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Sample records for amblyopia

  1. amblyopia

    African Journals Online (AJOL)

    A review of types, presentation and treatment of amblyopia was done. There are four major types of amblyopia namely: strabismic ..... eye has a competitive advantage in order to encourage .... amblyopia: An analysis comparing the results of.

  2. [Amblyopia].

    Science.gov (United States)

    Orssaud, C

    2014-06-01

    Amblyopia is a developmental disorder of the entire visual system, including the extra-striate cortex. It manifests mainly by impaired visual acuity in the amblyopic eye. However, other abnormalities of visual function can be observed, such as decreased contrast sensitivity and stereoscopic vision, and some abnormalities can be found in the "good" eye. Amblyopia occurs during the critical period of brain development. It may be due to organic pathology of the visual pathways, visual deprivation or functional abnormalities, mainly anisometropia or strabismus. The diagnosis of amblyopia must be confirmed prior to treatment. Confirmation is based on cycloplegic refraction, visual acuity measurement and orthoptic assessment. However, screening for amblyopia and associated risk factors permits earlier diagnosis and treatment. The younger the child, the more effective the treatment, and it can only be achieved during the critical period. It requires parental cooperation in order to be effective and is based on occlusion or penalization of the healthy eye. The amblyopic eye may then develop better vision. Maintenance therapy must be performed until the end of the critical period to avoid recurrence. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. [Functional amblyopia].

    Science.gov (United States)

    Avram, Elena; Stănilă, Adriana

    2013-01-01

    Amblyopia is a disorder of the visual system that represents unilateral or bi-lateral reduction of visual acuity in which an organic cause cannot be detected. The illness represents a syndrome of visual deficits, not only a deterioration of visual acuity. This syndrome includes: presence of crowding phenomena, contrast sensitivity deterioration, deficits in accommodation, deterioration of spatial orientation and ocular motility dysfunction. Depending on its etiology, amblyopia is classified into four main types: strabismic amblyopia, anisometropic amblyopia, isoametropic amblyopia and stimulus deprivation amblyopia. To successfully treat the "lazy eye" it is essential to remove the amblyopic factor with techniques addressing each disturbing factor. Techniques used for treating amblyopia include: occlusion, optical penalty or pharmacological, therapy with Levodopa and computer vision therapy. Amblyopia treatment is lengthy and it is very important to counsel not only the child but the whole family and to establish a relationship of trust between doctor and patient in order to get high treatment compliance and high child motivation.

  4. Facts about Amblyopia

    Science.gov (United States)

    ... amblyopia? Amblyopia is the most common cause of visual impairment among children, affecting approximately 2 to 3 out of every 100 children. Unless it is successfully treated in early childhood, amblyopia usually ... impairment among young and middle-aged adults. Cause What ...

  5. Amblyopia update: new treatments.

    Science.gov (United States)

    Vagge, Aldo; Nelson, Leonard B

    2016-09-01

    This review article is an update on the current treatments for amblyopia. In particular, the authors focus on the concepts of brain plasticity and their implications for novel treatment strategies for both children and adults affected by amblyopia. A variety of strategies has been developed to treat amblyopia in children and adults. New evidence on the pathogenesis of amblyopia has been obtained both in animal models and in clinical trials. Mainly, these studies have challenged the classical concept that amblyopia becomes untreatable after the 'end' of the sensitive or critical period of visual development, because of a lack of sufficient plasticity in the adult brain. New treatments for amblyopia in children and adults are desirable and should be encouraged. However, further studies should be completed before such therapies are widely accepted into clinical practice.

  6. Amblyopia and binocular vision.

    Science.gov (United States)

    Birch, Eileen E

    2013-03-01

    Amblyopia 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. All rights reserved.

  7. Amblyopia and Strabismus

    OpenAIRE

    Cline, Roy A.

    1990-01-01

    Strabismus and amblyopia, two of the most common problems in children's vision, can be prevented only by early recognition, diagnosis, and treatment. Strabismus, a misalignment of the eyes that causes one eye to deviate from its normal position, is the most common cause of amblyopia. Amblyopia is impaired vision in one eye caused by disuse. The author describes diagnostic tests, common causes, and frequently used treatment for both conditions.

  8. Amblyopia and Binocular Vision

    OpenAIRE

    Birch, Eileen E.

    2012-01-01

    Amblyopia is the most common cause of monocular visual loss in children, affecting 1.3% to 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 bin...

  9. [Treatment of amblyopia].

    Science.gov (United States)

    von Noorden, G K

    1990-01-01

    Animal experiments have explored the structural and functional alterations of the afferent visual pathways in amblyopia and have emphasized the extraordinary sensitivity of the immature visual system to abnormal visual stimulation. The practical consequences of these experiments are obvious: early diagnosis of amblyopia and energetic occlusion therapy as early in life as possible. At the same time, measures must be taken to prevent visual deprivation amblyopia in the occluded eye. After successful treatment, alternating penalization with two pairs of spectacles is recommended. Pleoptics involves an enormous commitment in terms of time, personnel and costs. In view of the fact that the superiority of this treatment over occlusion therapy has yet to be proven, the current value of pleoptics appears dubious. Moreover, overtreated patients may end up with intractable diplopia. Diverging opinions exist with regard to the use of penalization as a primary treatment of amblyopia. We employ it only in special cases as an alternative to occlusion therapy. Visual deprivation in infancy caused by opacities of the ocular media, especially when they occur unilaterally, must be eliminated, and deprivation amblyopia must be treated without delay to regain useful vision. Brief periods of bilateral occlusion are recommended to avoid the highly amblyopiogenic imbalance between binocular afferent visual input. Future developments will hopefully include new objective methods to diagnose amblyopia in preverbal children and infants. The application of positron emission tomography is perhaps the first step in the direction of searching for new approaches to this problem.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Amblyopia therapy: an update.

    Science.gov (United States)

    Stewart, Catherine E; Moseley, Merrick J; Fielder, Alistair R

    2011-09-01

    We review the findings of trials of mainstay amblyopia treatment conducted within the last 5 years. These have confirmed that an initial period of full-time refractive correction is beneficial in all types of amblyopia. Adopting this practice may allow up to 30% of children to avoid any further treatment. Studies that have investigated the role of atropine occlusion as a first-line treatment for amblyopia have shown "weekend atropine" to be as effective as patching for children with both moderate and severe amblyopia. Where patching is prescribed, 2-4 hours/day of occlusion appears sufficient to provide an optimum outcome for the majority of children, although those over 6 years tend to require a larger dose to achieve best outcome, their amblyopia being more resistant to treatment. Educational interventions such as cartoons and written and video explanations of treatment aimed at improving compliance appear to raise it to a therapeutic level in those who may otherwise have poor compliance or drop out from treatment. Formal, evidence-based practice guidelines for the management of amblyopia have emerged although their adoption by practitioners, at least in the United Kingdom, has been questioned.

  11. NEI You Tube Videos: Amblyopia

    Medline Plus

    Full Text Available ... YouTube Videos: Amblyopia Embedded video for NEI YouTube Videos: Amblyopia ... *PDF files require the free Adobe® Reader® software for viewing. This website is maintained by the ...

  12. Pharmacological therapy for amblyopia

    Directory of Open Access Journals (Sweden)

    Anupam Singh

    2017-01-01

    Full Text Available Amblyopia is the most common cause of preventable blindness in children and young adults. Most of the amblyopic visual loss is reversible if detected and treated at appropriate time. It affects 1.0 to 5.0% of the general population. Various treatment modalities have been tried like refractive correction, patching (both full time and part time, penalization and pharmacological therapy. Refractive correction alone improves visual acuity in one third of patients with anisometropic amblyopia. Various drugs have also been tried of which carbidopa & levodopa have been popular. Most of these agents are still in experimental stage, though levodopa-carbidopa combination therapy has been widely studied in human amblyopes with good outcomes. Levodopa therapy may be considered in cases with residual amblyopia, although occlusion therapy remains the initial treatment choice. Regression of effect after stoppage of therapy remains a concern. Further studies are therefore needed to evaluate the full efficacy and side effect profile of these agents.

  13. Pharmacological therapy for amblyopia

    Science.gov (United States)

    Singh, Anupam; Nagpal, Ritu; Mittal, Sanjeev Kumar; Bahuguna, Chirag; Kumar, Prashant

    2017-01-01

    Amblyopia is the most common cause of preventable blindness in children and young adults. Most of the amblyopic visual loss is reversible if detected and treated at appropriate time. It affects 1.0 to 5.0% of the general population. Various treatment modalities have been tried like refractive correction, patching (both full time and part time), penalization and pharmacological therapy. Refractive correction alone improves visual acuity in one third of patients with anisometropic amblyopia. Various drugs have also been tried of which carbidopa & levodopa have been popular. Most of these agents are still in experimental stage, though levodopa-carbidopa combination therapy has been widely studied in human amblyopes with good outcomes. Levodopa therapy may be considered in cases with residual amblyopia, although occlusion therapy remains the initial treatment choice. Regression of effect after stoppage of therapy remains a concern. Further studies are therefore needed to evaluate the full efficacy and side effect profile of these agents. PMID:29018759

  14. Visual search deficits in amblyopia.

    Science.gov (United States)

    Tsirlin, Inna; Colpa, Linda; Goltz, Herbert C; Wong, Agnes M F

    2018-04-01

    Amblyopia is a neurodevelopmental disorder defined as a reduction in visual acuity that cannot be corrected by optical means. It has been associated with low-level deficits. However, research has demonstrated a link between amblyopia and visual attention deficits in counting, tracking, and identifying objects. Visual search is a useful tool for assessing visual attention but has not been well studied in amblyopia. Here, we assessed the extent of visual search deficits in amblyopia using feature and conjunction search tasks. We compared the performance of participants with amblyopia (n = 10) to those of controls (n = 12) on both feature and conjunction search tasks using Gabor patch stimuli, varying spatial bandwidth and orientation. To account for the low-level deficits inherent in amblyopia, we measured individual contrast and crowding thresholds and monitored eye movements. The display elements were then presented at suprathreshold levels to ensure that visibility was equalized across groups. There was no performance difference between groups on feature search, indicating that our experimental design controlled successfully for low-level amblyopia deficits. In contrast, during conjunction search, median reaction times and reaction time slopes were significantly larger in participants with amblyopia compared with controls. Amblyopia differentially affects performance on conjunction visual search, a more difficult task that requires feature binding and possibly the involvement of higher-level attention processes. Deficits in visual search may affect day-to-day functioning in people with amblyopia.

  15. The challenges of amblyopia treatment

    OpenAIRE

    Maconachie, Gail D.E.; Gottlob, Irene

    2015-01-01

    The treatment of amblyopia, particularly anisometropic (difference in refractive correction) and/or strabismic (turn of one eye) amblyopia has long been a challenge for many clinicians. Achieving optimum outcomes, where the amblyopic eye reaches a visual acuity similar to the fellow eye, is often impossible in many patients. Part of this challenge has resulted from a previous lack of scientific evidence for amblyopia treatment that was highlight by a systematic review by Snowdon et al. in 199...

  16. [Amblyopia and uveitis in childhood].

    Science.gov (United States)

    Eckstein, A; Robering, A; Rudolph, G; Esser, J

    2007-06-01

    Manifestations of uveitis in the sensitive period of childhood can cause amblyopia. In most of the cases band keratopathy, dense cataracts and cyclitic membranes cause deprivation amblyopia. Asymmetrical damage can result in relative amblyopia. Secondary squint can lead to suppression amblyopia. For these reasons every visit during uveitis treatment should be accompanied by a search for amblyogenic factors and visual acuity measurements. In the case of a side difference in the visual acuity, occlusion therapy should be started. The follow-up should not only contain visual acuity measurements but also cycloplegic refraction. Especially when pupil-dilating drugs are necessary for a longer period, bifocals should be prescribed.

  17. Interventions for strabismic amblyopia.

    Science.gov (United States)

    Taylor, Kate; Elliott, Sue

    2014-07-23

    Amblyopia is reduced visual acuity in one or both eyes in the absence of any demonstrable abnormality of the visual pathway. It is not immediately resolved by the correction of refractive error. Strabismus develops in approximately 5% to 8% of the general population. The aim of treatment for amblyopia is to obtain the best possible level of vision in the amblyopic eye. Different treatment options were examined within the review. By reviewing the available evidence we wanted to establish the most effective treatment for strabismic amblyopia. In particular this review aimed to examine the impact of conventional occlusion therapy for strabismic amblyopia and to analyse the role of partial occlusion and optical penalisation for strabismic amblyopia. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2013, Issue 12), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to January 2014), EMBASE (January 1980 to January 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to January 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 30 January 2014. We included randomised controlled trials (RCTs) for the treatment of strabismic amblyopia including participants of any age. Two authors working independently extracted and entered data into Review Manager 5 and then independently checked the data for errors. We included three RCTs in this review. The studies reported mean logMAR visual acuity achieved. Mean difference in visual acuity was calculated. When comparing conventional part-time occlusion (with

  18. Reverse amblyopia with atropine treatment.

    Science.gov (United States)

    Hainline, Bryan C; Sprunger, Derek C; Plager, David A; Neely, Daniel E; Guess, Matthew G

    2009-01-01

    Occlusion, pharmacologic pernalization and combined therapy have been documented in controlled studies to effectively treat amblyopia with few complications. However, there remain concerns about the effectiveness and complications when, as in this case, there are not standardized treatment protocols. A retrospective chart review of 133 consecutive patients in one community based ophthalmology practice treated for amblyopia was performed. Treatments evaluated were occlusion only, atropine penalization, and combination of occlusion and atropine. Reverse amblyopia was defined as having occured when the visual acuity of the sound eye was 3 LogMar units worse than visual acuity of the amblyopia eye after treatment. Improvement in vision after 6 months and 1 year of amblyopia therapy was similar among all three groups: 0.26 LogMar lines and 0.30 in the atropine group, 0.32 and 0.34 in the occlusion group, and 0.24 and 0.32 in the combined group. Eight (6%) patients demonstrated reverse amblyopia. The mean age of those who developed reverse amblyopia was 3.5 years, 1.5 years younger than the mean age of the study population, 7/8 had strabismic amblyopia, 6/8 were on daily atropine and had a mean refractive error of +4.77 diopters in the amblyopic eye and +5.06 diopters in the sound eye. Reverse amblyopia did not occur with occlusion only therapy. In this community based ophthalmology practice, atropine, patching, and combination therapy appear to be equally effective modalities to treat ambyopia. Highly hyperopic patients under 4 years of age with dense, strabismic amblyopia and on daily atropine appeared to be most at risk for development of reverse amblyopia.

  19. NEI You Tube Videos: Amblyopia

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    Full Text Available ... search for current job openings visit HHS USAJobs Home >> NEI YouTube Videos >> NEI YouTube Videos: Amblyopia Listen NEI YouTube Videos YouTube Videos Home Age-Related Macular Degeneration Amblyopia Animations Blindness Cataract ...

  20. NEI You Tube Videos: Amblyopia

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  1. NEI You Tube Videos: Amblyopia

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    Full Text Available ... Amblyopia Listen NEI YouTube Videos YouTube Videos Home Age-Related Macular Degeneration Amblyopia Animations Blindness Cataract Convergence ... is maintained by the NEI Office of Science Communications, Public Liaison, and Education. Technical questions about this ...

  2. NEI You Tube Videos: Amblyopia

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    Full Text Available ... Amaurosis Low Vision Refractive Errors Retinopathy of Prematurity Science Spanish Videos Webinars NEI YouTube Videos: Amblyopia Embedded video for NEI YouTube Videos: Amblyopia NEI Home Contact Us A-Z Site Map NEI on Social Media Information in Spanish (Información en español) Website, ...

  3. NEI You Tube Videos: Amblyopia

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    Full Text Available ... search for current job openings visit HHS USAJobs Home » NEI YouTube Videos » NEI YouTube Videos: Amblyopia Listen NEI YouTube Videos YouTube Videos Home Age-Related Macular Degeneration Amblyopia Animations Blindness Cataract ...

  4. INSTRUMENTAL TREATMENT OF AMBLYOPIA

    Directory of Open Access Journals (Sweden)

    B. F. Lavrent’ev

    2016-01-01

    Full Text Available To develop a device with broad functionality for treatment amblyopia. methods. Analysis of functionality and technical characteristics of devices for amblyopia treatment and the development of multifunctional apparatus. results. The full-color light transmitters (i.e., LEDs are used in device. It provides the radiation withfull color spectrum. There are several directions of movement of stimuli which are presented on the display: horizontally from left to right or from right to left, vertically bottom-up or top-down, multidirectionally from the center of the display to the periphery or from the periphery of the display to the center, in a circumferential or helical pattern clockwise or counterclockwise. The period of motion of the stimuli varies from 0.25 to 4 seconds in increments of 0.25 seconds. Pulse modulation is 0-20 Hz. Light intensity is 0.1-3.0 cd. The duration of one treatment session is 1-7 min. The characteristic property of the device is multiprogram operating, i.e., several modes are switched consistently in the course of one session. Operating modes are customized for each patient. Computer control provides reprogramming of the device when assigning new tasks. Light-emitting display can be placed in the cone or be made as external component (rectangular-, quadratic-, or round-shaped. Conclusions. Stimulation of visual analyzer is performed with full-color light stimuli which move in various directions or rotate. Adjustment of modulation frequency and movement rate of the stimuli allows to change stimulation mode temporally and spatially. The device can be used in clinical and domestic settings to treat amblyopia, myopia and computer vision syndrome as well as to prevent eye fatigue.

  5. [Dichoptic training for amblyopia].

    Science.gov (United States)

    Bach, M

    2016-04-01

    Dichoptic training is a promising new therapeutic approach to amblyopia, which employs simultaneous and separate stimulation of both eyes (thus dichoptic). The contrast for the good eye is reduced thus aiming at a balance with the amblyopic eye. In contrast to monocular patching, binocular vision is trained by video game tasks that can only be solved binocularly. To date the average gain in visual acuity achieved in currently available studies is only 0.20 ± 0.07 logMAR and is not significantly better than competing treatment options. This article explains the basic approach of dichoptic training, summarizes pertinent studies, names unsolved problems and closes with a personal critical assessment.

  6. NEI You Tube Videos: Amblyopia

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    Full Text Available ... the special health problems and requirements of the blind.” News & Events Events Calendar NEI Press Releases News ... Videos Home Age-Related Macular Degeneration Amblyopia Animations Blindness Cataract Convergence Insufficiency Diabetic Eye Disease Dilated Eye ...

  7. NEI You Tube Videos: Amblyopia

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  8. NEI You Tube Videos: Amblyopia

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    Full Text Available ... Eye Disease Dilated Eye Exam Dry Eye For Kids Glaucoma Healthy Vision Tips Leber Congenital Amaurosis Low Vision Refractive Errors Retinopathy of Prematurity Science Spanish Videos Webinars NEI YouTube Videos: Amblyopia Embedded ...

  9. NEI You Tube Videos: Amblyopia

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    Full Text Available ... questions Clinical Studies Publications Catalog Photos and Images Spanish Language Information Grants and Funding Extramural Research Division ... Low Vision Refractive Errors Retinopathy of Prematurity Science Spanish Videos Webinars NEI YouTube Videos: Amblyopia Embedded video ...

  10. NEI You Tube Videos: Amblyopia

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    Full Text Available ... Amblyopia Animations Blindness Cataract Convergence Insufficiency Diabetic Eye Disease Dilated Eye Exam Dry Eye For Kids Glaucoma Healthy Vision Tips Leber Congenital Amaurosis Low Vision Refractive Errors Retinopathy of Prematurity ...

  11. Update on strabismus and amblyopia.

    Science.gov (United States)

    Campos, E C

    1995-01-01

    This review analyzes progress in the field of infantile strabismus and amblyopia. Only works which are of clinical interest have been reviewed. A brief survey is provided also of subjects matter of international debate, as surgery for accommodative esotropia, the prism adaptation test and the use of sectors for amblyopia treatment. Mention is made of new developments in the field which are not yet applicable to clinical practice. Finally, progress in the approach towards ocular nystagmus is considered as well.

  12. Deprivation amblyopia and congenital hereditary cataract.

    Science.gov (United States)

    Mansouri, Behzad; Stacy, Rebecca C; Kruger, Joshua; Cestari, Dean M

    2013-01-01

    Amblyopia is a neurodevelopmental disorder of vision associated with decreased visual acuity, poor or absent stereopsis, and suppression of information from one eye.(1,2) Amblyopia may be caused by strabismus (strabismic amblyopia), refractive error (anisometropic amblyopia), or deprivation from obstructed vision (deprivation amblyopia). 1 In the developed world, amblyopia is the most common cause of childhood visual impairment, 3 which reduces quality of life 4 and also almost doubles the lifetime risk of legal blindness.(5, 6) Successful treatment of amblyopia greatly depends on early detection and treatment of predisposing disorders such as congenital cataract, which is the most common cause of deprivational amblyopia. Understanding the genetic causes of congenital cataract leads to more effective screening tests, early detection and treatment of infants and children who are at high risk for hereditary congenital cataract.

