Amblyopia - Sometimes the Answer is "Don't Treat"

Here's a common scenario that I estimate happens 2-3/mo in our practice, it just happened again 6min ago: 13 year old girl comes in. She has been in glasses her whole life, literally starting at age 3. One eye is prescriptionless and 20/15 acuity. Other eye is +3.50-1.00x010 with BCVA (best corrected visual acuity) 20/50. That means that with her glasses *ON* she still can't see any better than 20/50. Here's the kicker tho: her uncorrected vision without glasses on in the bad eye is... also 20/50. So the right eye is awesome and doesn't need glasses, and the left eye is 20/50 with the glasses off and 20/50 with the glasses on. Wearing the glasses does not make her see any better in either eye, not even the "bad" left eye. So guess what I did? Nothing. I told her she didn't have to wear glasses. She was very happy! Mother was flabbergasted. See she's been told every year by every optometrist ever that her daughter MUST wear glasses at ALL TIMES, and if she doesn't wear glasses at all times her left eye will "go blind" (which is untrue, but I digress). Eye care professionals mostly agree that the "critical period" of visual development stops at around age 8. Basically an amblyopic ("lazy") eye probably can't get very much worse or better after that. So before they're 8 we are prescribing these kids glasses and making them "patch" their good eye, etc etc etc. But when they reach 10 or so and they're still 20/50...and putting the perfect Rx in front of their bad eye DOES NOT IMPROVE THE ACUITY AT ALL...well then IMO a strong case can be made for *not* prescribing those kids glasses anymore. The mother later told me that the child "doesn't wear the glasses anyway". Yeah, not surprising at all. You know why? BECAUSE WEARING THE GLASSES DOES NOT INCREASE THE ACUITY. She puts the glasses on and sees EXACTLY THE SAME. And then she tries to play volleyball and be on the Jr High cheerleading squad etc etc with glasses on that literally just get in the way and don't help at all. Exactly what is the point of that? Nothing, I say. Now obviously I am not saying give up on all amblyopes or anything like that, but I am saying that sometimes the correct answer is "don't do anything".