amblyopia binocular vision

Prog Retin Eye Res. 2013 Mar;33:67-84. Epub 2012 Nov 29.Author information1Pediatric Laboratory, Retina Foundation of the Southwest, Dallas, TX 75231, USA. AbstractAmblyopia is the most common cause of monocular visual loss in children, affecting 1.3%-3.6% of children. Current treatments are effective in reducing the visual acuity deficit but many amblyopic individuals are left with residual visual acuity deficits, ocular motor abnormalities, deficient fine motor skills, and risk for recurrent amblyopia. Using a combination of psychophysical, electrophysiological, imaging, risk factor analysis, and fine motor skill assessment, the primary role of binocular dysfunction in the genesis of amblyopia and the constellation of visual and motor deficits that accompany the visual acuity deficit has been identified. These findings motivated us to evaluate a new, binocular approach to amblyopia treatment with the goals of reducing or eliminating residual and recurrent amblyopia and of improving the deficient ocular motor function and fine motor skills that accompany amblyopia.
Copyright © 2012 Elsevier Ltd. PMID: 23201436 PMCID: PMC3577063 DOI: 10.1016/j.preteyeres.2012.11.001 [PubMed - indexed for MEDLINE] Free PMC ArticlePublication TypesResearch Support, N.I.H., ExtramuralResearch Support, Non-U.S. Gov'tReviewMeSH TermsAmblyopia/physiopathology*Amblyopia/therapyChildChild, PreschoolHumansInfantStrabismus/physiopathologyVision, Binocular/physiology*Grant SupportR01 EY005236/EY/NEI NIH HHS/United StatesR01 EY022313/EY/NEI NIH HHS/United StatesEY022313/EY/NEI NIH HHS/United StatesEY05236/EY/NEI NIH HHS/United StatesFull Text SourcesElsevier ScienceEurope PubMed Central - Author ManuscriptOvid Technologies, Inc.PubMed Central - Author ManuscriptPubMed Central Canada - Author ManuscriptMedicalAmblyopia - MedlinePlus Health InformationThe IP address used for your Internet connection is part of a subnet that has been blocked from access to PubMed Central. Addresses across the entire subnet were used to download content in bulk, in violation of the terms of the PMC Copyright Notice.
Use of PMC is free, but must comply with the terms of the Copyright Notice on the PMC site. For additional information, or to request that your IP address be unblocked, For requests to be unblocked, you must include all of the information in the box above in your message.doi: 10.3109/09273972.2011.600418.Hess RF1, Mansouri B, Thompson B.Author information1McGill Vision Research, Department of Ophthalmology, McGill University, Montreal, Quebec, Canada. night vision binoculars malaysia pricerobert.hess@mcgill.caAbstractPURPOSE: To develop a treatment for amblyopia based on re-establishing binocular vision.best compact safari binocularsMETHODS: A novel procedure is outlined for measuring and reducing the extent to which the fixing eye suppresses the fellow amblyopic eye in adults with amblyopia. best compact safari binoculars
We hypothesize that suppression renders a structurally binocular system, functionally monocular.RESULTS: We demonstrate that strabismic amblyopes can combine information normally between their eyes under viewing conditions where suppression is reduced by presenting stimuli of different contrast to each eye. Furthermore we show that prolonged periods of binocular combination leads to a strengthening of binocular vision in strabismic amblyopes and eventual combination of binocular information under natural viewing conditions (stimuli of the same contrast in each eye). swarovski pocket binocularConcomitant improvement in monocular acuity of the amblyopic eye occurs with this reduction in suppression and strengthening of binocular fusion. buy binoculars edinburghAdditionally, stereoscopic function was established in the majority of patients tested. best nikon binoculars football
We have implemented this approach on a headmounted device as well as on a handheld iPod.CONCLUSION: This provides the basis for a new treatment of amblyopia, one that is purely binocular and aimed at reducing suppression as a first step.PMID: 21870914 DOI: 10.3109/09273972.2011.600418 [PubMed - indexed for MEDLINE] Publication TypesResearch Support, Non-U.S. Gov'tReviewMeSH TermsAmblyopia/physiopathologyAmblyopia/therapy*AnimalsHumansRecovery of Function*Sensory Deprivation*Vision, Binocular/physiology*Grant SupportMOP 53346/Canadian Institutes of Health Research/CanadaFull Text SourcesTaylor & FrancisOther Literature SourcesCOS Scholar UniverseMedicalClinicalTrials.govAmblyopia - MedlinePlus Health InformationCan binocular gaming improve amblyopia? What if playing a game for an hour a day over the course of several weeks could help adults and children with amblyopia restore binocular vision?Under the right conditions, patients with amblyopia can indeed restore binocular vision." That's the question at the heart of research focused on binocular treatment.
It focuses on "training" both eyes simultaneously by altering such factors as contrast for each eye, notes Yi Pang, M.D., O.D., Ph.D., assistant dean for research at the Illinois College of Optometry and a practitioner and researcher with experience in amblyopia.For example, in a study published in July 2014 in Eye, researchers treated 50 children using a binocular iPad game and 25 using a "sham" game, in some cases in conjunction with patching. According to results, mean visual acuity improved in the binocular group, but there was no significant change for the sham group.This was but one among nine small-scale studies focused on binocular treatments, both in adults and children. The approach—and the technology behind it—has been championed by Robert F. Hess, D.Sc., of McGill University's Department of Ophthalmology at the University of Montreal, Quebec."We have done experiments that show that, under the right conditions, patients with amblyopia can indeed restore binocular vision," Dr. Hess says.
Based on the small-scale studies' results, a randomized clinical trial is in recruitment, to be administered by the Pediatric Eye Disease Investigatory Group (PEDIG). Dr. Pang, a PEDIG researcher, points out that such a trial is critical to establishing the efficacy of binocular gaming for treatment. The work so far has shown enough promise to warrant further research."Now, we need a large, randomized clinical trial to show whether it will work effectively for many patients—especially in comparison with patching," Dr. Pang says.How treatments would work In Dr. Hess' most recent research, the results were positive in terms of outcomes and patient compliance.The screens used in such treatment incorporate a lenticular layover, which separates the field of vision for each eye. A patient plays a game that requires each eye to function to complete the game successfully. For example, in the familiar puzzle game Tetris, the game is fine-tuned in terms of contrast and other factors. The amblyopic eye sees game blocks as they fall from the top of the screen, while the healthy eye sees the blocks that are fixed in place at the bottom of the screen."
The basic idea is you have different information for each eye," Dr. Hess notes. "Initially, that information is quite off-balance to counteract the patient's degree of suppression. Over time, as they complete the game successfully, the game slowly adjusts back to a more similar level of contrast. Eventually, you can get to a similar situation for both eyes."Of the 14 cases included in the study, 13 patients showed significant improvements in visual acuity and stereopsis.But would patients follow through on a doctor's orders to use this program for a half hour to an hour a day for four to six weeks?The answer was yes. Dr. Hess notes that the devices record and report whether a patient logged daily use, and for how long. An OD or other eye care professional's oversight is critical to the process.  "What is absolutely essential from my perspective is that this is not a downloadable app anyone can access," he notes. "This has to be prescribed and managed. That's the way we can ensure it has the best chance of working for patients."