Friday, February 21, 2014

Amblyopia treatment

amblyopia treatment
A large focus of what we do at our Vancouver eye clinic is the treatment of amblyopia using optometric vision therapy.

Developmental optometrists have long used active forms of therapy to rehabilitate the lazy eye that does not see well in amblyopic patients. The advantages of therapy over patching are that therapy is much more enjoyable for children than wearing an eye patch.  Moreover, therapy develops the binocularity (i.e. binocular vision or the two eyes working together as a team) of the visual system.

While optometrists have been doing this for a very long time, only recently have eye surgeons and the wider medical community come on-board with this approach. Dr. Leonard Press has found this passage in a new book on Vision Development by Dr. Daw, Professor Emeritus of Ophthalmology and Neuroscience at Yale University, where Dr. Daw acknowledges that vision therapists have been using effective active forms of therapy for a long time.

“Use of perceptual learning and video games has helped by increasing activity and attention as the therapy is done. Many of the principles have been employed by pediatric vision therapists for some time, but the publicity generated by “Stereo Sue” and others has helped to broadcast them.”
As stated in this passage, much credit goes to Dr. Susan Barry (known as "Stereo Sue") and her book Fixing My Gaze for increasing awareness of vision therapy techniques.  Dr. Barry is a neuroscientist, who was born with strabismus (an eye turn) and had lived all her life without stereo vision, meaning that she could not see in three dimensions. Her case was also the subject of an article in the New Yorker by Oliver Sacks.

She had three surgeries to "correct" the eye turn cosmetically but she still could not see properly and the eye was still turned, although less than before. She had lived this way for over 40 years until she met optometrist Dr. Theresa Ruggiero. Dr. Ruggiero treated Susan with vision therapy which corrected the eye turn and allowed her see in three dimensions for the first time in her life.

Thanks to vision therapy and the work of developmental optometrists, amblyopia is now widely regarded as a binocular problem, not a monocular problem upon which the old treatment of eye patching was based.  Here is one quotation from a study that makes the point:

amblyopia is an intrinsically binocular problem and not the monocular problem on which current patching treatment is predicated. Thought of in this way, the binocular problem involving suppression should be tackled at the very outset if one is to achieve a good binocular outcome as opposed to hoping binocular vision will be regained simply as a consequence of acuity recovery in the amblyopic eye, which is the current approach and which is often not found to be the case.
Hess, Robert F.; Mansouri, Behzad; Thompson, Benjamin, A Binocular Approach to Treating Amblyopia: Antisuppression Therapy. Optometry & Vision Science:September 2010 - Volume 87 - Issue 9 - pp 697-704

Related Articles

Risk Factors for Amblyopia in Preschoolers
Dec 12, 2013

Evidence that patching alone is not enough for amblyopia treatment
Apr 29, 2013

Patching alone is not good enough for amblyopia ... - See for Life
Apr 22, 2013

More evidence that patching alone is not enough for amblyopia treatment ...
Apr 29, 2013

The ultimate amblyopia infographic - See for Life
Jun 01, 2013

Advance treatment for amblyopia (lazy eye) - it's not patching
Friday, September 20, 2013

Active therapy is more effective for amblyopia
Nov 20, 2011

Take your kids to see "Thor": doctor's orders!
Thursday, October 25, 2012

Video Game therapy, optometric vision therapy are more effective than patching alone in treating amblyopia
Sunday, November 20, 2011

Is your child at risk for a vision disorder? Take this interactive quiz to find out. Wednesday, February 8, 2012

Vancouver Parents: Amblyopia treatment in a nutshell!
Monday, July 1, 2013