  13. Stereopsis and amblyopia: A mini-review

    OpenAIRE

    Levi, DM; Knill, DC; Bavelier, D

    2015-01-01

    © 2015 Elsevier Ltd. Amblyopia is a neuro-developmental disorder of the visual cortex that arises from abnormal visual experience early in life. Amblyopia is clinically important because it is a major cause of vision loss in infants and young children. Amblyopia is also of basic interest because it reflects the neural impairment that occurs when normal visual development is disrupted. Amblyopia provides an ideal model for understanding when and how brain plasticity may be harnessed for recove...

  14. The challenges of amblyopia treatment.

    Science.gov (United States)

    Maconachie, Gail D E; Gottlob, Irene

    2015-12-01

    The treatment of amblyopia, particularly anisometropic (difference in refractive correction) and/or strabismic (turn of one eye) amblyopia has long been a challenge for many clinicians. Achieving optimum outcomes, where the amblyopic eye reaches a visual acuity similar to the fellow eye, is often impossible in many patients. Part of this challenge has resulted from a previous lack of scientific evidence for amblyopia treatment that was highlight by a systematic review by Snowdon et al. in 1998. Since this review, a number of publications have revealed new findings in the treatment of amblyopia. This includes the finding that less intensive occlusion treatments can be successful in treating amblyopia. A relationship between adherence to treatment and visual acuity has also been established and has been shown to be influenced by the use of intervention material. In addition, there is growing evidence of that a period of glasses wearing only can significantly improve visual acuity alone without any other modes of treatment. This review article reports findings since the Snowdon's report. Copyright © 2016 Chang Gung University. Published by Elsevier B.V. All rights reserved.

  15. The challenges of amblyopia treatment

    Directory of Open Access Journals (Sweden)

    Gail D.E. Maconachie

    2015-12-01

    Full Text Available The treatment of amblyopia, particularly anisometropic (difference in refractive correction and/or strabismic (turn of one eye amblyopia has long been a challenge for many clinicians. Achieving optimum outcomes, where the amblyopic eye reaches a visual acuity similar to the fellow eye, is often impossible in many patients. Part of this challenge has resulted from a previous lack of scientific evidence for amblyopia treatment that was highlight by a systematic review by Snowdon et al. in 1998. Since this review, a number of publications have revealed new findings in the treatment of amblyopia. This includes the finding that less intensive occlusion treatments can be successful in treating amblyopia. A relationship between adherence to treatment and visual acuity has also been established and has been shown to be influenced by the use of intervention material. In addition, there is growing evidence of that a period of glasses wearing only can significantly improve visual acuity alone without any other modes of treatment. This review article reports findings since the Snowdon's report.

  16. NEI You Tube Videos: Amblyopia

    Medline Plus

    Full Text Available ... Macular Degeneration Amblyopia Animations Blindness Cataract Convergence Insufficiency Diabetic Eye Disease Dilated Eye Exam Dry Eye For Kids Glaucoma Healthy Vision Tips Leber Congenital Amaurosis Low Vision Refractive Errors Retinopathy of Prematurity Science Spanish Videos Webinars NEI YouTube ...

  17. [Amblyopia. Epidemiology, causes and risk factors].

    Science.gov (United States)

    Elflein, H M

    2016-04-01

    Amblyopia is the main cause for mostly monocular, impaired vision in childhood. Treatment and prevention of amblyopia is only effective during childhood. Ophthalmological screening of children does not yet exist in Germany. The prevalence of amblyopia in Germany is 5.6%, which is higher than in reports from studies in Australia; however, the prevalence of amblyopia is not comparable in these studies due to different definitions of amblyopia and the inclusion/exclusion criteria of the study cohorts. At present it is unknown at what age ophthalmological screening should be carried out to prevent amblyopia and the appropriate frequency of screening examinations. Amblyopia is a disorder of the visual cortex that is due to suppression and deprivation of one eye leading to unilateral visual impairment. Approximately 50% of cases of amblyopia are caused by anisometropia, 25% by strabismus and in every sixth person by a combination of both. Other causes, such as unilateral congenital cataracts are relatively rare. A variety of factors, such as ocular pathologies, premature birth, familial disposition and general diseases are associated with an increased risk for amblyopia.

  18. Refractory reverse amblyopia with atropine penalization

    Directory of Open Access Journals (Sweden)

    Preeti Ajit Patil

    2010-01-01

    Full Text Available Pharmacological penalization with atropine has been shown to be equally effective as conventional occlusion therapy in the treatment of amblyopia in children. Reverse amblyopia of the sound eye with atropine penalization has been reported before, but is more common in cases where the effect is augmented with optical penalization and is mostly reversible. We report a case of reverse amblyopia with atropine penalization, in a 4-year-old girl, which was refractory to treatment. This report highlights the need for strict monitoring of the vision in the sound eye and regular follow-up in children undergoing amblyopia treatment.

  19. Effects of strabismic amblyopia and strabismus without amblyopia on visuomotor behavior, I: saccadic eye movements.

    Science.gov (United States)

    Niechwiej-Szwedo, Ewa; Chandrakumar, Manokaraananthan; Goltz, Herbert C; Wong, Agnes M F

    2012-11-01

    It has previously been shown that anisometropic amblyopia affects the programming and execution of saccades. The aim of the current study was to investigate the impact of strabismic amblyopia on saccade performance. Fourteen adults with strabismic amblyopia, 13 adults with strabismus without amblyopia, and 14 visually normal adults performed saccades and reach-to-touch movements to targets presented at ± 5° and ± 10° eccentricity during binocular and monocular viewing. Latency, amplitude, and peak velocity of primary and secondary saccades were measured. In contrast to visually normal participants who had shorter primary saccade latency during binocular viewing, no binocular advantage was found in patients with strabismus with or without amblyopia. Patients with amblyopia had longer saccade latency during amblyopic eye viewing (P amblyopia and no stereopsis (n = 4) exhibited longer latency (which was more pronounced for more central targets; P amblyopia (n = 5) and no stereopsis had normal latency and reduced precision during amblyopic eye viewing (P amblyopia were found. These findings were in contrast to those in anisometropic amblyopia in which the altered saccade performance was independent of the extent of visual acuity or stereoscopic deficits. These results were most likely due to different long-term sensory suppression mechanisms in strabismic versus anisometropic amblyopia.

  20. Alexia and quadrant-amblyopia

    DEFF Research Database (Denmark)

    Habekost, Thomas; Starrfelt, Randi

    2006-01-01

    Reading difficulties caused by hemianopia are well described. We present a study of alexia in a patient (NT) with a milder visual field deficit. The patient had suffered a cerebral haemorrhage causing damage to the left occipital cortex and underlying white matter. NT's text reading was slow and ...... to normal eye movements. Still, subtle reading difficulties and oculo-motor abnormalities remained. Overall, the study shows how amblyopia in one quadrant can lead to a characteristic form of alexia....

  1. Efficacy of comprehensive treatment on amblyopia in 255 children

    Directory of Open Access Journals (Sweden)

    Xing-Hui Xu

    2015-11-01

    Full Text Available AIM: To study the efficacy of comprehensive treatment on amblyopia in children.METHODS: A total of 255 cases 386 eyes diagnosed as amblyopia were given refractive errors correction, multi-media training system, coveting treatment, CAM treatment and red light stimulation. The relationship of therapeutic effect with age, type and degree of amblyopia was analyzed. RESULTS: The total effective rate was 94%, and total cure rate was 71%. Mild amblyopia, 3~6 years group, ametropia amblyopia had the highest cure rate. CONCLUSION: Efficacy of comprehensive treatment on amblyopia is certain, which is relation with age, type and degree of amblyopia.

  2. Amblyopia in Rural Nigerian School Children

    African Journals Online (AJOL)

    Conclusion: The prevalence of amblyopia among these rural school children was ... Amblyopia is defined as suboptimal vision in one eye despite best spectacle ..... Data obtained were entered into the computer and analyzed using the Statistical ..... the National Postgraduate Medical College in Ophthalmology;. 1999. 21.

  3. Interocular suppression in children with deprivation amblyopia.

    Science.gov (United States)

    Hamm, Lisa; Chen, Zidong; Li, Jinrong; Black, Joanna; Dai, Shuan; Yuan, Junpeng; Yu, Minbin; Thompson, Benjamin

    2017-04-01

    In patients with anisometropic or strabismic amblyopia, interocular suppression can be minimized by presenting high contrast stimulus elements to the amblyopic eye and lower contrast elements to the fellow eye. This suggests a structurally intact binocular visual system that is functionally suppressed. We investigated whether suppression can also be overcome by contrast balancing in children with deprivation amblyopia due to childhood cataracts. To quantify interocular contrast balance, contrast interference thresholds were measured using an established dichoptic global motion technique for 21 children with deprivation amblyopia, 14 with anisometropic or mixed strabismic/anisometropic amblyopia and 10 visually normal children (mean age mean=9.9years, range 5-16years). We found that interocular suppression could be overcome by contrast balancing in most children with deprivation amblyopia, at least intermittently, and all children with anisometropic or mixed anisometropic/strabismic amblyopia. However, children with deprivation amblyopia due to early unilateral or bilateral cataracts could tolerate only very low contrast levels to the stronger eye indicating strong suppression. Our results suggest that treatment options reliant on contrast balanced dichoptic presentation could be attempted in a subset of children with deprivation amblyopia. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Stereopsis and amblyopia: A mini-review.

    Science.gov (United States)

    Levi, Dennis M; Knill, David C; Bavelier, Daphne

    2015-09-01

    Amblyopia is a neuro-developmental disorder of the visual cortex that arises from abnormal visual experience early in life. Amblyopia is clinically important because it is a major cause of vision loss in infants and young children. Amblyopia is also of basic interest because it reflects the neural impairment that occurs when normal visual development is disrupted. Amblyopia provides an ideal model for understanding when and how brain plasticity may be harnessed for recovery of function. Over the past two decades there has been a rekindling of interest in developing more effective methods for treating amblyopia, and for extending the treatment beyond the critical period, as exemplified by new clinical trials and new basic research studies. The focus of this review is on stereopsis and its potential for recovery. Impaired stereoscopic depth perception is the most common deficit associated with amblyopia under ordinary (binocular) viewing conditions (Webber & Wood, 2005). Our review of the extant literature suggests that this impairment may have a substantial impact on visuomotor tasks, difficulties in playing sports in children and locomoting safely in older adults. Furthermore, impaired stereopsis may also limit career options for amblyopes. Finally, stereopsis is more impacted in strabismic than in anisometropic amblyopia. Our review of the various approaches to treating amblyopia (patching, perceptual learning, videogames) suggests that there are several promising new approaches to recovering stereopsis in both anisometropic and strabismic amblyopes. However, recovery of stereoacuity may require more active treatment in strabismic than in anisometropic amblyopia. Individuals with strabismic amblyopia have a very low probability of improvement with monocular training; however they fare better with dichoptic training than with monocular training, and even better with direct stereo training. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Stereopsis and amblyopia: A mini-review

    Science.gov (United States)

    Levi, Dennis M.; Knill, David C.; Bavelier, Daphne

    2015-01-01

    Amblyopia is a neuro-developmental disorder of the visual cortex that arises from abnormal visual experience early in life. Amblyopia is clinically important because it is a major cause of vision loss in infants and young children. Amblyopia is also of basic interest because it reflects the neural impairment that occurs when normal visual development is disrupted. Amblyopia provides an ideal model for understanding when and how brain plasticity may be harnessed for recovery of function. Over the past two decades there has been a rekindling of interest in developing more effective methods for treating amblyopia, and for extending the treatment beyond the critical period, as exemplified by new clinical trials and new basic research studies. The focus of this review is on stereopsis and its potential for recovery. Impaired stereoscopic depth perception is the most common deficit associated with amblyopia under ordinary (binocular) viewing conditions (Webber & Wood, 2005). Our review of the extant literature suggests that this impairment may have a substantial impact on visuomotor tasks, difficulties in playing sports in children and locomoting safely in older adults. Furthermore, impaired stereopsis may also limit career options for amblyopes. Finally, stereopsis is more impacted in strabismic than in anisometropic amblyopia. Our review of the various approaches to treating amblyopia (patching, perceptual learning, videogames) suggests that there are several promising new approaches to recovering stereopsis in both anisometropic and strabismic amblyopes. However, recovery of stereoacuity may require more active treatment in strabismic than in anisometropic amblyopia. Individuals with strabismic amblyopia have a very low probability of improvement with monocular training; however they fare better with dichoptic training than with monocular training, and even better with direct stereo training. PMID:25637854

  6. Recurrence of amblyopia after occlusion therapy.

    Science.gov (United States)

    Bhola, Rahul; Keech, Ronald V; Kutschke, Pamela; Pfeifer, Wanda; Scott, William E

    2006-11-01

    To determine the stability of visual acuity (VA) after a standardized occlusion regimen in children with strabismic and/or anisometropic amblyopia. Retrospective, population-based, consecutive observational case series. Four hundred forty-nine patients younger than 10 years who underwent an occlusion trial for amblyopia and were observed until there was a recurrence of amblyopia or for a maximum of 1 year after decrease or cessation of occlusion therapy. We performed a retrospective chart review of all patients treated by occlusion therapy for strabismic and/or anisometropic amblyopia at our institution over a 34-year period. Of the 1621 patients identified in our database, 449 met the eligibility criteria and were included in this study. Patients having at least a 2 logarithm of the minimum angle of resolution (logMAR)-level improvement in VA by optotypes or a change from unmaintained to maintained fixation preference during the course of occlusion therapy were included. A recurrence of amblyopia was defined as > or =2 logMAR levels of VA reduction or reversal of fixation preference within 1 year after a decrease or cessation of occlusion therapy. Recurrence of amblyopia after a decrease or cessation of occlusion therapy and its relationship with patient age and VA of the amblyopic eye at the time of decrease or cessation of occlusion therapy. Of 653 occlusion trials, 179 (27%) resulted in recurrence of amblyopia. The recurrence was found to be inversely correlated with patient age. There was no statistically significant association between the recurrence of amblyopia and VA of the amblyopic eye at the end of maximal occlusion therapy. There is a clinically important risk of amblyopia recurrence when occlusion therapy is decreased before the age of 10 years. The risk of recurrence is inversely correlated with age (P<0.0001).

  7. Image segregation in strabismic amblyopia.

    Science.gov (United States)

    Levi, Dennis M

    2007-06-01

    Humans with naturally occurring amblyopia show deficits thought to involve mechanisms downstream of V1. These include excessive crowding, abnormal global image processing, spatial sampling and symmetry detection and undercounting. Several recent studies suggest that humans with naturally occurring amblyopia show deficits in global image segregation. The current experiments were designed to study figure-ground segregation in amblyopic observers with documented deficits in crowding, symmetry detection, spatial sampling and counting, using similar stimuli. Observers had to discriminate the orientation of a figure (an "E"-like pattern made up of 17 horizontal Gabor patches), embedded in a 7x7 array of Gabor patches. When the 32 "background" patches are vertical, the "E" pops-out, due to segregation by orientation and performance is perfect; however, if the background patches are all, or mostly horizontal, the "E" is camouflaged, and performance is random. Using a method of constant stimuli, we varied the number of "background" patches that were vertical and measured the probability of correct discrimination of the global orientation of the E (up/down/left/right). Surprisingly, amblyopes who showed strong crowding and deficits in symmetry detection and counting, perform normally or very nearly so in this segregation task. I therefore conclude that these deficits are not a consequence of abnormal segregation of figure from background.

  8. The Relationship between Anisometropia and Amblyopia

    Science.gov (United States)

    Barrett, Brendan T.; Bradley, Arthur; Candy, T. Rowan

    2013-01-01

    This review aims to disentangle cause and effect in the relationship between anisometropia and amblyopia. Specifically, we examine the literature for evidence to support different possible developmental sequences that could ultimately lead to the presentation of both conditions. The prevalence of anisometropia is around 20% for an inter-ocular difference of 0.5D or greater in spherical equivalent refraction, falling to 2-3%, for an inter-ocular difference of 3D or above. Anisometropia prevalence is relatively high in the weeks following birth, in the teenage years coinciding with the onset of myopia and, most notably, in older adults starting after the onset of presbyopia. It has about one-third the prevalence of bilateral refractive errors of the same magnitude. Importantly, the prevalence of anisometropia is higher in highly ametropic groups, suggesting that emmetropization failures underlying ametropia and anisometropia may be similar. Amblyopia is present in 1-3% of humans and around one-half to two-thirds of amblyopes have anisometropia either alone or in combination with strabismus. The frequent co-existence of amblyopia and anisometropia at a child’s first clinical examination promotes the belief that the anisometropia has caused the amblyopia, as has been demonstrated in animal models of the condition. In reviewing the human and monkey literature however it is clear that there are additional paths beyond this classic hypothesis to the co-occurrence of anisometropia and amblyopia. For example, after amblyopia secondary to either deprivation or strabismus has emerged, anisometropia often follows. In cases of anisometropia with no apparent deprivation or strabismus, questions remain about the failure of the emmetropization mechanism that routinely eliminates infantile anisometropia. Also, the chronology of amblyopia development is poorly documented in cases of ‘pure’ anisometropic amblyopia. Although indirect, the therapeutic impact of refractive

  9. Alterations in audiovisual simultaneity perception in amblyopia

    OpenAIRE

    Richards, Michael D.; Goltz, Herbert C.; Wong, Agnes M. F.

    2017-01-01

    Amblyopia is a developmental visual impairment that is increasingly recognized to affect higher-level perceptual and multisensory processes. To further investigate the audiovisual (AV) perceptual impairments associated with this condition, we characterized the temporal interval in which asynchronous auditory and visual stimuli are perceived as simultaneous 50% of the time (i.e., the AV simultaneity window). Adults with unilateral amblyopia (n = 17) and visually normal controls (n = 17) judged...

  10. Pharmacological enhancement of treatment for amblyopia

    OpenAIRE

    Rashad, Mohammad A

    2012-01-01

    Mohammad A RashadOphthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, EgyptBackground: The purpose of this study was to compare a weight-adjusted dose of carbidopa-levodopa as treatment adjunctive to occlusion therapy with occlusion therapy alone in children and adults with different types of amblyopia.Methods: This prospective study included 63 patients with amblyopia classified into two groups, ie, an occlusion group which included 35 patients who received occlusion t...

  11. [Binocular functions in amblyopia and strabismus].

    Science.gov (United States)

    Awaya, S; Sato, M; Tsuzuki, K; Takara, T; Hiraiwa, S; Ota, K; Arai, M; Yoshida, M; Miyake, Y; Terasaki, H; Horiguchi, M; Hirano, K; Hirose, H; Uno, Y; Suzuki, Y; Iwata, M; Takai, Y; Maeda, M; Hisano, S; Kawakita, T; Omura, T; Ota, Y; Kondo, N; Takashi, A; Kawakami, O

    1997-12-01

    Regarding the changing trends in the concept, definition, etiological classification, and criteria for diagnosis of amblyopia, we reviewed a total of 4,693 cases of amblyopia seen during the past 37 years. The amblyopia was divided into four types: strabismic, anisometropic, ametropic, and form vision deprivative. There was a definite trend for the incidence to decrease and for the diagnosis to be made during earlier age in recent years. Although favorable recovery of visual acuity is obtained after treatment of amblyopia and strabismus, there are difficulties in obtaining good binocular functions in early-onset amblyopia and strabismus. This feature was evaluated in regard to motion perception asymmetry (MPA) and binocular depth from motion (DFM). Many cases of early-onset amblyopia and strabismus showed no disparity stereopsis, or position stereopsis, in spite of the presence of DFM. The MPA appeared to be closely related to early-onset esotropia regardless of age, while it disappeared and motion perception became symmetric 4 to 5 months after birth in normal infants. The DFM seemed to play an important role in maintaining good motor alignment for several years after surgery. I developed a checkerboard pattern stimulator in 1978. This method proved to be useful in developing binocular functions and motor alignment by applying simultaneous bifoveolar stimulation and anti-suppression. Extensive exposure to the stimulation was essential for therapeutic success.

  12. The Measurement and Treatment of Suppression in Amblyopia

    OpenAIRE

    Black, Joanna M.; Hess, Robert F.; Cooperstock, Jeremy R.; To, Long; Thompson, Benjamin

    2012-01-01

    Amblyopia, a developmental disorder of the visual cortex, is one of the leading causes of visual dysfunction in the working age population. Current estimates put the prevalence of amblyopia at approximately 1-3%1-3, the majority of cases being monocular2. Amblyopia is most frequently caused by ocular misalignment (strabismus), blur induced by unequal refractive error (anisometropia), and in some cases by form deprivation. Although amblyopia is initially caused by abnormal visual input in infa...

