyes together effectively. This can help to reduce or eliminate double vision, improve depth perception, and enhance overall visual function.

What is the Vision Therapy program like?

Vision therapy is a customized program of eye–brain exercises that helps patients improve how their eyes work together. It’s designed to train the brain to coordinate both eyes effectively for clear, comfortable, and efficient vision—especially during activities like reading, writing, and paying attention in class. It focuses on strengthening visual skills such as eye coordination, depth perception, tracking, and focusing—skills that are essential for learning and everyday tasks.

What it looks like:

• Weekly office sessions: Typically one hour per week. Most commonly 12-18 weeks.

• At-home activities: 15–20 minutes of practice per day to support progress.

• Progress checks: Regular evaluations to monitor changes and adjust goals.

• Family support: Parents receive guidance to help reinforce skills at home.

After completing the in-office vision therapy program, we expect patients to continue practicing the exercises at home. Think of the program as learning and strengthening new visual skills with our guidance, and then maintaining and building on those skills through regular home practice. We’ll continue to check progress with periodic follow-up visits every few months to make sure the improvements are holding and to adjust exercises if needed.

Cost and Insurance: The vision therapy program itself at our office is not usually covered by medical insurance or vision insurance, but our office offers affordable payment plans to make care accessible. There’s a one-time start-up fee at the beginning that covers testing, equipment, and materials, and then the cost of the one-hour therapy sessions billed per session. Along the way, we also do a couple of progress check-ins that are typically billed to medical insurance. Most families find that the overall cost for the full program ends up in the mid two-thousand-dollar range and upward, spread out over the course of treatment.

Ready to get started?

If you’re ready to get started with vision therapy, or have any questions, the best way to reach us is by texting our office (253-201-2515)—it’s quick, easy, and our preferred method of communication. You’re also welcome to call or email if you prefer. Please note that we typically have a 2–4 month wait time to begin therapy due to limited availability. Our sessions are offered Tuesday through Friday. We’ll be happy to answer any questions and help reserve a spot for your child as soon as possible!

Do you need treatment for strabismus or amblyopia in the Kent, Auburn, Renton, Covington, Maple Valley, Enumclaw, or Black Diamond area?

Schedule an eye exam today!