A “lazy eye” is not lazy at all! Research has shown that amblyopia is a disorder of the brain’s ability to use both eyes together as a team, and is a treatable form of vision loss that can be improved. It occurs when the brain and eye are not working together properly, causing reduced vision in one or both eyes. Unlike strabismus, which is a crossed or turned eye, the amblyopic eye may look normal. However, when there is a disruption in binocular vision, or eye-teaming, the brain will shut off the weaker eye in favor of the stronger eye. If left untreated, outside of poor vision, amblyopia can affect a child’s self- image, school life, friendships, and may impact mental health.
Amblyopia typically develops during infancy and early childhood. This condition affects over 12 million people in the US alone (about 3.5% of the US population). Those with amblyopia experience mild to severe vision loss in one or both eyes. Symptoms typically include:
- Impaired depth perception
- Poor eye-hand coordination
- Frequent tripping or other accidents
- Trouble with processing information visually (visual perceptual skills)
- Struggling with reading speed and/or or comprehension
There are three types of amblyopia:
- Strabismic amblyopia. This common form of amblyopia occurs when the eyes are misaligned, with a condition medically known as, or an “eye turn.” To avoid double vision, the brain shuts off the weaker eye, which is known as suppression.
- Refractive amblyopia. This form of amblyopia occurs when one eye has significantly different amount of nearsightedness, farsightedness, or astigmatism. When this happens, the brain favors the eye with better vision and shuts off the weaker eye, known as suppression.
- Deprivation amblyopia. This occurs when something obstructs light from entering an eye, such as cataracts. As a result of the obstruction, one eye becomes weaker and the brain favors the eye without the obstruction, turning off the weaker eye. This is known as, you guessed it, suppression.
Historically, amblyopia treatment was limited to penalization therapy by using an eye patch or atropine eye drops on the better-seeing eye. By penalizing the good eye, the goal was to “strengthen” the weaker eye. However, as most doctors know, patient compliance is poor because of the many negative side effects of patching and eyedrops. Furthermore, patching often causes family battles when trying to force a child to comply with wearing their eye patch.
Outside of the classroom, a child can have trouble with social interactions and bullying due to forced patching. Kids just don’t want to wear their eye patch because it impacts their quality of life and atropine drops can cause light sensitivity and disorientation. As a result, amblyopia is rarely fully resolved with occlusion therapy alone.
Even a patient who has done occlusion therapy and improved the weaker eye to near-20/20, will still typically have suppression, leading to poor teaming and function. The brain still suppresses (shuts off) the “bad eye,” leading to stereo blindness – a deficit in depth perception. This contributes to being accident prone, poor reading efficiency, and poor eye-hand coordination. Occlusion therapy is an outdated, and largely ineffective, approach to a complex and serious vision disorder.
The team at Blacksburg’s Vision+ Performance and Rehab provides advanced amblyopia vision development and neurorehabilitation. This method emphasizes the development of true binocular vision and visual information processing. Treatment sessions are conducted in the office by a trained vision development therapist, under the supervision of our physicians, along with guided home-support activities. There are no negative side effects of optometric vision development therapy, and the child gets to have little impact on their daily routine (no fighting over patches or medications). As a result, our patients see results significantly faster and with better end-results, including restoration of sight, depth perception, visual processing abilities, and eye-hand coordination. Depending on your case, the treatment plan may start with eye drops or patching, and then progress to more advanced amblyopia therapy when appropriate.
Age is not a barrier to the treatment of amblyopia! Research shows there is neuroplasticity in the adult brain and by applying the advanced amblyopia treatment protocols, like we use at our Blacksburg rehab facility, adults with amblyopia can be successfully treated, as well!
Our advanced binocular vision treatment for amblyopia includes:
- Visual Perceptual Learning
- Visual Processing Development
- Vision Development and Binocular Neurorehabilitation
- Ocular-motor Training
- Accommodation “Focusing” Training
- Eye-hand Coordination Training
- Sensory Integration
ADDITIONAL RESOURCES AND RESEARCH
The below links are for scholarly research on amblyopia treatment.
- A New Form of Rapid Binocular Plasticity in Adult with Amblyopia.
- Amblyopia and Binocular Vision.
- Binocular Combination in Anisometropic Amblyopia.
- Binocular Vision in Amblyopia: Structure, Suppression and Plasticity.
- Perceptual Learning Improves Visual Performance in Juvenile Amblyopia.
- Prentice Award Lecture 2011: Removing the Brakes on Plasticity in the Amblyopic Brain.
- Stereopsis and Amblyopia: A mini-review
- The Amblyopia Project | VisionHelp
- The Effect of Video Game Training on the Vision of Adults with Bilateral Deprivation Amblyopia.
- The Pattern of Learned Visual Improvements in Adult Amblyopia.
- Restoration of binocular vision in amblyopia.
- Amblyopia and quality of life: a systematic review.