  13. Latent binocular function in amblyopia.

    Science.gov (United States)

    Chadnova, Eva; Reynaud, Alexandre; Clavagnier, Simon; Hess, Robert F

    2017-11-01

    Recently, psychophysical studies have shown that humans with amblyopia do have binocular function that is not normally revealed due to dominant suppressive interactions under normal viewing conditions. Here we use magnetoencephalography (MEG) combined with dichoptic visual stimulation to investigate the underlying binocular function in humans with amblyopia for stimuli that, because of their temporal properties, would be expected to bypass suppressive effects and to reveal any underlying binocular function. We recorded contrast response functions in visual cortical area V1 of amblyopes and normal observers using a steady state visually evoked responses (SSVER) protocol. We used stimuli that were frequency-tagged at 4Hz and 6Hz that allowed identification of the responses from each eye and were of a sufficiently high temporal frequency (>3Hz) to bypass suppression. To characterize binocular function, we compared dichoptic masking between the two eyes in normal and amblyopic participants as well as interocular phase differences in the two groups. We observed that the primary visual cortex responds less to the stimulation of the amblyopic eye compared to the fellow eye. The pattern of interaction in the amblyopic visual system however was not significantly different between the amblyopic and fellow eyes. However, the amblyopic suppressive interactions were lower than those observed in the binocular system of our normal observers. Furthermore, we identified an interocular processing delay of approximately 20ms in our amblyopic group. To conclude, when suppression is greatly reduced, such as the case with our stimulation above 3Hz, the amblyopic visual system exhibits a lack of binocular interactions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Rebalancing binocular vision in amblyopia.

    Science.gov (United States)

    Ding, Jian; Levi, Dennis M

    2014-03-01

    Humans with amblyopia have an asymmetry in binocular vision: neural signals from the amblyopic eye are suppressed in the cortex by the fellow eye. The purpose of this study was to develop new models and methods for rebalancing this asymmetric binocular vision by manipulating the contrast and luminance in the two eyes. We measured the perceived phase of a cyclopean sinewave by asking normal and amblyopic observers to indicate the apparent location (phase) of the dark trough in the horizontal cyclopean sine wave relative to a black horizontal reference line, and used the same stimuli to measure perceived contrast by matching the binocular combined contrast to a standard contrast presented to one eye. We varied both the relative contrast and luminance of the two eyes' inputs, in order to rebalance the asymmetric binocular vision. Amblyopic binocular vision becomes more and more asymmetric the higher the stimulus contrast or spatial frequency. Reanalysing our previous data, we found that, at a given spatial frequency, the binocular asymmetry could be described by a log-linear formula with two parameters, one for the maximum asymmetry and one for the rate at which the binocular system becomes asymmetric as the contrast increases. Our new data demonstrates that reducing the dominant eye's mean luminance reduces its suppression of the non-dominant eye, and therefore rebalances the asymmetric binocular vision. While the binocular asymmetry in amblyopic vision can be rebalanced by manipulating the relative contrast or luminance of the two eyes at a given spatial frequency and contrast, it is very difficult or even impossible to rebalance the asymmetry for all visual conditions. Nonetheless, wearing a neutral density filter before the dominant eye (or increasing the mean luminance in the non-dominant eye) may be more beneficial than the traditional method of patching the dominant eye for treating amblyopia. © 2014 The Authors Ophthalmic & Physiological Optics © 2014 The

  15. Design of the Monitored Occlusion Treatment of Amblyopia Study (MOTAS)

    OpenAIRE

    Stewart, C E; Fielder, A R; Stephens, D A; Moseley, M J

    2002-01-01

    Background/aims: The effectiveness of occlusion therapy for the treatment of amblyopia is a research priority. The authors describe the design of the Monitored Occlusion Treatment for Amblyopia Study (MOTAS) and its methodology. MOTAS will determine the dose-response relation for occlusion therapy as a function of age and category of amblyopia.

  16. The role of suppression in amblyopia.

    Science.gov (United States)

    Li, Jingrong; Thompson, Benjamin; Lam, Carly S Y; Deng, Daming; Chan, Lily Y L; Maehara, Goro; Woo, George C; Yu, Minbin; Hess, Robert F

    2011-06-13

    This study had three main goals: to assess the degree of suppression in patients with strabismic, anisometropic, and mixed amblyopia; to establish the relationship between suppression and the degree of amblyopia; and to compare the degree of suppression across the clinical subgroups within the sample. Using both standard measures of suppression (Bagolini lenses and neutral density [ND] filters, Worth 4-Dot test) and a new approach involving the measurement of dichoptic motion thresholds under conditions of variable interocular contrast, the degree of suppression in 43 amblyopic patients with strabismus, anisometropia, or a combination of both was quantified. There was good agreement between the quantitative measures of suppression made with the new dichoptic motion threshold technique and measurements made with standard clinical techniques (Bagolini lenses and ND filters, Worth 4-Dot test). The degree of suppression was found to correlate directly with the degree of amblyopia within our clinical sample, whereby stronger suppression was associated with a greater difference in interocular acuity and poorer stereoacuity. Suppression was not related to the type or angle of strabismus when this was present or the previous treatment history. These results suggest that suppression may have a primary role in the amblyopia syndrome and therefore have implications for the treatment of amblyopia.

  17. Alterations in audiovisual simultaneity perception in amblyopia.

    Science.gov (United States)

    Richards, Michael D; Goltz, Herbert C; Wong, Agnes M F

    2017-01-01

    Amblyopia is a developmental visual impairment that is increasingly recognized to affect higher-level perceptual and multisensory processes. To further investigate the audiovisual (AV) perceptual impairments associated with this condition, we characterized the temporal interval in which asynchronous auditory and visual stimuli are perceived as simultaneous 50% of the time (i.e., the AV simultaneity window). Adults with unilateral amblyopia (n = 17) and visually normal controls (n = 17) judged the simultaneity of a flash and a click presented with both eyes viewing. The signal onset asynchrony (SOA) varied from 0 ms to 450 ms for auditory-lead and visual-lead conditions. A subset of participants with amblyopia (n = 6) was tested monocularly. Compared to the control group, the auditory-lead side of the AV simultaneity window was widened by 48 ms (36%; p = 0.002), whereas that of the visual-lead side was widened by 86 ms (37%; p = 0.02). The overall mean window width was 500 ms, compared to 366 ms among controls (37% wider; p = 0.002). Among participants with amblyopia, the simultaneity window parameters were unchanged by viewing condition, but subgroup analysis revealed differential effects on the parameters by amblyopia severity, etiology, and foveal suppression status. Possible mechanisms to explain these findings include visual temporal uncertainty, interocular perceptual latency asymmetry, and disruption of normal developmental tuning of sensitivity to audiovisual asynchrony.

  18. Detection, prevention, and rehabilitation of amblyopia.

    Science.gov (United States)

    Spiritus, M

    1997-10-01

    The necessity of visual preschool screening for reducing the prevalence of amblyopia is widely accepted. The beneficial results of large-scale screening programs conducted in Scandinavia are reported. Screening monocular visual acuity at 3.5 to 4 years of age appears to be an excellent basis for detecting and treating amblyopia and an acceptable compromise between the pitfalls encountered in screening younger children and the cost-to-benefit ratio. In this respect, several preschoolers' visual acuity charts have been evaluated. New recently developed small-target random stereotests and binocular suppression tests have also been developed with the aim of correcting the many false negatives (anisometropic amblyopia or bilateral high ametropia) induced by the usual stereotests. Longitudinal studies demonstrate that correction of high refractive errors decreases the risk of amblyopia and does not impede emmetropization. The validity of various photoscreening and videoscreening procedures for detecting refractive errors in infants prior to the onset of strabismus or amblyopia, as well as alternatives to conventional occlusion therapy, is discussed.

  19. Unifying concepts in mechanism of amblyopia.

    Science.gov (United States)

    Tong, L M

    1997-02-01

    Most of the evidence of formation of amblyopia is derived traditionally from electrophysiological studies. Recently, there have been many discoveries from genetics, histopathology, biochemistry, immunology and interventional studies. On the basis of evidence gathered in the last five years, the various types of amblyopia (strabismic and non-strabismic amblyopia) can be seen not only as disturbance of the development of the visual system at different points but as basically different pathologic processes. It is postulated here that strabismic amblyopia is initiated as a maladaptive differentiation in the ocular dominance columns, whereas the non-strabismic amblyopia may be initiated from the ganglion cell population of the amblyopic eye. The total clinical picture is confusing because of secondary changes in other parts of the central nervous system. The manifested features can be due to a slower, more enduring type of change (pooling, loss and re-wiring of the neurones) as well as a more transient, adaptive type of response (such as suppression of diplopia). Neurotransmitter replacement has a potential therapeutic application.

  20. Alterations in audiovisual simultaneity perception in amblyopia.

    Directory of Open Access Journals (Sweden)

    Michael D Richards

    Full Text Available Amblyopia is a developmental visual impairment that is increasingly recognized to affect higher-level perceptual and multisensory processes. To further investigate the audiovisual (AV perceptual impairments associated with this condition, we characterized the temporal interval in which asynchronous auditory and visual stimuli are perceived as simultaneous 50% of the time (i.e., the AV simultaneity window. Adults with unilateral amblyopia (n = 17 and visually normal controls (n = 17 judged the simultaneity of a flash and a click presented with both eyes viewing. The signal onset asynchrony (SOA varied from 0 ms to 450 ms for auditory-lead and visual-lead conditions. A subset of participants with amblyopia (n = 6 was tested monocularly. Compared to the control group, the auditory-lead side of the AV simultaneity window was widened by 48 ms (36%; p = 0.002, whereas that of the visual-lead side was widened by 86 ms (37%; p = 0.02. The overall mean window width was 500 ms, compared to 366 ms among controls (37% wider; p = 0.002. Among participants with amblyopia, the simultaneity window parameters were unchanged by viewing condition, but subgroup analysis revealed differential effects on the parameters by amblyopia severity, etiology, and foveal suppression status. Possible mechanisms to explain these findings include visual temporal uncertainty, interocular perceptual latency asymmetry, and disruption of normal developmental tuning of sensitivity to audiovisual asynchrony.

  1. Childhood amblyopia: current management and new trends.

    Science.gov (United States)

    Tailor, Vijay; Bossi, Manuela; Greenwood, John A; Dahlmann-Noor, Annegret

    2016-09-01

    With a prevalence of 2-5%, amblyopia is the most common vision deficit in children in the UK and the second most common cause of functional low vision in children in low-income countries. Pubmed, Cochrane library and clinical trial registries (clinicaltrials.gov, ISRCTN, UKCRN portfolio database). Screening and treatment at the age of 4-5 years are cost efficient and clinically effective. Optical treatment (glasses) alone can improve visual acuity, with residual amblyopia treated by part-time occlusion or pharmacological blurring of the better-seeing eye. Treatment after the end of the conventional 'critical period' can improve vision, but in strabismic amblyopia carries a low risk of double vision. It is not clear whether earlier vision screening would be cost efficient and associated with better outcomes. Optimization of treatment by individualized patching regimes or early start of occlusion, and novel binocular treatment approaches may enhance adherence to treatment, provide better outcomes and shorten treatment duration. Binocular treatments for amblyopia. Impact of amblyopia on education and quality of life; optimal screening timing and tests; optimal administration of conventional treatments; development of child-friendly, effective and safe binocular treatments. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Amblyopia

    Science.gov (United States)

    ... the amblyopic eye. On the other hand, the child may be more cooperative or more open to bargaining if patching is performed during certain, favorite activities (such as watching a preferred television program or video). Some eye doctors believe that ...

  3. Fixation Characteristics of Severe Amblyopia Subtypes: Which One is Worse?

    Science.gov (United States)

    Koylu, Mehmet Talay; Ozge, Gokhan; Kucukevcilioglu, Murat; Mutlu, Fatih Mehmet; Ceylan, Osman Melih; Akıncıoglu, Dorukcan; Ayyıldız, Onder

    2017-01-01

    To determine differences in macular sensitivity and fixation patterns in different subtypes of severe amblyopia. This case-control study enrolled a total of 73 male adults, including 18 with pure strabismic severe amblyopia, 19 with pure anisometropic severe amblyopia, 18 with mixed (strabismic plus anizometropic) severe amblyopia, and 18 healthy controls. MP-1 microperimetry was used to evaluate macular sensitivity, location of fixation, and stability of fixation. Mean macular sensitivity, stability of fixation, and location of fixation were significantly worse in all amblyopia subtypes when compared with healthy controls. Intergroup comparisons between amblyopia subtypes revealed that mean macular sensitivity, stability of fixation, and location of fixation were significantly worse in pure strabismic and mixed amblyopic eyes when compared with pure anisometropic amblyopic eyes. Strabismus seems to be a worse prognostic factor in severe amblyopia than anisometropia in terms of fixation characteristics and retinal sensitivity.

  4. The attentional blink in amblyopia.

    Science.gov (United States)

    Popple, Ariella V; Levi, Dennis M

    2008-10-31

    Amblyopia is a disorder of visual acuity in one eye, thought to arise from suppression by the other eye during development of the visual cortex. In the attentional blink, the second of two targets (T2) in a Rapid Serial Visual Presentation (RSVP) stream is difficult to detect and identify when it appears shortly but not immediately after the first target (T1). We investigated the attentional blink seen through amblyopic eyes and found that it was less finely tuned in time than when the 12 amblyopic observers viewed the stimuli with their preferred eyes. T2 performance was slightly better through amblyopic eyes two frames after T1 but worse one frame after T1. Previously (A. V. Popple & D. M. Levi, 2007), we showed that when the targets were red letters in a stream of gray letters (or vice versa), normal observers frequently confused T2 with the letters before and after it (neighbor errors). Observers viewing through their amblyopic eyes made significantly fewer neighbor errors and more T2 responses consisting of letters that were never presented. In normal observers, T1 (on the rare occasions when it was reported incorrectly) was often confused with the letter immediately after it. Viewing through their amblyopic eyes, observers with amblyopia made more responses to the letter immediately before T1. These results suggest that childhood suppression of the input from amblyopic eyes disrupts attentive processing. We hypothesize reduced connectivity between monocularly tuned lower visual areas, subcortical structures that drive foveal attention, and more frontal regions of the brain responsible for letter recognition and working memory. Perhaps when viewing through their amblyopic eyes, the observers were still processing the letter identity of a prior distractor when the color flash associated with the target was detected. After T1, unfocused temporal attention may have bound together erroneously the features of succeeding letters, resulting in the appearance of

  5. Amblyopia treatment strategies and new drug therapies.

    Science.gov (United States)

    Pescosolido, Nicola; Stefanucci, Alessio; Buomprisco, Giuseppe; Fazio, Stefano

    2014-01-01

    Amblyopia is a unilateral or bilateral reduction of visual acuity secondary to abnormal visual experience during early childhood. It is one of the most common causes of vision loss and monocular blindness and is commonly associated with strabismus, anisometropia, and visual deprivation (in particular congenital cataract and ptosis). It is clinically defined as a two-line difference of best-corrected visual acuity between the eyes. The purpose of this study was to understand the neural mechanisms of amblyopia and summarize the current therapeutic strategies. In particular, the authors focused on the concept of brain plasticity and its implication for new treatment strategies for children and adults with amblyopia. Copyright 2014, SLACK Incorporated.

  6. Pharmacological enhancement of treatment for amblyopia

    Directory of Open Access Journals (Sweden)

    Rashad MA

    2012-03-01

    Full Text Available Mohammad A RashadOphthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, EgyptBackground: The purpose of this study was to compare a weight-adjusted dose of carbidopa-levodopa as treatment adjunctive to occlusion therapy with occlusion therapy alone in children and adults with different types of amblyopia.Methods: This prospective study included 63 patients with amblyopia classified into two groups, ie, an occlusion group which included 35 patients who received occlusion therapy only and a pharmacological enhancement group which included 28 patients who received oral carbidopa-levodopa together with occlusion therapy for 6 weeks.Results: The mean logarithm of the minimal angle of resolution (logMAR of the eyes with amblyopia was not significantly different in the occlusion group (0.52, 0.52, and 0.51 than in the pharmacological enhancement group (0.58, 0.49, and 0.56 at three follow-up visits (at months 1, 3, and 12, respectively. There was a highly significant improvement in mean logMAR of amblyopic eyes compared with baseline in both occlusion groups (from 0.68 to 0.52, from 0.68 to 0.52, and from 0.68 to 0.51 and in the pharmacological enhancement group (from 0.81 to 0.58, from 0.81 to 0.49, and from 0.81 to 0.56 at the month 1, 3, and 12 visits (P = 0.01, P = 0.01, and P = 0.001, respectively. The improvement of mean logMAR in the subgroup of patients older than 12 years was greater in the pharmacological enhancement group (42.5% than in the occlusion group (30%. The improvement of mean logMAR in the subgroup of patients with severe amblyopia was greater in the pharmacological enhancement group (34.3% than in the occlusion group (22%.Conclusion: Significant improvement was reported in both groups at all follow-up visits over 1 year. Regardless of the etiology of amblyopia, levodopa-carbidopa may be added to part-time occlusion in older patients as a means of increasing the plasticity of the visual cortex. Levodopa may add

  7. Could visual neglect induce amblyopia?

    Science.gov (United States)

    Bier, J C; Vokaer, M; Fery, P; Garbusinski, J; Van Campenhoudt, G; Blecic, S A; Bartholomé, E J

    2004-12-01

    Oculomotor nerve disease is a common cause of diplopia. When strabismus is present, absence of diplopia has to induce the research of either uncovering of visual fields or monocular suppression, amblyopia or blindness. We describe the case of a 41-year-old woman presenting with right oculomotor paresis and left object-centred visual neglect due to a right fronto-parietal haemorrhage expanding to the right peri-mesencephalic cisterna caused by the rupture of a right middle cerebral artery aneurysm. She never complained of diplopia despite binocular vision and progressive recovery of strabismus, excluding uncovering of visual fields. Since all other causes were excluded in this case, we hypothesise that the absence of diplopia was due to the object-centred visual neglect. Partial internal right oculomotor paresis causes an ocular deviation in abduction; the image being perceived deviated contralaterally to the left. Thus, in our case, the neglect of the left image is equivalent to a right monocular functional blindness. However, bell cancellation test clearly worsened when assessed in left monocular vision confirming that eye patching can worsen attentional visual neglect. In conclusion, our case argues for the possibility of a functional monocular blindness induced by visual neglect. We think that in presence of strabismus, absence of diplopia should induce the search for hemispatial visual neglect when supratentorial lesions are suspected.

  8. A game platform for treatment of amblyopia.

    Science.gov (United States)

    To, Long; Thompson, Benjamin; Blum, Jeffrey R; Maehara, Goro; Hess, Robert F; Cooperstock, Jeremy R

    2011-06-01

    We have developed a prototype device for take-home use that can be used in the treatment of amblyopia. The therapeutic scenario we envision involves patients first visiting a clinic, where their vision parameters are assessed and suitable parameters are determined for therapy. Patients then proceed with the actual therapeutic treatment on their own, using our device, which consists of an Apple iPod Touch running a specially modified game application. Our rationale for choosing to develop the prototype around a game stems from multiple requirements that such an application satisfies. First, system operation must be sufficiently straightforward that ease-of-use is not an obstacle. Second, the application itself should be compelling and motivate use more so than a traditional therapeutic task if it is to be used regularly outside of the clinic. This is particularly relevant for children, as compliance is a major issue for current treatments of childhood amblyopia. However, despite the traditional opinion that treatment of amblyopia is only effective in children, our initial results add to the growing body of evidence that improvements in visual function can be achieved in adults with amblyopia.

  9. Comparison of anisometropes with and without amblyopia

    Directory of Open Access Journals (Sweden)

    Huban Atilla

    2011-01-01

    Full Text Available Background: To compare binocular functions in amblyopic and non-amblyopic anisometropes and to investigate the possible associated factors for amblyopia development such as type of refractive error and initial age of refractive error correction. Materials and Methods: Prospectively anisometropic subjects with (n=42 and without amblyopia (n=33 were included in the study. Full ophthalmological examination including binocularity and motility was performed. Results: There was no statistically significant difference between the ages at the time of initial refractive error correction ( p0 =0.946. All of the anisometropes (100% had fusion with Worth 4-dot test and Bagolini glasses. However 81% of amblyopic subjects had fusion with Worth 4 dot test and 88.1% had normal response with Bagolini glasses. Median stereopsis was 60 sec of arc in anisometropic subjects and 400 sec of arc in amblyopes. Conclusion: Our data support that, binocular functions are well developed in anisometropes without amblyopia and initial age at correction of refractive error has no primary effect on development of amblyopia.

