弱视越早治疗效果越好，未治疗的弱视会导致弱视眼终身视力受损并增加双眼视力受损可能。弱视治疗几周至几个月内就会有效，视力在治疗初期提高较快并逐渐进入平台期。
未治疗的弱视
未经治疗的弱视其视力很难自行提高。[81]Simons K, Preslan M. Natural history of amblyopia untreated owing to lack of compliance. Br J Ophthalmol. 1999;83:582-587.http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1723047&blobtype=pdfhttp://www.ncbi.nlm.nih.gov/pubmed/10216059?tool=bestpractice.com弱视患儿如在儿童时期未及时治疗将会导致终身视力受损。[1]American Academy of Ophthalmology. Preferred practice pattern: amblyopia. San Francisco, CA: American Academy of Ophthalmology; 2012.https://www.aao.org/preferred-practice-pattern/amblyopia-ppp--september-2012[18]Rahi JS, Logan S, Borja MC, et al. Prediction of improved vision in the amblyopic eye after visual loss in the non-amblyopic eye. Lancet. 2002;360:621-622.http://www.ncbi.nlm.nih.gov/pubmed/12241937?tool=bestpractice.com[19]Wilson ME. Adult amblyopia reversed by contralateral cataract formation. J Pediatr Ophthalmol Strabismus. 1992;29:100-102.http://www.ncbi.nlm.nih.gov/pubmed/1588469?tool=bestpractice.com因弱视导致单眼视力丧失的患者，其正常眼视力丧失的风险也会增加。一项人群为基础的研究表明在单眼弱视患者中其正常眼视力丧失的比例为1.75/1000人，而同时正常人群致盲的比例仅为0.66/1000人。[84]Tommila V, Tarkkanen A. Incidence of loss of vision in the healthy eye in amblyopia. Br J Ophthalmol. 1981;65:575-577.http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1039584&blobtype=pdfhttp://www.ncbi.nlm.nih.gov/pubmed/7295619?tool=bestpractice.com超过一半导致其视力丧失的原因为外伤。[84]Tommila V, Tarkkanen A. Incidence of loss of vision in the healthy eye in amblyopia. Br J Ophthalmol. 1981;65:575-577.http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1039584&blobtype=pdfhttp://www.ncbi.nlm.nih.gov/pubmed/7295619?tool=bestpractice.com另一项人群研究结果显示弱视患者终身双眼视力受损的几率为18%而同时在正常人群为11%，且前者双眼视力受损时间较后者长6个月。[85]van Leeuwen R, Eijkemans MJ, Vingerling JR, et al. Risk of bilateral visual impairment in individuals with amblyopia: the Rotterdam study. Br J Ophthalmol. 2007;91:1450-1451.http://www.ncbi.nlm.nih.gov/pubmed/17522151?tool=bestpractice.com
经治疗后的弱视
美国儿童眼病研究小组的首次弱视治疗研究显示75%7岁以下的中度弱视儿童治疗后可达到20/30或更好的视力。[35]Pediatric Eye Disease Investigator Group. A randomized trial of atropine vs. patching for treatment of moderate amblyopia in children. Arch Ophthalmol. 2002;120:268-278.http://www.ncbi.nlm.nih.gov/pubmed/11879129?tool=bestpractice.com可长期保持视力提高效果。[41]Repka MX, Kraker RT, Beck RW, et al. A randomized trial of atropine vs patching for treatment of moderate amblyopia: follow-up at age 10 years. Arch Ophthalmol. 2008;126:1039-1044.http://www.ncbi.nlm.nih.gov/pubmed/18695096?tool=bestpractice.com[59]Hertle RW, Scheiman MM, Beck RW, et al. Pediatric Eye Disease Investigator Group. Stability of visual acuity improvement following discontinuation of amblyopia treatment in children aged 7 to 12 years. Arch Ophthalmol. 2007;125:655-659.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2614923/http://www.ncbi.nlm.nih.gov/pubmed/17502505?tool=bestpractice.com但经治疗的屈光参差性弱视虽然视力可达到20/25或更佳，但其立体视觉明显差于同龄非弱视儿童。[86]Wallace DK, Lazar EL, Melia M, et al; Pediatric Eye Disease Investigator Group. Stereoacuity in children with anisometropic amblyopia. J AAPOS. 2011;15:455-461.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3223370/http://www.ncbi.nlm.nih.gov/pubmed/22108357?tool=bestpractice.com