  10. Neuronal basis of amblyopia: A review

    Directory of Open Access Journals (Sweden)

    Grigg John

    1996-01-01

    Full Text Available Amblyopia is an acquired defect in vision due to an abnormal visual experience during a sensitive period of visual development. The neuronal basis of amblyopia is the study of the effects of "abnormal" environmental influences on the genetically programmed development of the visual processing system. Visual pathway development commences with ganglion cells forming the optic nerve. The process that guides these neurones initially to the lateral geniculate nucleus (LGN and then onto the visual cortex is genetically programmed. Initially this process is influenced by spontaneously generated impulses and neurotrophic factors. Following birth, visual stimuli modify and refine the genetically programmed process. Exposure to the visual environment includes the risk of abnormal inputs. Abnormal stimuli disrupt the formation of patterned inputs allowing alteration of visual cortical wiring with reduction in ocular dominance columns driven by the abnormal eye. Correction of the abnormal visual input and penalisation of the "normal" input is the mainstay of therapy for amblyopia. Further understanding of the mechanisms involved in the development of a normal visual processing system will allow trialing therapies for amblyopia not responding to occlusion therapy. Levodopa is one agent providing insights into recovery of visual function for short periods in apparently mature visual systems.

  11. Occlusion for stimulus deprivation amblyopia.

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    Antonio-Santos, Aileen; Vedula, Satyanarayana S; Hatt, Sarah R; Powell, Christine

    2014-02-06

    Stimulus deprivation amblyopia (SDA) develops due to an obstruction to the passage of light secondary to a condition such as cataract. The obstruction prevents formation of a clear image on the retina. SDA can be resistant to treatment, leading to poor visual prognosis. SDA probably constitutes less than 3% of all amblyopia cases, although precise estimates of prevalence are unknown. In developed countries, most patients present under the age of one year; in less developed parts of the world patients are likely to be older at the time of presentation. The mainstay of treatment is removal of the cataract and then occlusion of the better-seeing eye, but regimens vary, can be difficult to execute, and traditionally are believed to lead to disappointing results. Our objective was to evaluate the effectiveness of occlusion therapy for SDA in an attempt to establish realistic treatment outcomes. Where data were available, we also planned to examine evidence of any dose response effect and to assess the effect of the duration, severity, and causative factor on the size and direction of the treatment effect. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 9), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to October 2013), EMBASE (January 1980 to October 2013), the Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to October 2013), PubMed (January 1946 to October 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com ), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 28 October 2013. We planned to include randomized and quasi-randomized controlled

  12. Pharmacological enhancement of treatment for amblyopia

    Science.gov (United States)

    Rashad, Mohammad A

    2012-01-01

    Background The purpose of this study was to compare a weight-adjusted dose of carbidopa- levodopa as treatment adjunctive to occlusion therapy with occlusion therapy alone in children and adults with different types of amblyopia. Methods This prospective study included 63 patients with amblyopia classified into two groups, ie, an occlusion group which included 35 patients who received occlusion therapy only and a pharmacological enhancement group which included 28 patients who received oral carbidopa-levodopa together with occlusion therapy for 6 weeks. Results The mean logarithm of the minimal angle of resolution (logMAR) of the eyes with amblyopia was not significantly different in the occlusion group (0.52, 0.52, and 0.51) than in the pharmacological enhancement group (0.58, 0.49, and 0.56) at three follow-up visits (at months 1, 3, and 12, respectively). There was a highly significant improvement in mean logMAR of amblyopic eyes compared with baseline in both occlusion groups (from 0.68 to 0.52, from 0.68 to 0.52, and from 0.68 to 0.51) and in the pharmacological enhancement group (from 0.81 to 0.58, from 0.81 to 0.49, and from 0.81 to 0.56) at the month 1, 3, and 12 visits (P = 0.01, P = 0.01, and P = 0.001, respectively). The improvement of mean logMAR in the subgroup of patients older than 12 years was greater in the pharmacological enhancement group (42.5%) than in the occlusion group (30%). The improvement of mean logMAR in the subgroup of patients with severe amblyopia was greater in the pharmacological enhancement group (34.3%) than in the occlusion group (22%). Conclusion Significant improvement was reported in both groups at all follow-up visits over 1 year. Regardless of the etiology of amblyopia, levodopa-carbidopa may be added to part-time occlusion in older patients as a means of increasing the plasticity of the visual cortex. Levodopa may add to the effect of occlusion in severe amblyopia and bilateral amblyopia. PMID:22536029

  13. Neuroimaging of amblyopia and binocular vision: a review

    OpenAIRE

    Joly, Olivier; Frankó, Edit

    2014-01-01

    Amblyopia is a cerebral visual impairment considered to derive from abnormal visual experience (e.g., strabismus, anisometropia). Amblyopia, first considered as a monocular disorder, is now often seen as a primarily binocular disorder resulting in more and more studies examining the binocular deficits in the patients. The neural mechanisms of amblyopia are not completely understood even though they have been investigated with electrophysiological recordings in animal models and more recently ...

  14. [The advances of suppression in research of amblyopia].

    Science.gov (United States)

    Liu, S; Liu, H

    2016-04-11

    Suppression that is the result of interocular competition is an important machanism of amblyopia. The imbalance of suppression may lead the consequence to amblyopia. In the early study, researchers had raised the theory of II. Quadratic Summation which had revealed the relationship of interocular interaction and suppression. In some basic researches, other studies had showed the most possible anatomic location of suppression. Recently, researchers found a new method to quantify the interocular suppression named the noise model. Further studies found a novel disinhibition therapy to treat amblyopia. We summarized the research advances in suppression and disinhibition treatment in amblyopia. (Chin J Ophthalmol, 2016, 52: 305-308).

  15. Visual functions in amblyopia as determinants of response to treatment.

    Science.gov (United States)

    Singh, Vinita; Agrawal, Siddharth

    2013-01-01

    To describe the visual functions in amblyopia as determinants of response to treatment. Sixty-nine patients with unilateral and bilateral amblyopia (114 amblyopic eyes) 3 to 15 years old (mean age: 8.80 ± 2.9 years), 40 males (58%) and 29 females (42%), were included in this study. All patients were treated by conventional occlusion 6 hours per day for mild to moderate amblyopia (visual acuity 0.70 or better) and full-time for 4 weeks followed by 6 hours per day for severe amblyopia (visual acuity 0.8 or worse). During occlusion, near activities requiring hand-eye coordination were advised. The follow-up examination was done at 3 and 6 months. Improvement in visual acuity was evaluated on the logMAR chart and correlated with the visual functions. Statistical analysis was done using Wilcoxon rank sum test (Mann-Whitney U test) and Kruskal-Wallis analysis. There was a statistically significant association of poor contrast sensitivity with the grade of amblyopia (P amblyopia (P amblyopia therapy. The grade of amblyopia (initial visual acuity) and accommodation are strong determinants of response to amblyopia therapy, whereas stereopsis and mesopic visual acuity have some value as determinants. Copyright 2013, SLACK Incorporated.

  16. Resolution in partially accomodative esotropia during occlusion treatment for amblyopia.

    Science.gov (United States)

    Koc, F; Ozal, H; Yasar, H; Firat, E

    2006-03-01

    To evaluate alignment changes in partially accommodative esotropia during occlusion treatment for amblyopia. Changes at the deviation angles of 63 partially accommodative esotropia patients, who had occlusion treatment for amblyopia, were evaluated retrospectively. Mean deviation angle at the start of therapy without glasses was 45 PD (10-90 PD) and became 27 PD (5-70 PD) after at least 2 months with glasses. During 12 (2-36) months of occlusion period, mean manifest deviation angle with glasses decreased to 11 PD (0-50) (P amblyopia resolved in 71.5% of the cases. After termination of amblyopia treatment 24 (38%) cases had surgery for the residual deviation but if we had planned surgery before amblyopia treatment, 81% of the patients would have had surgery. Should amblyopia be treated initially or should we operate first in patients with strabismus and amblyopia together? Our research suggests that we should not hurry to operate in high hypermetropic partially accommodative cases, which have amblyopia and a long-term history of strabismus. Initial amblyopia treatment in these cases allows time for resolution of the nonaccomodative component in strabismus and can significantly decrease the necessity for surgery.

  17. Childhood amblyopia: current management and new trends

    OpenAIRE

    Tailor, V.; Bossi, M.; Greenwood, J. A.; Dahlmann-Noor, A.

    2016-01-01

    INTRODUCTION OR BACKGROUND: With a prevalence of 2-5%, amblyopia is the most common vision deficit in children in the UK and the second most common cause of functional low vision in children in low-income countries. SOURCES OF DATA: Pubmed, Cochrane library and clinical trial registries (clinicaltrials.gov, ISRCTN, UKCRN portfolio database). AREAS OF AGREEMENT: Screening and treatment at the age of 4-5 years are cost efficient and clinically effective. Optical treatment (glasses) alone can im...

  18. Compliance with occlusion therapy for childhood amblyopia.

    Science.gov (United States)

    Wallace, Michael P; Stewart, Catherine E; Moseley, Merrick J; Stephens, David A; Fielder, Alistair R

    2013-09-17

    Explore compliance with occlusion treatment of amblyopia in the Monitored and Randomized Occlusion Treatment of Amblyopia Studies (MOTAS and ROTAS), using objective monitoring. Both studies had a three-phase protocol: initial assessment, refractive adaptation, and occlusion. In the occlusion phase, participants were instructed to dose for 6 hours/day (MOTAS) or randomized to 6 or 12 hour/day (ROTAS). Dose was monitored continuously using an occlusion dose monitor (ODM). One hundred and fifty-two patients (71 male, 81 female; 122 Caucasian, 30 non-Caucasian) of mean ± SD age 68 ± 18 months participated. Amblyopia was defined as an interocular acuity difference of at least 0.1 logMAR and was associated with anisometropia in 50, strabismus in 44, and both (mixed) in 58. Median duration of occlusion was 99 days (interquartile range 72 days). Mean compliance was 44%, mean proportion of days with no patch worn was 42%. Compliance was lower (39%) on weekends compared with weekdays (46%, P = 0.04), as was the likelihood of dosing at all (52% vs. 60%, P = 0.028). Compliance was lower when attendance was less frequent (P amblyopia type, and severity were not associated with compliance. Mixture modeling suggested three subpopulations of patch day doses: less than 30 minutes; doses that achieve 30% to 80% compliance; and doses that achieve around 100% compliance. This study shows that compliance with patching treatment averages less than 50% and is influenced by several factors. A greater understanding of these influences should improve treatment outcome. (ClinicalTrials.gov number, NCT00274664).

  19. Measuring colour rivalry suppression in amblyopia.

    Science.gov (United States)

    Hofeldt, T S; Hofeldt, A J

    1999-11-01

    To determine if the colour rivalry suppression is an index of the visual impairment in amblyopia and if the stereopsis and fusion evaluator (SAFE) instrument is a reliable indicator of the difference in visual input from the two eyes. To test the accuracy of the SAFE instrument for measuring the visual input from the two eyes, colour rivalry suppression was measured in six normal subjects. A test neutral density filter (NDF) was placed before one eye to induce a temporary relative afferent defect and the subject selected the NDF before the fellow eye to neutralise the test NDF. In a non-paediatric private practice, 24 consecutive patients diagnosed with unilateral amblyopia were tested with the SAFE. Of the 24 amblyopes, 14 qualified for the study because they were able to fuse images and had no comorbid disease. The relation between depth of colour rivalry suppression, stereoacuity, and interocular difference in logMAR acuity was analysed. In normal subjects, the SAFE instrument reversed temporary defects of 0.3 to 1. 8 log units to within 0.6 log units. In amblyopes, the NDF to reverse colour rivalry suppression was positively related to interocular difference in logMAR acuity (beta=1.21, psuppression as measured with the SAFE was found to agree closely with the degree of visual acuity impairment in non-paediatric patients with amblyopia.

  20. Restoration of binocular vision in amblyopia.

    Science.gov (United States)

    Hess, R F; Mansouri, B; Thompson, B

    2011-09-01

    To develop a treatment for amblyopia based on re-establishing binocular vision. 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. We hypothesize that suppression renders a structurally binocular system, functionally monocular. 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). Concomitant improvement in monocular acuity of the amblyopic eye occurs with this reduction in suppression and strengthening of binocular fusion. Additionally, stereoscopic function was established in the majority of patients tested. We have implemented this approach on a headmounted device as well as on a handheld iPod. This provides the basis for a new treatment of amblyopia, one that is purely binocular and aimed at reducing suppression as a first step.

  1. Measurement of suprathreshold binocular interactions in amblyopia.

    Science.gov (United States)

    Mansouri, B; Thompson, B; Hess, R F

    2008-12-01

    It has been established that in amblyopia, information from the amblyopic eye (AME) is not combined with that from the fellow fixing eye (FFE) under conditions of binocular viewing. However, recent evidence suggests that mechanisms that combine information between the eyes are intact in amblyopia. The lack of binocular function is most likely due to the imbalanced inputs from the two eyes under binocular conditions [Baker, D. H., Meese, T. S., Mansouri, B., & Hess, R. F. (2007b). Binocular summation of contrast remains intact in strabismic amblyopia. Investigative Ophthalmology & Visual Science, 48(11), 5332-5338]. We have measured the extent to which the information presented to each eye needs to differ for binocular combination to occur and in doing so we quantify the influence of interocular suppression. We quantify these suppressive effects for suprathreshold processing of global stimuli for both motion and spatial tasks. The results confirm the general importance of these suppressive effects in rendering the structurally binocular visual system of a strabismic amblyope, functionally monocular.

  2. Audiovisual perception in amblyopia: A review and synthesis.

    Science.gov (United States)

    Richards, Michael D; Goltz, Herbert C; Wong, Agnes M F

    2018-05-17

    Amblyopia is a common developmental sensory disorder that has been extensively and systematically investigated as a unisensory visual impairment. However, its effects are increasingly recognized to extend beyond vision to the multisensory domain. Indeed, amblyopia is associated with altered cross-modal interactions in audiovisual temporal perception, audiovisual spatial perception, and audiovisual speech perception. Furthermore, although the visual impairment in amblyopia is typically unilateral, the multisensory abnormalities tend to persist even when viewing with both eyes. Knowledge of the extent and mechanisms of the audiovisual impairments in amblyopia, however, remains in its infancy. This work aims to review our current understanding of audiovisual processing and integration deficits in amblyopia, and considers the possible mechanisms underlying these abnormalities. Copyright © 2018. Published by Elsevier Ltd.

  3. Zagreb Amblyopia Preschool Screening Study: near and distance visual acuity testing increase the diagnostic accuracy of screening for amblyopia.

    Science.gov (United States)

    Bušić, Mladen; Bjeloš, Mirjana; Petrovečki, Mladen; Kuzmanović Elabjer, Biljana; Bosnar, Damir; Ramić, Senad; Miletić, Daliborka; Andrijašević, Lidija; Kondža Krstonijević, Edita; Jakovljević, Vid; Bišćan Tvrdi, Ana; Predović, Jurica; Kokot, Antonio; Bišćan, Filip; Kovačević Ljubić, Mirna; Motušić Aras, Ranka

    2016-02-01

    To present and evaluate a new screening protocol for amblyopia in preschool children. Zagreb Amblyopia Preschool Screening (ZAPS) study protocol performed screening for amblyopia by near and distance visual acuity (VA) testing of 15 648 children aged 48-54 months attending kindergartens in the City of Zagreb County between September 2011 and June 2014 using Lea Symbols in lines test. If VA in either eye was >0.1 logMAR, the child was re-tested, if failed at re-test, the child was referred to comprehensive eye examination at the Eye Clinic. 78.04% of children passed the screening test. Estimated prevalence of amblyopia was 8.08%. Testability, sensitivity, and specificity of the ZAPS study protocol were 99.19%, 100.00%, and 96.68% respectively. The ZAPS study used the most discriminative VA test with optotypes in line as they do not underestimate amblyopia. The estimated prevalence of amblyopia was considerably higher than reported elsewhere. To the best of our knowledge, the ZAPS study protocol reached the highest sensitivity and specificity when evaluating diagnostic accuracy of VA tests for screening. The pass level defined at ≤0.1 logMAR for 4-year-old children, using Lea Symbols in lines missed no amblyopia cases, advocating that both near and distance VA testing should be performed when screening for amblyopia.

  4. Research of refraction status in 354 amblyopia children and influence factors for its treatment

    Directory of Open Access Journals (Sweden)

    Wen-Ting Tang

    2016-03-01

    Full Text Available AIM:To study the refraction status in 354 amblyopia children and to investigate the related influence factors for the treatment effect. METHODS:Three hundred and fifty-four children diagnosed as ametropia amblyopia from January 2010 to June 2015 in our hospital were selected. The children were divided into groups according to the children's age, refraction types of amblyopia and degree of amblyopia. The clinical treatment effect of different groups was compared. RESULTS:The cure rate for amblyopia children in different groups was significantly different(PPPCONCLUSION:The treatment effect of ametropia amblyopia is correlated with the children's age, types of amblyopia and degree of amblyopia. It has a poor treatment effect for the older children with severe myopia and amblyopia.

  5. Observations on the Relationship between Anisometropia, Amblyopia and Strabismus

    Science.gov (United States)

    Smith, Earl L; Hung, Li-Fang; Arumugam, Baskar; Wensveen, Janice M.; Chino, Yuzo M.; Harwerth, Ronald S.

    2017-01-01

    We investigated the potential causal relationships between anisometropia, amblyopia and strabismus, specifically to determine whether either amblyopia or strabismus interfered with emmetropization. We analyzed data from non-human primates that were relevant to the co-existence of anisometropia, amblyopia and strabismus in children. We relied on interocular comparisons of spatial vision and refractive development in animals reared with 1) monocular form deprivation; 2) anisometropia optically imposed by either contact lenses or spectacle lenses; 3) organic amblyopia produced by laser ablation of the fovea; and 4) strabismus that was either optically imposed with prisms or produced by either surgical or pharmacological manipulation of the extraocular muscles. Hyperopic anisometropia imposed early in life produced amblyopia in a dose-dependent manner. However, when potential methodological confounds were taken into account, there was no support for the hypothesis that the presence of amblyopia interferes with emmetropization or promotes hyperopia or that the degree of image degradation determines the direction of eye growth. To the contrary, there was strong evidence that amblyopic eyes were able to detect the presence of a refractive error and alter ocular growth to eliminate the ametropia. On the other hand, early onset strabismus, both optically and surgically imposed, disrupted the emmetropization process producing anisometropia. In surgical strabismus, the deviating eyes were typically more hyperopic than their fellow fixating eyes. The results show that early hyperopic anisometropia is a significant risk factor for amblyopia. Early esotropia can trigger the onset of both anisometropia and amblyopia. However, amblyopia, in isolation, does not pose a significant risk for the development of hyperopia or anisometropia. PMID:28404522

  6. Amblyopia and quality of life: a systematic review

    Science.gov (United States)

    Carlton, J; Kaltenthaler, E

    2011-01-01

    Amblyopia is a common condition, which can affect up to 5% of the general population. Health-related quality-of-life (HRQoL) implications of amblyopia and/or its treatment have been explored in the literature. A systematic literature search was undertaken during the period of 7–14 May 2010 to identify the HRQoL implications of amblyopia and/or its treatment. A total of 35 papers were included in the literature review. The HRQoL implications of amblyopia related specifically to amblyopia treatment, rather than to the condition itself. These included impact on family life, social interactions, difficulties in undertaking daily activities, as well as feelings and behaviour. The identified studies adopted a number of methodologies. The study populations included children with the condition, parents of children with amblyopia, and adults who had undertaken amblyopia treatment as a child. Some studies developed their own measures of HRQoL, and others determined HRQoL through proxy measures. The reported findings of the HRQoL implications are of importance when considering the management of cases of amblyopia. The issues identified in the literature review are discussed with respect to how HRQoL is measured (treatment compliance vs proxy measures), and whether HRQoL is taken from a child's or a parent's perspective. Changing societal views over glasses and occlusion therapy are also discussed. Further research is required to assess the immediate and long-term effects of amblyopia and/or its treatment on HRQoL using a more standardised approach. PMID:21274010

  7. Diplopia Following Short Treatment for Moderate Amblyopia.

    Science.gov (United States)

    Hoole, Janice; Barrow, Natasha

    2017-09-01

    A case of an autistic child, aged 8 years, who reported binocular diplopia following just 2 hours total occlusion per day for 6 weeks for strabismic/anisometropic amblyopia is reported. There was a history of known long-standing reduced uniocular acuity without treatment. Pretreatment Sbisa bar assessment suggested moderate suppression. The diplopia was treated over 6 months including occluding the amblyopic eye and gradually reducing the density of the occluder until fixation with the nonamblyopic eye could be maintained and diplopia ignored. Possible contributing factors are discussed.

  8. [Visual evoked potentials in management of amblyopia in children].

    Science.gov (United States)

    Gromová, M; Gerinec, A

    2010-11-01

    The authors want to point out the possibility of using the visual evoked potentials (VEP) in the diagnostic process of amblyopia, especially in preverbal children. We also researched the possibility of screening for amblyopia with VEP in young patients with anisometropia without strabismus being present, especially those who come from affected families. The authors followed changes in the course of an occlusion therapy and suggest that VEP could be used to predict a success of the amblyopia therapy. We analyzed group of 45 pediatric patients ages 2-10 years who were investigated in years 2006-2009 at Pediatric Ophthalmology Department of Children University Hospital in Bratislava with amblyopia. This group was compared with a control group of 25 healthy children. The cause of amblyopia in a majority of children (29 patients) was hyperopic anisometropia, 13 children had hyperopic isometropia, 3 patients had myopia over -3D. These causes in 22 children were combined with strabismus. The monocular pattern of VEP was evaluated in all patients. In cooperative children (25) we also evaluated binocular pattern of VEP. 18 patients with amblyopia had a second VEP evaluation done during the occlusion therapy, among those were 23 amblyopic eyes. The time frame from the first VEP evaluation to the second VEP evaluation was 1-11 months, average 5,1 months. The material was statistically evaluated. Our study showed statistically significant prolongation of the latency of both P and N2 waves (p = 0.01) in children with amblyopia.This can be used in diagnostic process of amblyopia in preverbal children as well as in the screening for amblyopia. We also followed changes during the occlusion therapy and we discovered persistent prolongation of the latency of the P wave and also changes in the amplitudes (p = 0.05) During repeated measurements and with applied therapy one can follow the dynamics of amblyopia, course of therapy by VEP changes. Results of our research suggest a great

  9. Straatsma syndrome: Satisfactory amblyopia treatment. Report of two cases.

    Science.gov (United States)

    Quezada-Del Cid, N C; Zimmermann-Paiz, Martin A; Ordoñez-Rivas, A M; Burgos-Elías, V Y; Marroquin-Sarti, M J

    2018-06-01

    The cases are presented on 2 female patients with Straatsma syndrome, with satisfactory treatment of amblyopia. The level of anisometropia and myelination of retinal nerve fibres were different in these two patients. However, both achieved 0.20 (logMAR) visual acuity with correction in both eyes following amblyopia treatment with ocular patching. Visual prognosis of amblyopia associated with myelination of retinal nerve fibres and anisometropia is poorer than anisometropic amblyopia without myelination. It is well known that the former is refractory to occlusive therapy. Despite having a poor prognosis, visual rehabilitation should be attempted. The two cases presented were successfully treated with eye-patching. Copyright © 2018 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. [The lazy eye - contemporary strategies of amblyopia treatment].

    Science.gov (United States)

    Sturm, V

    2011-02-16

    Amblyopia is a condition of decreased monocular or binocular visual acuity caused by form deprivation or abnormal binocular interaction. Amblyopia is the most common cause of monocular vision loss in children with a prevalence of 2 to 5%. During the last decade, several prospective randomized studies have influenced our clinical management. Based on these studies, optimum refractive correction should be prescribed first. However, most patients will need additional occlusion therapy which is still considered the «gold standard» of amblyopia management. Now much lower doses have been shown to be effective. In moderate amblyopia, penalization with atropine is as effective as patching. New treatment modalities including perceptual learning, pharmacotherapy with levodopa and citicholine or transcranial magnetic stimulation have not yet been widely accepted.

  11. Treatment dose-response in amblyopia therapy: the Monitored Occlusion Treatment of Amblyopia Study (MOTAS).

    Science.gov (United States)

    Stewart, Catherine E; Moseley, Merrick J; Stephens, David A; Fielder, Alistair R

    2004-09-01

    Amblyopia is the commonest visual disorder of childhood. Yet the contributions of the two principal treatments (spectacle wear and occlusion) to outcome are unknown. This study was undertaken to investigate the dose-response relationship of amblyopia therapy. The study comprised three distinct phases: baseline, in which repeat measures of visual function were undertaken to confirm the initial visual deficit; refractive adaptation: an 18-week period of spectacle wear with six weekly measurements of logarithm of the minimum angle of resolution (logMAR) visual acuity; occlusion: in which participants were prescribed 6 hours of "patching" per day. In the latter phase, occlusion was objectively monitored and logMAR visual acuity recorded at 2-week intervals until any observed gains had ceased. Data were obtained from 94 participants (mean age, 5.1 +/- 1.4 years) with amblyopia associated with strabismus (n = 34), anisometropia (n = 23), and both anisometropia and strabismus (n = 37). Eighty-six underwent refractive adaptation. Average concordance with patching was 48%. The relationship between logMAR visual acuity gain and total occlusion dose was monotonic and linear. Increasing dose rate beyond 2 h/d hastened the response but did not improve outcome. More than 80% of the improvement during occlusion occurred within 6 weeks. Treatment outcome was significantly better for children younger than 4 years (n = 17) than in those older than 6 years (n = 24; P = 0.0014). Continuous objective monitoring of the amount of patching therapy received has provided insight into the dose-response relationship of occlusion therapy for amblyopia. Patching is most effective within the first few weeks of treatment, even for those in receipt of a relatively small dose. Further studies are needed to elucidate the neural basis for the dose-response functions. Copyright Association for Research in Vision and Ophthalmology

  12. Eye-hand exercise: new variant in amblyopia management.

    Science.gov (United States)

    Svĕrák, J; Peregrin, J; Juran, J

    1990-01-01

    A total of 50 children with unilateral amblyopia was treated by short term 10 minute-lasting weekly occlusions of visually well eye. During the occlusion the child is providing the intensive detailed activities under patient's supervision. After an approximately half-a-year lasting interval, the "eye-hand" exercise resulted in the mean improvement of visual acuity for 2.44 normalised lines. The visual motor factor is involved in amblyopia treatment.

  13. Part-time occlusion therapy for amblyopia in older children

    Directory of Open Access Journals (Sweden)

    Singh Inderpreet

    2008-01-01

    Full Text Available Aim: To compare the efficacy of part-time versus full-time occlusion for treatment of amblyopia in children aged 7-12 years. Materials and Methods: Prospective interventional case series. One hundred children between 7-12 years of age with anisometropic (57, strabismic (25 and mixed (18 unilateral amblyopia were randomized (simple randomization into four groups (25 each to receive two hours, four hours, six hours or full-time occlusion therapy. Children were regularly followed up at six-weekly intervals for a minimum of three visits. Statistical Analysis: Intragroup visual improvement was analyzed using paired t-test while intergroup comparisons were done using ANOVA and unpaired t-test. Results: All four groups showed significant visual improvement after 18 weeks of occlusion therapy ( P < 0.001. Seventy-three (73% of the total 100 eyes responded to amblyopia therapy with 11 eyes (44%, 17 eyes (68%, 22 eyes (88% and 23 eyes (92% being amblyopia responders in the four groups respectively, with the least number of responders in the two hours group. In mild to moderate amblyopia (vision 20/30 to 20/80, there was no significant difference in visual outcome among the four groups ( P =0.083. However, in severe amblyopia (vision 20/100 or worse, six hours ( P =0.048 and full-time occlusion ( P =0.027 treatment were significantly more effective than two hours occlusion. Conclusion: All grades of part-time occlusion are comparable to full-time occlusion in effectiveness of treatment for mild to moderate amblyopia in children between 7-12 years of age unlike in severe amblyopia, where six hours and full-time occlusion were more effective than two hours occlusion therapy.

  14. Part-time occlusion therapy for amblyopia in older children.

    Science.gov (United States)

    Singh, Inderpreet; Sachdev, Nishant; Brar, Gagandeep S; Kaushik, Sushmita

    2008-01-01

    To compare the efficacy of part-time versus full-time occlusion for treatment of amblyopia in children aged 7-12 years. Prospective interventional case series. One hundred children between 7-12 years of age with anisometropic (57), strabismic (25) and mixed (18) unilateral amblyopia were randomized (simple randomization) into four groups (25 each) to receive two hours, four hours, six hours or full-time occlusion therapy. Children were regularly followed up at six-weekly intervals for a minimum of three visits. Intragroup visual improvement was analyzed using paired t-test while intergroup comparisons were done using ANOVA and unpaired t-test. All four groups showed significant visual improvement after 18 weeks of occlusion therapy ( P amblyopia therapy with 11 eyes (44%), 17 eyes (68%), 22 eyes (88%) and 23 eyes (92%) being amblyopia responders in the four groups respectively, with the least number of responders in the two hours group. In mild to moderate amblyopia (vision 20/30 to 20/80), there was no significant difference in visual outcome among the four groups ( P =0.083). However, in severe amblyopia (vision 20/100 or worse), six hours ( P =0.048) and full-time occlusion ( P =0.027) treatment were significantly more effective than two hours occlusion. All grades of part-time occlusion are comparable to full-time occlusion in effectiveness of treatment for mild to moderate amblyopia in children between 7-12 years of age unlike in severe amblyopia, where six hours and full-time occlusion were more effective than two hours occlusion therapy.

  15. Contrast-balanced binocular treatment in children with deprivation amblyopia.

    Science.gov (United States)

    Hamm, Lisa M; Chen, Zidong; Li, Jinrong; Dai, Shuan; Black, Joanna; Yuan, Junpeng; Yu, Minbin; Thompson, Benjamin

    2017-11-28

    Children with deprivation amblyopia due to childhood cataract have been excluded from much of the emerging research into amblyopia treatment. An investigation was conducted to determine whether contrast-balanced binocular treatment - a strategy currently being explored for children with anisometropic and strabismic amblyopia - may be effective in children with deprivation amblyopia. An unmasked, case-series design intended to assess proof of principle was employed. Eighteen children with deprivation amblyopia due to childhood cataracts (early bilateral n = 7, early unilateral n = 7, developmental n = 4), as well as 10 children with anisometropic (n = 8) or mixed anisometropic and strabismic amblyopia (n = 2) were prescribed one hour a day of treatment over a six-week period. Supervised treatment was available. Visual acuity, contrast sensitivity, global motion perception and interocular suppression were measured pre- and post-treatment. Visual acuity improvements occurred in the anisometropic/strabismic group (0.15 ± 0.05 logMAR, p = 0.014), but contrast sensitivity did not change. As a group, children with deprivation amblyopia had a smaller but statistically significant improvement in weaker eye visual acuity (0.09 ± 0.03 logMAR, p = 0.004), as well a significant improvement in weaker eye contrast sensitivity (p = 0.004). Subgroup analysis suggested that the children with early bilateral deprivation had the largest improvements, while children with early unilateral cataract did not improve. Interestingly, binocular contrast sensitivity also improved in children with early bilateral deprivation. Global motion perception improved for both subgroups with early visual deprivation, as well as children with anisometropic or mixed anisometropic/strabismic amblyopia. Interocular suppression improved for all subgroups except children with early unilateral deprivation. These data suggest that supervised contrast-balanced binocular

  16. The method of treatment cessation and recurrence rate of amblyopia.

    Science.gov (United States)

    Walsh, Leah A; Hahn, Erik K; LaRoche, G Robert

    2009-09-01

    To date, much of the research regarding amblyopia has been focused on which therapeutic modality is the most efficacious in amblyopia management. Unfortunately, there is a lack of research into which method of treatment cessation is the most appropriate once therapy has been completed. The purpose of this study is to investigate if the cessation method affects the recurrence rate of amblyopia. This study was a prospective randomized clinical trial of 20 subjects who were wearing full-time occlusion and were at the end point of their therapy. The subjects were randomized into one of two groups: abrupt cessation or therapy tapering. All subjects were followed for 3 consecutive 4-week intervals, for a total of 12 weeks, to assess the short-term recurrence rate of amblyopia. Subjects who were in the tapered group had their occlusion reduced from full-time occlusion (all waking hours minus one) to 50% of waking hours at study enrollment (i.e., from 12 hours/day to 6 hours per day); occlusion was reduced by an additional 50% at the first 4-week study visit (i.e., from 6 hours/day to 3 hours), with occlusion being discontinued completely at the week 8 visit. All subjects who were in the abrupt cessation group had their full-time occlusion discontinued completely at the start of the study (i.e., from 12 hours/day to none). Additional assessments were also conducted at week 26 and week 52 post-therapy cessation to determine the longer term amblyopia regression rate. For the purposes of this study, recurrence was defined as a 0.2 (10 letters) or more logarithm of the minimum angle of resolution (logMAR) loss of visual acuity. A recurrence of amblyopia occurred in 4 of 17 (24%; CI 9%-47%) participants completing the study by the week 52 study end point. There were 2 subjects from each treatment group who demonstrated a study protocol-defined recurrence. There was a 24% risk of amblyopia recurrence if therapy was discontinued abruptly or tapered in 8 weeks. In this small

  17. Amblyopia: neural basis and therapeutic approaches.

    Science.gov (United States)

    Bretas, Caio César Peixoto; Soriano, Renato Nery

    2016-01-01

    Abnormalities in visual processing caused by visual deprivation or abnormal binocular interaction may induce amblyopia, which is characterized by reduced visual acuity. Occlusion therapy, the conventional treatment, requires special attention as occlusion of the fellow normal eye may reduce its visual acuity and impair binocular vision. Besides recovering visual acuity, some researchers have recommended restoration of stereoacuity and motor fusion and reverse suppression in order to prevent diplopia. Recent studies have documented that the amblyopic visual cortex has a normal complement of cells but reduced spatial resolution and a disordered topographical map. Changes occurring in the late sensitive period selectively impact the parvocellular pathway. Distinct morphophysiologic and psychophysical deficits may demand individualization of therapy, which might provide greater and longer-lasting residual plasticity in some children.

  18. Amblyopia: neural basis and therapeutic approaches

    Directory of Open Access Journals (Sweden)

    Caio César Peixoto Bretas

    Full Text Available ABSTRACT Abnormalities in visual processing caused by visual deprivation or abnormal binocular interaction may induce amblyopia, which is characterized by reduced visual acuity. Occlusion therapy, the conventional treatment, requires special attention as occlusion of the fellow normal eye may reduce its visual acuity and impair binocular vision. Besides recovering visual acuity, some researchers have recommended restoration of stereoacuity and motor fusion and reverse suppression in order to prevent diplopia. Recent studies have documented that the amblyopic visual cortex has a normal complement of cells but reduced spatial resolution and a disordered topographical map. Changes occurring in the late sensitive period selectively impact the parvocellular pathway. Distinct morphophysiologic and psychophysical deficits may demand individualization of therapy, which might provide greater and longer-lasting residual plasticity in some children.

  19. Regional Extent of Peripheral Suppression in Amblyopia.

    Science.gov (United States)

    Babu, Raiju J; Clavagnier, Simon; Bobier, William R; Thompson, Benjamin; Hess, Robert F

    2017-04-01

    Previously, we have mapped amblyopic eye suppression within the central 20° of the visual field and observed a gradient of suppression that is strongest in central vision and weakens with increasing eccentricity. In this study, using a large dichoptic display, we extend our novel suppression mapping approach further into the periphery (from 20°-60°) to assess whether suppression continues to decline with eccentricity or plateaus. Sixteen participants with amblyopia (10 with strabismus, 6 with anisometropia without strabismus; mean age: 37.9 ± 11 years) and six normal observers (mean age: 28.3 ± 5 years) took part. The visual stimulus (60° diameter), viewed from 57 cm, was composed of four concentric annuli (5° radius) with alternate contrast polarities starting from an eccentricity of 10°. Each annulus was divided into eight sectors subtending 45° of visual angle. Participants adjusted the contrast of a single sector presented to the fellow eye to match the perceived contrast of the remaining stimulus elements that were presented to the amblyopic eye. A matching contrast that was lower in the fellow eye than the amblyopic eye indicated suppression. Patients with strabismus exhibited significantly stronger interocular suppression than controls across all eccentricities (P = 0.01). Patients with anisometropia did not differ from controls (P = 0.58). Suppression varied significantly with eccentricity (P = 0.005) but this effect did not differ between patient groups (P = 0.217). In amblyopia, suppression is present beyond the central 10° in patients with strabismus. Suppression becomes weaker at greater eccentricities and this may enable peripheral fusion that could be used by binocular treatment methods.

  20. Can human amblyopia be treated in adulthood?

    Science.gov (United States)

    Astle, Andrew T.; McGraw, Paul V.; Webb, Ben S.

    2012-01-01

    Amblyopia is a common visual disorder that results in a spatial acuity deficit in the affected eye. Orthodox treatment is to occlude the unaffected eye for lengthy periods, largely determined by the severity of the visual deficit at diagnosis. Although this treatment is not without its problems (poor compliance, potential to reduce binocular function etc.) it is effective in many children with moderate to severe amblyopia. Diagnosis and initiation of treatment early in life are thought to be critical to the success of this form of therapy. Occlusion is rarely undertaken in older children (over 10 years old) as the visual benefits are considered to be marginal. Therefore, in subjects where occlusion is not effective or those missed by mass screening programmes there is no alternative therapy available later in life. More recently, burgeoning evidence has begun to reveal previously unrecognised levels of residual neural plasticity in the adult brain and scientists have developed new genetic, pharmacological and behavioural interventions to activate these latent mechanisms in order to harness their potential for visual recovery. Prominent amongst these is the concept of perceptual learning - the fact that repeatedly practicing a challenging visual task leads to substantial and enduring improvements in visual performance over time. In the normal visual system the improvements are highly specific to the attributes of the trained stimulus. However, in the amblyopic visual system learned improvements have been shown to generalize to novel tasks. In this paper we ask whether amblyopic deficits can be reduced in adulthood and explore the pattern of transfer of learned improvements. We also show that developing training protocols that target the deficit in stereo acuity allows the recovery of normal stereo function even in adulthood. This information will help guide further development of learning-based interventions in this clinical group. PMID:21870913

  1. Dichoptic movie viewing treats childhood amblyopia.

    Science.gov (United States)

    Li, Simone L; Reynaud, Alexandre; Hess, Robert F; Wang, Yi-Zhong; Jost, Reed M; Morale, Sarah E; De La Cruz, Angie; Dao, Lori; Stager, David; Birch, Eileen E

    2015-10-01

    Contrast-balanced dichoptic experience with perceptual-learning tasks or simple games has been shown to improve visual acuity significantly in amblyopia. However, these tasks are intensive and repetitive, and up to 40% of unsupervised patients are noncompliant. We investigated the efficacy of a potentially more engaging movie method to provide contrast-balanced binocular experience via complementary dichoptic stimulation. Eight amblyopic children 4-10 years of age were enrolled in a prospective cohort study to watch 3 dichoptic movies per week for 2 weeks on a passive 3D display. Dichoptic versions of 18 popular animated feature films were created. A patterned image mask of irregularly shaped blobs was multiplied with the movie images seen by the amblyopic eye and an inverse mask was multiplied with the images seen by the fellow eye. Fellow-eye contrast was initially set at a reduced level that allowed binocular vision and was then incremented by 10% at each visit. Best-corrected visual acuity, random dot stereoacuity, and interocular suppression were measured at baseline and 2 weeks. Mean amblyopic eye visual acuity (with standard error of the mean) improved from a logarithm of minimum angle of resolution of 0.72 ± 0.08 at baseline to 0.52 ± 0.09 (P = 0.003); that is, 2.0 lines of improvement at the 2-week outcome visit. No significant change in interocular suppression or stereoacuity was found. Passive viewing of dichoptic feature films is feasible and could be a promising new treatment for childhood amblyopia. The maximum improvement that may be achieved by watching dichoptic movies remains to be determined. No known side effects are associated with this new treatment. Copyright © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  2. Occlusion-amblyopia following high dose oral levodopa combined with part time patching

    OpenAIRE

    Mihir Kothari

    2014-01-01

    Part time occlusion therapy is not reported to cause occlusion (reverse) amblyopia. However, when combined with high dose oral levodopa, an increase in the plasticity of the visual cortex can lead to occlusion amblyopia. In this case report, we describe a six year old child who developed occlusion amblyopia following part time patching combined with oral levodopa.

  3. Occlusion-amblyopia following high dose oral levodopa combined with part time patching.

    Science.gov (United States)

    Kothari, Mihir

    2014-12-01

    Part time occlusion therapy is not reported to cause occlusion (reverse) amblyopia. However, when combined with high dose oral levodopa, an increase in the plasticity of the visual cortex can lead to occlusion amblyopia. In this case report, we describe a six year old child who developed occlusion amblyopia following part time patching combined with oral levodopa.

  4. Occlusion-amblyopia following high dose oral levodopa combined with part time patching

    Directory of Open Access Journals (Sweden)

    Mihir Kothari

    2014-01-01

    Full Text Available Part time occlusion therapy is not reported to cause occlusion (reverse amblyopia. However, when combined with high dose oral levodopa, an increase in the plasticity of the visual cortex can lead to occlusion amblyopia. In this case report, we describe a six year old child who developed occlusion amblyopia following part time patching combined with oral levodopa.

  5. The measurement and treatment of suppression in amblyopia.

    Science.gov (United States)

    Black, Joanna M; Hess, Robert F; Cooperstock, Jeremy R; To, Long; Thompson, Benjamin

    2012-12-14

    Amblyopia, a developmental disorder of the visual cortex, is one of the leading causes of visual dysfunction in the working age population. Current estimates put the prevalence of amblyopia at approximately 1-3%(1-3), the majority of cases being monocular(2). Amblyopia is most frequently caused by ocular misalignment (strabismus), blur induced by unequal refractive error (anisometropia), and in some cases by form deprivation. Although amblyopia is initially caused by abnormal visual input in infancy, once established, the visual deficit often remains when normal visual input has been restored using surgery and/or refractive correction. This is because amblyopia is the result of abnormal visual cortex development rather than a problem with the amblyopic eye itself(4,5) . Amblyopia is characterized by both monocular and binocular deficits(6,7) which include impaired visual acuity and poor or absent stereopsis respectively. The visual dysfunction in amblyopia is often associated with a strong suppression of the inputs from the amblyopic eye under binocular viewing conditions(8). Recent work has indicated that suppression may play a central role in both the monocular and binocular deficits associated with amblyopia(9,10) . Current clinical tests for suppression tend to verify the presence or absence of suppression rather than giving a quantitative measurement of the degree of suppression. Here we describe a technique for measuring amblyopic suppression with a compact, portable device(11,12) . The device consists of a laptop computer connected to a pair of virtual reality goggles. The novelty of the technique lies in the way we present visual stimuli to measure suppression. Stimuli are shown to the amblyopic eye at high contrast while the contrast of the stimuli shown to the non-amblyopic eye are varied. Patients perform a simple signal/noise task that allows for a precise measurement of the strength of excitatory binocular interactions. The contrast offset at which

  6. Analysis of refractive state in 708 children with ametropic amblyopia

    Directory of Open Access Journals (Sweden)

    Ju-Fen Huang

    2016-01-01

    Full Text Available AIM: To analyze the refractive state and explore the epidemiologic feature of children with ametropic amblyopia.METHODS: This study retrospectively analyzed 708 children(1 416 eyeswith amblyopia from January 2012 to December 2013 in Special Department of Strabismus and Amblyopic and Department of Pediatric Ophthalmology in our hospital, who were diagnosed as ametropic amblyopia and accepted centrally comprehensive training. The refractive state were given epidemiologic analyze.RESULTS: In the 708 cases(1 416 eyes, there were 190 eyes with hyperopia(13.42%,612 eyes with hyperopia astigmatism(43.22%,18 eyes with myopia(1.27%,134 eyes with myopia astigmatism(9.46%,462 eyes with mixed astigmatism(32.63%. The distributions of refractive state in children at different age were different, and the difference was statistically significant(PCONCLUSION: Hyperopia ametropia and mixed astigmatism are the main types of refractive errors in amblyopia children. The level of amblyopia is related to refractive state and astigmatism axial.

  7. Modified virtual reality technology for treatment of amblyopia.

    Science.gov (United States)

    Eastgate, R M; Griffiths, G D; Waddingham, P E; Moody, A D; Butler, T K H; Cobb, S V; Comaish, I F; Haworth, S M; Gregson, R M; Ash, I M; Brown, S M

    2006-03-01

    The conventional patching/occlusion treatment for amblyopia sometimes gives disappointing results for a number of reasons: it is unpopular, prolonged, frequently resulting in poor or noncompliance, and also disrupts fusion. The aim of this research was to develop a novel virtual-reality (VR)-based display system that facilitates the treatment of amblyopia with both eyes stimulated simultaneously. We have adopted a multidisciplinary approach, combining VR expertise with a team of ophthalmologists and orthoptists to develop the Interactive Binocular Treatment (I-BiT) system. This system incorporates adapted VR technology and specially written software providing interactive 2D and 3D games and videos to the patient via a stereo (binocular) display, and a control screen for the clinician. We developed a prototype research system designed for treatment of amblyopia in children. The result is a novel way to treat amblyopia, which allows binocular treatment. It is interactive, and as it is partially software based, can be adapted to suit the age/ability, and needs of the patient. This means that the treatment can be made captivating and enjoyable. Further research is on-going to determine the efficacy of this new modality in the treatment of amblyopia.

  8. Factors influencing the prevalence of amblyopia in children with anisometropia.

    Science.gov (United States)

    Lee, Chong Eun; Lee, Young Chun; Lee, Se-Youp

    2010-08-01

    To evaluate factors that can influence the prevalence of amblyopia in children with anisometropia. We retrospectively reviewed the records of 63 children 2 to 13 years of age who had anisometropic amblyopia with a difference in the refractive errors between the eyes of at least two diopters (D). The type of anisometropia (myopia, hyperopia, and astigmatism), degree of anisometropia (4 D), best corrected visual acuity (BCVA) of the amblyopic eye at the time of initial examination, BCVA differences between sound and amblyopic eyes, whether or not occlusion therapy was performed, compliance with occlusion therapy, and the patient's age when eyeglasses were first worn were investigated. There was an increase in the risk of amblyopia with increased magnitude of anisometropia (p=0.021). The prevalence of amblyopia was higher in the BCVA 4 lines between sound and amblyopic eyes (p=0.008 and p=0.045, respectively). There was no statistical relationship between the prevalence of amblyopia and the type of anisometropia or the age when eyeglasses were first worn. Poor compliance with occlusion therapy was less likely to achieve successful outcome (p=0.015). Eyes with poor initial visual acuities of 4 line difference in the BCVA between sound and amblyopic eyes at the initial visit may require active treatment.

  9. Anisometropic amblyopia in a case of type 2 Waardenburg syndrome

    Science.gov (United States)

    Akal, Ali; Göncü, Tugba; Boyaci, Nurefsan; Yılmaz, Ömer Faruk

    2013-01-01

    This study presents a case of an 8-year-old boy with iris heterochromia and anisometropic amblyopia who was diagnosed with Waardenburg syndrome (WS) type 2. An ophthalmic examination revealed iris heterochromia and anisometropic amblyopia in our patient. In the systemic examination, a white forelock and vitiligo on the arms and body were observed and neurosensory hearing loss was revealed, for which the patient used hearing aids. Identification and typing of patients with WS is crucial to address neurosensory hearing loss, glaucoma and fundus changes. While it might be challenging to communicate with a patient with speech and hearing problems, visual acuity should be examined carefully and probable amblyopia should be identified. Anterior segment changes and signs of glaucoma should also be evaluated in detail. PMID:24351514

  10. Anisometropic amblyopia in a case of type 2 Waardenburg syndrome.

    Science.gov (United States)

    Akal, Ali; Göncü, Tugba; Boyaci, Nurefsan; Yılmaz, Ömer Faruk

    2013-12-18

    This study presents a case of an 8-year-old boy with iris heterochromia and anisometropic amblyopia who was diagnosed with Waardenburg syndrome (WS) type 2. An ophthalmic examination revealed iris heterochromia and anisometropic amblyopia in our patient. In the systemic examination, a white forelock and vitiligo on the arms and body were observed and neurosensory hearing loss was revealed, for which the patient used hearing aids. Identification and typing of patients with WS is crucial to address neurosensory hearing loss, glaucoma and fundus changes. While it might be challenging to communicate with a patient with speech and hearing problems, visual acuity should be examined carefully and probable amblyopia should be identified. Anterior segment changes and signs of glaucoma should also be evaluated in detail.

  11. Spatial interactions reveal inhibitory cortical networks in human amblyopia.

    Science.gov (United States)

    Wong, Erwin H; Levi, Dennis M; McGraw, Paul V

    2005-10-01

    Humans with amblyopia have a well-documented loss of sensitivity for first-order, or luminance defined, visual information. Recent studies show that they also display a specific loss of sensitivity for second-order, or contrast defined, visual information; a type of image structure encoded by neurons found predominantly in visual area A18/V2. In the present study, we investigate whether amblyopia disrupts the normal architecture of spatial interactions in V2 by determining the contrast detection threshold of a second-order target in the presence of second-order flanking stimuli. Adjacent flanks facilitated second-order detectability in normal observers. However, in marked contrast, they suppressed detection in each eye of the majority of amblyopic observers. Furthermore, strabismic observers with no loss of visual acuity show a similar pattern of detection suppression. We speculate that amblyopia results in predominantly inhibitory cortical interactions between second-order neurons.

  12. Quantitative measurement of interocular suppression in children with amblyopia.

    Science.gov (United States)

    Narasimhan, Sathyasri; Harrison, Emily R; Giaschi, Deborah E

    2012-08-01

    In this study we explored the possibility of using a dichoptic global motion technique to measure interocular suppression in children with amblyopia. We compared children (5-16 years old) with unilateral anisometropic and/or strabismic amblyopia to age-matched control children. Under dichoptic viewing conditions, contrast interference thresholds were determined with a global motion direction-discrimination task. Using virtual reality goggles, high contrast signal dots were presented to the amblyopic eye, while low contrast noise dots were presented to the non-amblyopic fellow eye. The contrast of the noise dots was increased until discrimination of the motion direction of the signal dots reached chance performance. Contrast interference thresholds were significantly lower in the strabismic group than in the anisometropic and control group. Our results suggest that interocular suppression is stronger in strabismic than in anisometropic amblyopia. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. New insights into amblyopia: binocular therapy and noninvasive brain stimulation.

    Science.gov (United States)

    Hess, Robert F; Thompson, Benjamin

    2013-02-01

    The current approach to the treatment of amblyopia is problematic for a number of reasons. First, it promotes recovery of monocular vision but because it is not designed to promote binocularity, its binocular outcomes often are disappointing. Second, compliance is poor and variable. Third, the effectiveness of the treatment is thought to decrease with increasing age. We discuss 2 new approaches aimed at recovering visual function in adults with amblyopia. The first is a binocular approach to amblyopia treatment that is showing promise in initial clinical studies. The second is still in development and involves the use of well-established noninvasive brain stimulation techniques to temporarily alter the balance of excitation and inhibition in the visual cortex. Copyright © 2013 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  14. Occlusion therapy of unilateral amblyopia with botulinum toxin induced ptosis.

    Science.gov (United States)

    Halkiadakis, Ioannis; Iliaki, Olga; Kalyvianaki, Maria I; Tsilimbaris, Miltiadis K

    2007-01-01

    In order to evaluate the role of botulinum toxin induced ptosis as an occlusion method to treat unilateral deep strabismic amblyopia in two uncooperative children, we injected 0.2 ml of diluted botulinum toxin in the levator palpaebrae; low sedation was necessary in one of the two children. In both cases a marked ptosis was achieved, which lasted about four weeks and then gradually resolved completely. The visual acuity of the ablyopic eye increased in both children, making patching easy thereafter. One child developed amblyopia in the injected eye, which was handled successfully using part-time occlusion. No other side effects were noted. Whether this new method could be a simple, safe and effective alternative method of occlusion for the treatment of deep amblyopia in uncooperative children needs to be proven with a larger series of children.

  15. Binocular vision in amblyopia: structure, suppression and plasticity.

    Science.gov (United States)

    Hess, Robert F; Thompson, Benjamin; Baker, Daniel H

    2014-03-01

    The amblyopic visual system was once considered to be structurally monocular. However, it now evident that the capacity for binocular vision is present in many observers with amblyopia. This has led to new techniques for quantifying suppression that have provided insights into the relationship between suppression and the monocular and binocular visual deficits experienced by amblyopes. Furthermore, new treatments are emerging that directly target suppressive interactions within the visual cortex and, on the basis of initial data, appear to improve both binocular and monocular visual function, even in adults with amblyopia. The aim of this review is to provide an overview of recent studies that have investigated the structure, measurement and treatment of binocular vision in observers with strabismic, anisometropic and mixed amblyopia. © 2014 The Authors Ophthalmic & Physiological Optics © 2014 The College of Optometrists.

  16. Cognitive processing of orientation discrimination in anisometropic amblyopia.

    Directory of Open Access Journals (Sweden)

    Jianglan Wang

    Full Text Available Cognition is very important in our daily life. However, amblyopia has abnormal visual cognition. Physiological changes of the brain during processes of cognition could be reflected with ERPs. So the purpose of this study was to investigate the speed and the capacity of resource allocation in visual cognitive processing in orientation discrimination task during monocular and binocular viewing conditions of amblyopia and normal control as well as the corresponding eyes of the two groups with ERPs. We also sought to investigate whether the speed and the capacity of resource allocation in visual cognitive processing vary with target stimuli at different spatial frequencies (3, 6 and 9 cpd in amblyopia and normal control as well as between the corresponding eyes of the two groups. Fifteen mild to moderate anisometropic amblyopes and ten normal controls were recruited. Three-stimulus oddball paradigms of three different spatial frequency orientation discrimination tasks were used in monocular and binocular conditions in amblyopes and normal controls to elicit event-related potentials (ERPs. Accuracy (ACC, reaction time (RT, the latency of novelty P300 and P3b, and the amplitude of novelty P300 and P3b were measured. Results showed that RT was longer in the amblyopic eye than in both eyes of amblyopia and non-dominant eye in control. Novelty P300 amplitude was largest in the amblyopic eye, followed by the fellow eye, and smallest in both eyes of amblyopia. Novelty P300 amplitude was larger in the amblyopic eye than non-dominant eye and was larger in fellow eye than dominant eye. P3b latency was longer in the amblyopic eye than in the fellow eye, both eyes of amblyopia and non-dominant eye of control. P3b latency was not associated with RT in amblyopia. Neural responses of the amblyopic eye are abnormal at the middle and late stages of cognitive processing, indicating that the amblyopic eye needs to spend more time or integrate more resources to process

  17. Occlusion therapy in amblyopia: an experience from Hong Kong.

    Science.gov (United States)

    Tang, Emily W H; Li, Brian C Y; Yeung, Ian Y L; Li, Kenneth K W

    2014-02-01

    OBJECTIVES. To review the results of patching for amblyopia management in Hong Kong. DESIGN. Retrospective case series. SETTING. Regional hospital, Hong Kong. PATIENTS. Records of all patients attending Paediatric Ophthalmology Clinic at United Christian Hospital, Hong Kong from 1 January 2009 to 31 March 2009 were retrospectively reviewed. Records of all children who underwent patching for amblyopia in the study period were evaluated. RESULTS. The mean age of 50 children (50 eyes) was 4 (standard deviation, 1; range, 2-7) years and mean pretreatment visual acuity was 0.35 (0.15; 0.02-0.63) [~20/60]. The values for mean, standard deviation, and range of treatment duration were 27, 16, 4-67 months respectively, and corresponding values for prescribed patching per day were 4, 1, 2-8 hours. The mean, standard deviation, and range of visual acuity at final post-treatment assessment were 0.66, 0.16, 0.1-1.0 (~20/30), respectively. The overall success rate (ie final visual acuity >0.7 or 20/30) was 62%. Children with moderate amblyopia (20/40-20/80) and severe amblyopia (20/100-20/400) had success rates of 74% and 55%, respectively. The mean visual acuity improvements for moderate and severely amblyopic children were 2.3 lines and 5.8 lines, respectively. The mean, standard deviation, and range of patching prescriptions for moderate and severely amblyopic children were 5, 1, 2-7 hours and 5, 1, 3-6 hours, respectively. Recurrence ensued in 7% of the children with moderate amblyopia and 46% of those with severe amblyopia. Reported compliance was good (>75% of the time) in 68% of the children. CONCLUSION. Occlusion therapy is the mainstay of treatment in Hong Kong. The overall success rate was comparable to that achieved in the Amblyopia Treatment Study. Recurrence was more common in patients with severe amblyopia, for whom maintenance therapy may reduce the risk of recurrence. The duration of treatment was much longer in our locality than in western countries. Reported

  18. [Learn new version of Preferred Practice Pattern to further standardize the diagnosis and treatment of amblyopia].

    Science.gov (United States)

    Zhao, Kanxing; Shi, Xuefeng

    2014-07-01

    The introduction of Preferred Practice Patterns (PPP) into China has given ophthalmologists in China more opportunities to acquaint themselves with international clinical guidelines for eye care, including its developing principles, methods and the application value. It had brought significant effects on the fast improvement of clinical eye care and standardization of diagnosis and treatment of eye diseases in China, and promoted the international academic exchanges. The 2nd Chinese version of PPPs translated by Prof. Jialiang Zhao was officially published in November, 2013. The new version of PPP for amblyopia adopted the newest standard for grading of evidence strength and recommendation assessment, and emphasizes the practicability based on evidence. New explanations of the definition of amblyopia are added according to the recent research progresses in amblyopia. The diagnostic criteria of best visual acuity for bilateral amblyopia at different ages is given with new specifications. Comprehensive and practical suggestions on the examination methods for amblyopia are provided from the qualitative assessment of visual acuity, the choice of eye chart, to the use of cycloplegic agents. In the aspect of the treatment of amblyopia, based on the findings of recent multi-central random controlled clinical trials, not only strong recommendations are provided, but also the insufficiency of evidence supporting for some choices of therapy is pointed out. The necessity of the follow-up evaluation after the cessation of the treatment of amblyopia is emphasized too. In the aspect of the prevention of amblyopia, the new amblyopia PPP points out the importance of the early-period screening of amblyopia, and that the healthcare insurance plans should cover timely screening, treatment, and monitoring for recurrence of amblyopia. This article deciphers the essential contents of the new version of Chinese PPP for amblyopia, and aims to promote the standardization of the diagnosis

  19. Amblyopia prevention screening program in Northwest Iran (Ardabil

    Directory of Open Access Journals (Sweden)

    Habib Ojaghi

    2016-01-01

    Conclusions: The present investigation showed that coverage of amblyopia screening program was not enough in Ardabil Province. To increase the screening accuracy, standard instruments and examination room must be used; more optometrists must be involved in this program and increasing the validity of obtained results for future programming.

  20. [Possibilities and limitations of amblyopia screening with auto-refractometers].

    Science.gov (United States)

    Ehrt, O

    2016-04-01

    Amblyopia is a frequent vision disorder with a prevalence of 3-6%, for which early treatment is more effective. More than half of the cases of amblyopia are due to refractive errors so that they are not obvious due to strabismus or other ocular abnormalities; therefore, examinations for early recognition are essential. Because no nationwide ophthalmological examination of infants with cycloplegia has been established in Germany, screening for refractive errors in the first 3 years of life could be very helpful. Only children with a very high risk of ametropia should be referred for a full ophthalmological and orthoptic assessment of cycloplegia in order to prevent excess prescription of eyeglasses. Mild amblyopia with a borderline refraction error can be more reliably detected with visual acuity tests at a later age of 3-4 years and still be treated successfully before entering school. Even with a good sensitivity and specificity of approximately 90%, refraction screening with handheld binocular video refractometers has a positive predictive value of 30%, which should be considered acceptable; however, screening with refractometers alone is insufficient to detect all types of amblyopia. Cataracts can easily be detected in >95% of patients but microstrabismus present, a full ophthalmological evaluation with cycloplegic refraction is necessary.

  1. Prevalence of amblyopia and refractive errors among primary school children

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    Zhale Rajavi

    2015-01-01

    Results: Amblyopia was present in 2.3% (95% CI: 1.8% to 2.9% of participants with no difference between the genders. Amblyopic subjects were significantly younger than non-amblyopic children (P=0.004. Overall, 15.9% of hyperopic and 5.9% of myopic cases had amblyopia. The prevalence of hyperopia ≥+2.00D, myopia ≤-0.50D, astigmatism ≥0.75D, and anisometropia (≥1.00D was 3.5%, 4.9%, 22.6%, and 3.9%, respectively. With increasing age, the prevalence of myopia increased (P<0.001, that of hyperopia decreased (P=0.007, but astigmatism showed no change. Strabismus was found in 2.3% of cases. Strabismus (OR=17.9 and refractive errors, especially anisometropia (OR=12.87 and hyperopia (OR=11.87, were important amblyogenic risk factors. Conclusion: The high prevalence of amblyopia in our subjects in comparison to developed countries reveals the necessity of timely and sensitive screening methods. Due to the high prevalence of amblyopia among children with refractive errors, particularly high hyperopia and anisometropia, provision of glasses should be specifically attended by parents and supported by the Ministry of Health and insurance organizations.

  2. Impaired temporal, not just spatial, resolution in amblyopia.

    Science.gov (United States)

    Spang, Karoline; Fahle, Manfred

    2009-11-01

    In amblyopia, neuronal deficits deteriorate spatial vision including visual acuity, possibly because of a lack of use-dependent fine-tuning of afferents to the visual cortex during infancy; but temporal processing may deteriorate as well. Temporal, rather than spatial, resolution was investigated in patients with amblyopia by means of a task based on time-defined figure-ground segregation. Patients had to indicate the quadrant of the visual field where a purely time-defined square appeared. The results showed a clear decrease in temporal resolution of patients' amblyopic eyes compared with the dominant eyes in this task. The extent of this decrease in figure-ground segregation based on time of motion onset only loosely correlated with the decrease in spatial resolution and spanned a smaller range than did the spatial loss. Control experiments with artificially induced blur in normal observers confirmed that the decrease in temporal resolution was not simply due to the acuity loss. Amblyopia not only decreases spatial resolution, but also temporal factors such as time-based figure-ground segregation, even at high stimulus contrasts. This finding suggests that the realm of neuronal processes that may be disturbed in amblyopia is larger than originally thought.

  3. Spatial-frequency dependent binocular imbalance in amblyopia.

    Science.gov (United States)

    Kwon, MiYoung; Wiecek, Emily; Dakin, Steven C; Bex, Peter J

    2015-11-25

    While amblyopia involves both binocular imbalance and deficits in processing high spatial frequency information, little is known about the spatial-frequency dependence of binocular imbalance. Here we examined binocular imbalance as a function of spatial frequency in amblyopia using a novel computer-based method. Binocular imbalance at four spatial frequencies was measured with a novel dichoptic letter chart in individuals with amblyopia, or normal vision. Our dichoptic letter chart was composed of band-pass filtered letters arranged in a layout similar to the ETDRS acuity chart. A different chart was presented to each eye of the observer via stereo-shutter glasses. The relative contrast of the corresponding letter in each eye was adjusted by a computer staircase to determine a binocular Balance Point at which the observer reports the letter presented to either eye with equal probability. Amblyopes showed pronounced binocular imbalance across all spatial frequencies, with greater imbalance at high compared to low spatial frequencies (an average increase of 19%, p imbalance may be useful for diagnosing amblyopia and as an outcome measure for recovery of binocular vision following therapy.

  4. Degraded attentional modulation of cortical neural populations in strabismic amblyopia.

    Science.gov (United States)

    Hou, Chuan; Kim, Yee-Joon; Lai, Xin Jie; Verghese, Preeti

    2016-01-01

    Behavioral studies have reported reduced spatial attention in amblyopia, a developmental disorder of spatial vision. However, the neural populations in the visual cortex linked with these behavioral spatial attention deficits have not been identified. Here, we use functional MRI-informed electroencephalography source imaging to measure the effect of attention on neural population activity in the visual cortex of human adult strabismic amblyopes who were stereoblind. We show that compared with controls, the modulatory effects of selective visual attention on the input from the amblyopic eye are substantially reduced in the primary visual cortex (V1) as well as in extrastriate visual areas hV4 and hMT+. Degraded attentional modulation is also found in the normal-acuity fellow eye in areas hV4 and hMT+ but not in V1. These results provide electrophysiological evidence that abnormal binocular input during a developmental critical period may impact cortical connections between the visual cortex and higher level cortices beyond the known amblyopic losses in V1 and V2, suggesting that a deficit of attentional modulation in the visual cortex is an important component of the functional impairment in amblyopia. Furthermore, we find that degraded attentional modulation in V1 is correlated with the magnitude of interocular suppression and the depth of amblyopia. These results support the view that the visual suppression often seen in strabismic amblyopia might be a form of attentional neglect of the visual input to the amblyopic eye.

  5. Temporal Ventriloquism Reveals Intact Audiovisual Temporal Integration in Amblyopia.

    Science.gov (United States)

    Richards, Michael D; Goltz, Herbert C; Wong, Agnes M F

    2018-02-01

    We have shown previously that amblyopia involves impaired detection of asynchrony between auditory and visual events. To distinguish whether this impairment represents a defect in temporal integration or nonintegrative multisensory processing (e.g., cross-modal matching), we used the temporal ventriloquism effect in which visual temporal order judgment (TOJ) is normally enhanced by a lagging auditory click. Participants with amblyopia (n = 9) and normally sighted controls (n = 9) performed a visual TOJ task. Pairs of clicks accompanied the two lights such that the first click preceded the first light, or second click lagged the second light by 100, 200, or 450 ms. Baseline audiovisual synchrony and visual-only conditions also were tested. Within both groups, just noticeable differences for the visual TOJ task were significantly reduced compared with baseline in the 100- and 200-ms click lag conditions. Within the amblyopia group, poorer stereo acuity and poorer visual acuity in the amblyopic eye were significantly associated with greater enhancement in visual TOJ performance in the 200-ms click lag condition. Audiovisual temporal integration is intact in amblyopia, as indicated by perceptual enhancement in the temporal ventriloquism effect. Furthermore, poorer stereo acuity and poorer visual acuity in the amblyopic eye are associated with a widened temporal binding window for the effect. These findings suggest that previously reported abnormalities in audiovisual multisensory processing may result from impaired cross-modal matching rather than a diminished capacity for temporal audiovisual integration.

  6. Neuroimaging of amblyopia and binocular vision: a review.

    Science.gov (United States)

    Joly, Olivier; Frankó, Edit

    2014-01-01

    Amblyopia is a cerebral visual impairment considered to derive from abnormal visual experience (e.g., strabismus, anisometropia). Amblyopia, first considered as a monocular disorder, is now often seen as a primarily binocular disorder resulting in more and more studies examining the binocular deficits in the patients. The neural mechanisms of amblyopia are not completely understood even though they have been investigated with electrophysiological recordings in animal models and more recently with neuroimaging techniques in humans. In this review, we summarize the current knowledge about the brain regions that underlie the visual deficits associated with amblyopia with a focus on binocular vision using functional magnetic resonance imaging. The first studies focused on abnormal responses in the primary and secondary visual areas whereas recent evidence shows that there are also deficits at higher levels of the visual pathways within the parieto-occipital and temporal cortices. These higher level areas are part of the cortical network involved in 3D vision from binocular cues. Therefore, reduced responses in these areas could be related to the impaired binocular vision in amblyopic patients. Promising new binocular treatments might at least partially correct the activation in these areas. Future neuroimaging experiments could help to characterize the brain response changes associated with these treatments and help devise them.

  7. Neuroimaging of amblyopia and binocular vision: a review

    Directory of Open Access Journals (Sweden)

    Olivier eJoly

    2014-08-01

    Full Text Available Amblyopia is a cerebral visual impairment considered to derive from abnormal visual experience (e.g., strabismus, anisometropia. Amblyopia, first considered as a monocular disorder, is now often seen as a primarily binocular disorder resulting in more and more studies examining the binocular deficits in the patients. The neural mechanisms of amblyopia are not completely understood even though they have been investigated with electrophysiological recordings in animal models and more recently with neuroimaging techniques in humans. In this review, we summarise the current knowledge about the brain regions that underlie the visual deficits associated with amblyopia with a focus on binocular vision using functional magnetic resonance imaging (fMRI. The first studies focused on abnormal responses in the primary and secondary visual areas whereas recent evidence show that there are also deficits at higher levels of the visual pathways within the parieto-occipital and temporal cortices. These higher level areas are part of the cortical network involved in 3D vision from binocular cues. Therefore, reduced responses in these areas could be related to the impaired binocular vision in amblyopic patients. Promising new binocular treatments might at least partially correct the activation in these areas. Future neuroimaging experiments could help to characterise the brain response changes associated with these treatments and help devise them.

  8. Amblyopia in astigmatic infants and toddlers.

    Science.gov (United States)

    Dobson, Velma; Harvey, Erin M; Clifford-Donaldson, Candice E; Green, Tina K; Miller, Joseph M

    2010-05-01

    To determine whether reduced astigmatism-corrected acuity for vertical (V) and/or horizontal (H) gratings and/or meridional amblyopia (MA) are present before 3 years of age in children who have with-the-rule astigmatism. Subjects were 448 children, 6 months through 2 years of age with no known ocular abnormalities other than with-the-rule astigmatism, who were recruited through Women, Infants and Children clinics on the Tohono O'odham reservation. Children were classified as non-astigmats (2.00 diopters) based on right eye non-cycloplegic autorefraction measurements (Welch Allyn SureSight). Right eye astigmatism-corrected grating acuity for V and H stimuli was measured using the Teller Acuity Card procedure while children wore cross-cylinder lenses to correct their astigmatism or plano lenses if they had no astigmatism. Astigmatism-corrected acuity for both V and H gratings was significantly poorer in the astigmats than in the non-astigmats, and the reduction in acuity for astigmats was present for children in all three age groups examined (6 months to <1 year, 1 to <2 years, and 2 to <3 years). There was no significant difference in V-H grating acuity (no evidence of MA) for the astigmatic group as a whole, or when data were analyzed for each age group. Even in the youngest age group, astigmats tested with astigmatism correction showed reduced acuity for both V and H gratings, which suggests that astigmatism is having a negative influence on visual development. We found no evidence of orientation-related differences in astigmatism-corrected grating acuity, indicating either that MA does not develop before 3 years of age, or that most of the astigmatic children had a type of astigmatism, i.e., hyperopic, that has proven to be less likely than myopic or mixed astigmatism to result in MA.

  9. Depth of suppression in anisometropic amblyopia (with or without microtropia).

    Science.gov (United States)

    Firth, Alison Y; Stevenson, Clare

    2012-01-01

    There are conflicting reports concerning the relationship between depth of suppression and level of amblyopia in strabismics. Little attention has been given to anisometropes. This study examines the density of suppression in anisometropic amblyopes, with or without microtropia, and investigates whether there is a relationship with level of amblyopia. Patients with anisometropia (defined as a difference of 1D or 0.5 D cyl), binocular single vision and a difference in corrected visual acuity of at least 0.1 logMAR between eyes were recalled. The degree of amblyopia was expressed as the interocular difference using the Bailey-Lovie logMAR chart. Stereoacuity (Titmus test), binocular alignment and fixation were recorded. The depth of suppression was measured using the neutral density filter bar together with the Worth four dot test at 4.5m (subtending an angle of 0.5 degrees). Best spherical equivalent (BSE) was calculated to represent anisometropia. Thirteen participants aged 8.3 years to 12.1 years (mean 9.7 years) completed the study. No significant correlation was present (r=0.10, p=0.74) between the depth of suppression and degree of amblyopia. However, there was a correlation between depth of suppression and level of stereoacuity (r=0.59, p=0.03). Six participants had microtropia and showed stronger suppression (p=0.03) and worse stereoacuity (p=0.001) than the pure anisometropes. No evidence was found of a relationship between density of suppression and amblyopia in this cohort of anisometropic amblyopes.

  10. Therapeutic effects of the smartphones and pads on hyperopia amblyopia of children

    OpenAIRE

    Ze-Hong Dong; Wei Zhao; Yu-Feng Ren; Xiao-Ni Yu; Xue-Ting Chen; Yu-Sheng Wang

    2017-01-01

    AIM: To evaluate the therapeutic effects of the fine sight training with the smartphones and pads on hyperopia amblyopia of children.METHODS: One hundred and twenty children(120 eyes)with hyperopia amblyopia were randomly divided into two groups in this prospective study. All the children in these two groups received the basic treatments of spectacle correction, penalization therapy and amblyopia trainings. The treatments of red-light blinking and grating as well as traditional fine sight tra...

  11. Binocular treatment of amblyopia using videogames (BRAVO): study protocol for a randomised controlled trial

    OpenAIRE

    Guo, Cindy X.; Babu, Raiju J.; Black, Joanna M.; Bobier, William R.; Lam, Carly S. Y.; Dai, Shuan; Gao, Tina Y.; Hess, Robert F.; Jenkins, Michelle; Jiang, Yannan; Kowal, Lionel; Parag, Varsha; South, Jayshree; Staffieri, Sandra Elfride; Walker, Natalie

    2016-01-01

    Background Amblyopia is a common neurodevelopmental disorder of vision that is characterised by visual impairment in one eye and compromised binocular visual function. Existing evidence-based treatments for children include patching the nonamblyopic eye to encourage use of the amblyopic eye. Currently there are no widely accepted treatments available for adults with amblyopia. The aim of this trial is to assess the efficacy of a new binocular, videogame-based treatment for amblyopia in older ...

  12. Pattern visual evoked potential as a predictor of occlusion therapy for amblyopia.

    Science.gov (United States)

    Chung, Woosuk; Hong, Samin; Lee, Jong Bok; Han, Sueng-Han

    2008-12-01

    This study was conducted to investigate the role of the pattern visual evoked potential (pVEP) as a predictor of occlusion therapy for patients with strabismic, anisometropic, and isometropic amblyopia. The secondary aim was to compare the characteristics of pVEP between strabismic and anisometropic amblyopia. This retrospective comparative case series included 120 patients who had received occlusion therapy or a glasses prescription for correction of strabismic, anisometropic, and isometropic amblyopia (20 patients had strabismic amblyopia, 41 patients had anisometropic amblyopia, and 59 patients had isometropic amblyopia). For each patient, the value of the P100 latency on pVEP at the time of the initial diagnosis of amblyopia was collected. Subsequently, the P100 latency was compared according to types of amblyopia. Fifty of 120 patients (7 patients with strabismic amblyopia, 21 patients with anisometropic amblyopia, and 22 patients with isometropic amblyopia) who were followed-up for longer than 6 months were divided into two groups based on the value of their P100 latency (Group 1, P100 latency 120 msec or less; Group 2, P100 latency longer than 120 msec.) The amount of visual improvement after occlusion therapy or glasses was compared between two study groups. The mean P100 latency was 119.7+/-25.2 msec in eyes with strabismic amblyopia and 111.9+/-17.8 msec in eyes with non-strabismic (anisometropic or isometropic) amblyopia (p=0.213). In Group 1, the mean visual improvement after occlusion therapy or glasses was 3.69+/-2.14 lines on Dr. Hahn's standard test chart; in Group 2, the mean improvement was 2.27+/-2.21 lines (p=0.023). The P100 latency on pVEP at the time of initial diagnosis was significantly related to the visual improvement after occlusion therapy or glasses in patients with strabismic, anisometropic, and isometropic amblyopia. Therefore, it was presumed that patients with a delayed P100 latency might have less visual improvement after

  13. Amblyopia and the binocular approach to its therapy.

    Science.gov (United States)

    Hess, Robert F; Thompson, Benjamin

    2015-09-01

    There is growing evidence that abnormal binocular interactions play a key role in amblyopia. In particular, stronger suppression of the amblyopic eye has been associated with poorer amblyopic eye visual acuity and a new therapy has been described that directly targets binocular function and has been found to improve both monocular and binocular vision in adults and children with amblyopia. Furthermore, non-invasive brain stimulation techniques that alter excitation and inhibition within the visual cortex have been shown to improve vision in the amblyopic eye. The aim of this review is to summarize this previous work and interpret the therapeutic effects of binocular therapy and non-invasive brain stimulation in the context of three potential neural mechanisms; active inhibition of signals from the amblyopic eye, attenuation of information from the amblyopic eye and metaplasticity of synaptic long term potentiation and long term depression. Copyright © 2015. Published by Elsevier Ltd.

  14. The Potential Cost-Effectiveness of Amblyopia Screening Programs

    Science.gov (United States)

    Rein, David B.; Wittenborn, John S.; Zhang, Xinzhi; Song, Michael; Saaddine, Jinan B.

    2013-01-01

    Background To estimate the incremental cost-effectiveness of amblyopia screening at preschool and kindergarten, we compared the costs and benefits of 3 amblyopia screening scenarios to no screening and to each other: (1) acuity/stereopsis (A/S) screening at kindergarten, (2) A/S screening at preschool and kindergarten, and (3) photoscreening at preschool and A/S screening at kindergarten. Methods We programmed a probabilistic microsimulation model of amblyopia natural history and response to treatment with screening costs and outcomes estimated from 2 state programs. We calculated the probability that no screening and each of the 3 interventions were most cost-effective per incremental quality-adjusted life year (QALY) gained and case avoided. Results Assuming a minimal 0.01 utility loss from monocular vision loss, no screening was most cost-effective with a willingness to pay (WTP) of less than $16,000 per QALY gained. A/S screening at kindergarten alone was most cost-effective between a WTP of $17,000 and $21,000. A/S screening at preschool and kindergarten was most cost-effective between a WTP of $22,000 and $75,000, and photoscreening at preschool and A/S screening at kindergarten was most cost-effective at a WTP greater than $75,000. Cost-effectiveness substantially improved when assuming a greater utility loss. All scenarios were cost-effective when assuming a WTP of $10,500 per case of amblyopia cured. Conclusions All 3 screening interventions evaluated are likely to be considered cost-effective relative to many other potential public health programs. The choice of screening option depends on budgetary resources and the value placed on monocular vision loss prevention by funding agencies. PMID:21877675

  15. Factors predicting recurrence in successfully treated cases of anisometropic amblyopia

    Directory of Open Access Journals (Sweden)

    Rohit Saxena

    2013-01-01

    Full Text Available Context: Recurrence after successful treatment of amblyopia is known and understanding the risk factors could help effective management. Aim: To measure incidence of recurrence in successfully treated cases of anisometropic amblyopia and evaluate factors predicting it. Settings and Design: Cohort Study at a tertiary level institution. Materials and Methods: Successfully treated anisometropic amblyopes aged 4−12 years were followed up for 1 year after stopping therapy. Best corrected visual acuity (BCVA, refractive error, stereoacuity and contrast sensitivity were evaluated at baseline and follow-up. Statistical Analysis: Intergroup analysis with appropriate tests: Chi-square test, Fisher′s exact test, Wilcoxon rank sum test and paired t-test. Results: One hundred and two patients with mean age at diagnosis 7.06 μ 1.81 years were followed-up for a mean duration of 1.0 μ 0.2 years. The mean pre-treatment BCVA (LogMAR score at diagnosis was 0.73 μ 0.36 units which improved to 0.20 μ 0.00 with treatment and after 1 year of stopping treatment was 0.22 μ 0.07. Thirteen (12.74% patients showed amblyopia recurrence during follow-up. Risk of recurrence was higher with older age of onset of treatment (6.64 μ 1.77 years without recurrence v/s 8.53 μ 1.39 years with recurrence, P = 0.0014. Greater extent of improvement of VA (P = 0.048 and final VA at stopping occlusion (P = 0.03 were associated with higher recurrence. Binocularity status or stereoacuity changes were not associated with risk of recurrence. Conclusions: Significant numbers of children suffer recurrence of amblyopia after stopping therapy. Older age, better BCVA after stopping therapy and greater magnitude of improvement in BCVA are important risk factors for recurrence. Careful follow-up is essential for early detection and management of recurrence.

  16. Latent stereopsis for motion in depth in strabismic amblyopia.

    Science.gov (United States)

    Hess, Robert F; Mansouri, Behzad; Thompson, Benjamin; Gheorghiu, Elena

    2009-10-01

    To investigate the residual stereo function of a group of 15 patients with strabismic amblyopia, by using motion-in-depth stimuli that allow discrimination of contributions from local disparity as opposed to those from local velocity mechanisms as a function of the rate of depth change. The stereo performance (percentage correct) was measured as a function of the rate of depth change for dynamic random dot stimuli that were either temporally correlated or uncorrelated. Residual stereoscopic function was demonstrated for motion in depth based on local disparity information in 2 of the 15 observers with strabismic amblyopia. The use of a neutral-density (ND) filter in front of the fixing eye enhanced motion-in-depth performance in four subjects randomly selected from the group that originally displayed only chance performance. This finding was true across temporal rate and for correlated and uncorrelated stimuli, suggesting that it was disparity based. The opposite occurred in a group of normal subjects. In a separate experiment, the hypothesis was that the beneficial effect of the ND filter is due to its contrast and/or mean luminance-reducing effects rather than any interocular time delay that it may introduce and that it is specific to motion-in-depth performance, as similar improvements were not found for static stereopsis. A small proportion of observers with strabismic amblyopia exhibit residual performance for motion in depth, and it is disparity based. Furthermore, some observers with strabismic amblyopia who do not display any significant stereo performance for motion in depth under normal binocular viewing may display above-chance stereo performance if the degree of interocular suppression is reduced. The authors term this phenomenon latent stereopsis.

  17. Factors predicting recurrence in successfully treated cases of anisometropic amblyopia

    Science.gov (United States)

    Saxena, Rohit; Puranik, Shraddha; Singh, Digvijay; Menon, Vimla; Sharma, Pradeep; Phuljhele, Swati

    2013-01-01

    Context: Recurrence after successful treatment of amblyopia is known and understanding the risk factors could help effective management. Aim: To measure incidence of recurrence in successfully treated cases of anisometropic amblyopia and evaluate factors predicting it. Settings and Design: Cohort Study at a tertiary level institution. Materials and Methods: Successfully treated anisometropic amblyopes aged 4−12 years were followed up for 1 year after stopping therapy. Best corrected visual acuity (BCVA), refractive error, stereoacuity and contrast sensitivity were evaluated at baseline and follow-up. Statistical Analysis: Intergroup analysis with appropriate tests: Chi-square test, Fisher's exact test, Wilcoxon rank sum test and paired t-test. Results: One hundred and two patients with mean age at diagnosis 7.06 ± 1.81 years were followed-up for a mean duration of 1.0 ± 0.2 years. The mean pre-treatment BCVA (LogMAR score) at diagnosis was 0.73 ± 0.36 units which improved to 0.20 ± 0.00 with treatment and after 1 year of stopping treatment was 0.22 ± 0.07. Thirteen (12.74%) patients showed amblyopia recurrence during follow-up. Risk of recurrence was higher with older age of onset of treatment (6.64 ± 1.77 years without recurrence v/s 8.53 ± 1.39 years with recurrence, P = 0.0014). Greater extent of improvement of VA (P = 0.048) and final VA at stopping occlusion (P = 0.03) were associated with higher recurrence. Binocularity status or stereoacuity changes were not associated with risk of recurrence. Conclusions: Significant numbers of children suffer recurrence of amblyopia after stopping therapy. Older age, better BCVA after stopping therapy and greater magnitude of improvement in BCVA are important risk factors for recurrence. Careful follow-up is essential for early detection and management of recurrence. PMID:24343594

  18. Binocular vision in amblyopia : structure, suppression and plasticity

    OpenAIRE

    Hess, Robert F; Thompson, Benjamin; Baker, Daniel Hart

    2014-01-01

    The amblyopic visual system was once considered to be structurally monocular. However, it now evident that the capacity for binocular vision is present in many observers with amblyopia. This has led to new techniques for quantifying suppression that have provided insights into the relationship between suppression and the monocular and binocular visual deficits experienced by amblyopes. Furthermore, new treatments are emerging that directly target suppressive interactions within the visual cor...

  19. Factors predicting recurrence in successfully treated cases of anisometropic amblyopia.

    Science.gov (United States)

    Saxena, Rohit; Puranik, Shraddha; Singh, Digvijay; Menon, Vimla; Sharma, Pradeep; Phuljhele, Swati

    2013-11-01

    Recurrence after successful treatment of amblyopia is known and understanding the risk factors could help effective management. To measure incidence of recurrence in successfully treated cases of anisometropic amblyopia and evaluate factors predicting it. Cohort Study at a tertiary level institution. Successfully treated anisometropic amblyopes aged 4-12 years were followed up for 1 year after stopping therapy. Best corrected visual acuity (BCVA), refractive error, stereoacuity and contrast sensitivity were evaluated at baseline and follow-up. Intergroup analysis with appropriate tests: Chi-square test, Fisher's exact test, Wilcoxon rank sum test and paired t-test. One hundred and two patients with mean age at diagnosis 7.06 μ 1.81 years were followed-up for a mean duration of 1.0 μ 0.2 years. The mean pre-treatment BCVA (LogMAR score) at diagnosis was 0.73 μ 0.36 units which improved to 0.20 μ 0.00 with treatment and after 1 year of stopping treatment was 0.22 μ 0.07. Thirteen (12.74%) patients showed amblyopia recurrence during follow-up. Risk of recurrence was higher with older age of onset of treatment (6.64 μ 1.77 years without recurrence v/s 8.53 μ 1.39 years with recurrence, P = 0.0014). Greater extent of improvement of VA (P = 0.048) and final VA at stopping occlusion (P = 0.03) were associated with higher recurrence. Binocularity status or stereoacuity changes were not associated with risk of recurrence. Significant numbers of children suffer recurrence of amblyopia after stopping therapy. Older age, better BCVA after stopping therapy and greater magnitude of improvement in BCVA are important risk factors for recurrence. Careful follow-up is essential for early detection and management of recurrence.

  20. Effectiveness of screening preschool children for amblyopia: a systematic review

    Directory of Open Access Journals (Sweden)

    Lange Stefan

    2009-07-01

    Full Text Available Abstract Background Amblyopia and amblyogenic factors like strabismus and refractive errors are the most common vision disorders in children. Although different studies suggest that preschool vision screening is associated with a reduced prevalence rate of amblyopia, the value of these programmes is the subject of a continuing scientific and health policy discussion. Therefore, this systematic review focuses on the question of whether screening for amblyopia in children up to the age of six years leads to better vision outcomes. Methods Ten bibliographic databases were searched for randomised controlled trials, non-randomised controlled trials and cohort studies with no limitations to a specific year of publication and language. The searches were supplemented by handsearching the bibliographies of included studies and reviews to identify articles not captured through our main search strategy. Results Five studies met the inclusion criteria. Of these, three studies suggested that screening is associated with an absolute reduction in the prevalence of amblyopia between 0.9% and 1.6% (relative reduction: between 45% and 62%. However, the studies showed weaknesses, limiting the validity and reliability of their findings. The main limitation was that studies with significant results considered only a proportion of the originally recruited children in their analysis. On the other hand, retrospective sample size calculation indicated that the power based on the cohort size was not sufficient to detect small changes between the groups. Outcome parameters such as quality of life or adverse effects of screening have not been adequately investigated in the literature currently available. Conclusion Population based preschool vision screening programmes cannot be sufficiently assessed by the literature currently available. However, it is most likely that the present systematic review contains the most detailed description of the main limitations in current

  1. Dichoptic training improves contrast sensitivity in adults with amblyopia.

    Science.gov (United States)

    Li, Jinrong; Spiegel, Daniel P; Hess, Robert F; Chen, Zidong; Chan, Lily Y L; Deng, Daming; Yu, Minbin; Thompson, Benjamin

    2015-09-01

    Dichoptic training is designed to promote binocular vision in patients with amblyopia. Initial studies have found that the training effects transfer to both binocular (stereopsis) and monocular (recognition acuity) visual functions. The aim of this study was to assess whether dichoptic training effects also transfer to contrast sensitivity (CS) in adults with amblyopia. We analyzed CS data from 30 adults who had taken part in one of two previous dichoptic training studies and assessed whether the changes in CS exceeded the 95% confidence intervals for change based on test-retest data from a separate group of observers with amblyopia. CS was measured using Gabor patches (0.5, 3 and 10cpd) before and after 10days of dichoptic training. Training was delivered using a dichoptic video game viewed through video goggles (n=15) or on an iPod touch equipped with a lenticular overlay screen (n=15). In the iPod touch study, training was combined with anodal transcranial direct current stimulation of the visual cortex. We found that dichoptic training significantly improved CS across all spatial frequencies tested for both groups. These results suggest that dichoptic training modifies the sensitivity of the neural systems that underpin monocular CS. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Improved Binocular Outcomes Following Binocular Treatment for Childhood Amblyopia.

    Science.gov (United States)

    Kelly, Krista R; Jost, Reed M; Wang, Yi-Zhong; Dao, Lori; Beauchamp, Cynthia L; Leffler, Joel N; Birch, Eileen E

    2018-03-01

    Childhood amblyopia can be treated with binocular games or movies that rebalance contrast between the eyes, which is thought to reduce depth of interocular suppression so the child can experience binocular vision. While visual acuity gains have been reported following binocular treatment, studies rarely report gains in binocular outcomes (i.e., stereoacuity, suppression) in amblyopic children. Here, we evaluated binocular outcomes in children who had received binocular treatment for childhood amblyopia. Data for amblyopic children enrolled in two ongoing studies were pooled. The sample included 41 amblyopic children (6 strabismic, 21 anisometropic, 14 combined; age 4-10 years; ≤4 prism diopters [PD]) who received binocular treatment (20 game, 21 movies; prescribed 9-10 hours treatment). Amblyopic eye visual acuity and binocular outcomes (Randot Preschool Stereoacuity, extent of suppression, and depth of suppression) were assessed at baseline and at 2 weeks. Mean amblyopic eye visual acuity (P suppression (P = 0.003) were reduced from baseline at the 2-week visit (87% game adherence, 100% movie adherence). Depth of suppression was reduced more in children aged suppression was correlated with a larger depth of suppression reduction at 2 weeks (P = 0.001). After 2 weeks, binocular treatment in amblyopic children improved visual acuity and binocular outcomes, reducing the extent and depth of suppression and improving stereoacuity. Binocular treatments that rebalance contrast to overcome suppression are a promising additional option for treating amblyopia.

  3. The neural basis of suppression and amblyopia in strabismus.

    Science.gov (United States)

    Sengpiel, F; Blakemore, C

    1996-01-01

    The neurophysiological consequences of artificial strabismus in cats and monkeys have been studied for 30 years. However, until very recently no clear picture has emerged of neural deficits that might account for the powerful interocular suppression that strabismic humans experience, nor for the severe amblyopia that is often associated with convergent strabismus. Here we review the effects of squint on the integrative capacities of the primary visual cortex and propose a hypothesis about the relationship between suppression and amblyopia. Most neurons in the visual cortex of normal cats and monkeys can be excited through either eye and show strong facilitation during binocular stimulation with contours of similar orientation in the two eyes. But in strabismic animals, cortical neurons tend to fall into two populations of monocularly excitable cells and exhibit suppressive binocular interactions that share key properties with perceptual suppression in strabismic humans. Such interocular suppression, if prolonged and asymmetric (with input from the squinting eye habitually suppressed by that from the fixating eye), might lead to neural defects in the representation of the deviating eye and hence to amblyopia.

  4. Perceptual learning improves visual performance in juvenile amblyopia.

    Science.gov (United States)

    Li, Roger W; Young, Karen G; Hoenig, Pia; Levi, Dennis M

    2005-09-01

    To determine whether practicing a position-discrimination task improves visual performance in children with amblyopia and to determine the mechanism(s) of improvement. Five children (age range, 7-10 years) with amblyopia practiced a positional acuity task in which they had to judge which of three pairs of lines was misaligned. Positional noise was produced by distributing the individual patches of each line segment according to a Gaussian probability function. Observers were trained at three noise levels (including 0), with each observer performing between 3000 and 4000 responses in 7 to 10 sessions. Trial-by-trial feedback was provided. Four of the five observers showed significant improvement in positional acuity. In those four observers, on average, positional acuity with no noise improved by approximately 32% and with high noise by approximately 26%. A position-averaging model was used to parse the improvement into an increase in efficiency or a decrease in equivalent input noise. Two observers showed increased efficiency (51% and 117% improvements) with no significant change in equivalent input noise across sessions. The other two observers showed both a decrease in equivalent input noise (18% and 29%) and an increase in efficiency (17% and 71%). All five observers showed substantial improvement in Snellen acuity (approximately 26%) after practice. Perceptual learning can improve visual performance in amblyopic children. The improvement can be parsed into two important factors: decreased equivalent input noise and increased efficiency. Perceptual learning techniques may add an effective new method to the armamentarium of amblyopia treatments.

  5. Rapid, high-accuracy detection of strabismus and amblyopia using the pediatric vision scanner

    NARCIS (Netherlands)

    S.E. Loudon (Sjoukje); C.A. Rook (Caitlin); D.S. Nassif (Deborah); N.V. Piskun (Nadya); D.G. Hunter (David)

    2011-01-01

    textabstractPurpose. The Pediatric Vision Scanner (PVS) detects strabismus by identifying ocular fixation in both eyes simultaneously. This study was undertaken to assess the ability of the PVS to identify patients with amblyopia or strabismus, particularly anisometropic amblyopia with no measurable

  6. Extended Daily Eye Patching Effective at Treating Stubborn Amblyopia in Children

    Science.gov (United States)

    ... Spanish Spanish Stargardt Disease Stem Cells Usher Syndrome Uveitis/Inflammatory Eye Disease Vision Screening World Sight Day Extended daily eye patching effective at treating stubborn amblyopia in children News Brief 09/20/13 The standard treatment for amblyopia, a condition of poor vision in ...

  7. Part-time vs. full-time occlusion for amblyopia: evidence for part-time patching.

    Science.gov (United States)

    Matta, Noelle S; Silbert, David I

    2013-01-01

    Amblyopia is characterized by a decreased uncorrectable visual acuity in a structurally normal eye. Occlusion therapy has been used for years to improve acuity, and, traditionally, practitioners have utilized full-time patching. This article will explore more recent research looking at using part-time patching in the treatment of amblyopia.

  8. Efficiency of occlusion therapy for management of amblyopia in older children.

    Science.gov (United States)

    Brar, Gagandeep S; Bandyopadhyay, Supratik; Kaushik, Sushmita; Raj, Surishti

    2006-12-01

    To analyse results of full time occlusion therapy for amblyopia in children older than 6 years. This was a retrospective consecutive case series analysis of children treated for amblyopia at a tertiary care center. All children received full time occlusion (FTO) for the dominant eye. Eighty-eight children older than 6 years at the time of initiation of therapy were included. Age at initiation of therapy ranged from 6 to 20 years (9.45 +/- 3.11 years). Forty-two children (47.7%) had strabismic amblyopia, 37 (42.0%) had anisometropic amblyopia and 9 (10.2%) had a combination of strabismic and anisometropic amblyopia. Eighty out of 88 eyes (90.0%) had improvement in visual acuity following FTO. Visual acuity (VA) improved from 0.82 +/- 0.34 at presentation to 0.42 +/- 0.34 (P amblyopia, VA improved from 0.81 +/- 0.42 to 0.42 +/- 0.39 (P amblyopia, visual acuity of the amblyopic eye improved fron 0.82 +/- 0.24 to 0.36 +/- 0.29 (Pocclusion was 8.37 +/- 1.78 months. Occlusion therapy yields favorable results in strabismic and/or anisometropic amblyopia, even when initiated for the first time after 6 years of age. After 12 years of age, some children may still respond to occlusion of the dominant eye.

  9. Factors affecting the stability of visual function following cessation of occlusion therapy for amblyopia.

    Science.gov (United States)

    Tacagni, Daniel J; Stewart, Catherine E; Moseley, Merrick J; Fielder, Alistair R

    2007-06-01

    To identify factors that predict which children with amblyopia are at greatest risk of regression of visual acuity (VA) following the cessation of occlusion therapy. A retrospective analysis was performed of 182 children (mean age at cessation of treatment; 5.9+/-1.6 years) who had undergone occlusion therapy for unilateral amblyopia, and had been followed up at least once within 15 months of cessation. Statistical analysis was used to identify whether change in VA following treatment cessation had any association with various factors, including the child's age, type of amblyopia, degree of anisometropia, initial severity of amblyopia, binocular vision status, length and dose of occlusion therapy, and VA response to treatment. At 1 year, follow-up from treatment cessation, children with "mixed" amblyopia (both anisometropia and strabismus) demonstrated significantly (p=0.03) greater deterioration in VA (0.11+/-0.11 log units) than children with only anisometropia (0.02+/-0.08 log units) or only strabismus (0.05+/-0.10 log units). However, none of the other factors investigated were found to be significant predictors. This study supports previous research that it is possible to identify those children most at risk of deterioration in VA following cessation of occlusion therapy. The presence of mixed amblyopia was the only risk factor identified in this study. Management of amblyopia should take this into account, with a more intensive follow-up recommended for those with both anisometropia and strabismus (mixed) amblyopia.

  10. Evaluation of Occlusion Treatment Outcomes for Unilateral Amblyopia Using Different Definitions of Outcome.

    Science.gov (United States)

    Su, Liping; Yan, Hong; Xing, Yongxin; Zhang, Yuhai; Zhu, Baoyi

    2016-01-01

    We studied 87 cases of children aged 3 to 10 with unilateral amblyopia (with types of anisometropia, strabismus, or both) who received good recovery after occlusion therapy. The proportional improvement had moderate positive correlation with amblyopic eye improvement (p amblyopia (p amblyopia residual had no correlation with amblyopic eye improvement (p occlusion therapy group displayed the best outcome (p amblyopia eye and residual amblyopia are simple and direct indicators for clinical application. The proportion of the deficit-corrected method should be graded as the proportion of change in visual acuity with respect to the absolute potential for improvement, and these optimum outcomes can provide powerful evidence for good therapeutic effect.

  11. [See the strabismus and amblyopia research development trend from the twelfth World Congress of strabismus].

    Science.gov (United States)

    Zhao, Kanxing; Kang, Xiaoli; Liu, Hu; Wei, Yan

    2015-06-01

    The International strabismus association conference has a history of fifty years until now. It's the most influential academic communication forum for the worldwide doctors and related scientists or technical carers in strabismus and amblyopia area. The conference gathered the top-level experts. The latest clinical/research achievements of strabismus, amblyopia in the field of binocular vision and ocular motility have been showed. The breakthroughs in the etiology study of incomitant strabismus have been and are being transformed into new therapeutic concepts and techniques. Re-adjust the competition between dominant and amblyopic eye using binocular stimulation methods may overcome the existing defects of monocular occlusion therapy, expand new interventional methods to treat amblyopia, and represent the future trends of amblyopia therapy. In this paper, we will introduce the main contents of the XII ISA meeting and spread knowledge of strabismus/amblyopia promoting directions in order to provide reference ideas for the clinicians and research colleagues in this field.

  12. Congenital eyelid ptosis: onset and prevalence of amblyopia, associations with systemic disorders, and treatment outcomes.

    Science.gov (United States)

    Stein, August; Kelly, John P; Weiss, Avery H

    2014-10-01

    To determine the age at onset of amblyopia, the response to occlusion therapy, and the association with systemic disorders in children with congenital eyelid ptosis. Retrospective chart review of children seen at Seattle Children's Hospital with moderate or severe congenital ptosis. Assessments were longitudinal visual acuity development using objective methods, definition of ptosis severity by eyelid margin to pupillary light reflex distance (margin reflex distance [MRD]), age at amblyopia diagnosis, correlation between amblyopia and MRD, and associated systemic disorders. Eighty-four children with moderate-to-severe congenital ptosis met inclusion criteria; the mean longitudinal follow-up was 49.1 months. Fifteen (18%) of these children had amblyopia, of which 9 had deprivation amblyopia (mean age 17.3 months ± 11.2) and 6 had anisometropic or strabismic amblyopia (mean age 60 months ± 11.8). Eleven (73%) of the children with amblyopia were successfully treated with occlusion therapy. Amblyopia was not correlated with MRD. A systemic disorder was identified in 29 (35%) of the children, the most common being genetic, chromosomal, or neurologic conditions. Patients with systemic disorders and developmental delay have significantly lower visual acuity bilaterally compared with patients without systemic disorders (P ≤ .003). Using longitudinal and objective visual acuity assessments, the incidence of amblyopia was 18% in children with moderate to severe congenital ptosis. Visual deprivation was the predominant risk factor that was reliably distinguished by its earlier onset in young children. The best indicator of amblyopia in children is visual acuity rather than MRD measurements. Systemic disorders are frequent in children with moderate to severe congenital ptosis. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. The effect of occlusion therapy on motion perception deficits in amblyopia.

    Science.gov (United States)

    Giaschi, Deborah; Chapman, Christine; Meier, Kimberly; Narasimhan, Sathyasri; Regan, David

    2015-09-01

    There is growing evidence for deficits in motion perception in amblyopia, but these are rarely assessed clinically. In this prospective study we examined the effect of occlusion therapy on motion-defined form perception and multiple-object tracking. Participants included children (3-10years old) with unilateral anisometropic and/or strabismic amblyopia who were currently undergoing occlusion therapy and age-matched control children with normal vision. At the start of the study, deficits in motion-defined form perception were present in at least one eye in 69% of the children with amblyopia. These deficits were still present at the end of the study in 55% of the amblyopia group. For multiple-object tracking, deficits were present initially in 64% and finally in 55% of the children with amblyopia, even after completion of occlusion therapy. Many of these deficits persisted in spite of an improvement in amblyopic eye visual acuity in response to occlusion therapy. The prevalence of motion perception deficits in amblyopia as well as their resistance to occlusion therapy, support the need for new approaches to amblyopia treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Binocular iPad treatment for amblyopia in preschool children.

    Science.gov (United States)

    Birch, Eileen E; Li, Simone L; Jost, Reed M; Morale, Sarah E; De La Cruz, Angie; Stager, David; Dao, Lori; Stager, David R

    2015-02-01

    Recent experimental evidence supports a role for binocular visual experience in the treatment of amblyopia. The purpose of this study was to determine whether repeated binocular visual experience with dichoptic iPad games could effectively treat amblyopia in preschool children. A total of 50 consecutive amblyopic preschool children 3-6.9 years of age were assigned to play sham iPad games (first 5 children) or binocular iPad games (n = 45) for at least 4 hours per week for 4 weeks. Thirty (67%) children in the binocular iPad group and 4 (80%) in the sham iPad group were also treated with patching at a different time of day. Visual acuity and stereoacuity were assessed at baseline, at 4 weeks, and at 3 months after the cessation of game play. The sham iPad group had no significant improvement in visual acuity (t4 = 0.34, P = 0.75). In the binocular iPad group, mean visual acuity (plus or minus standard error) improved from 0.43 ± 0.03 at baseline to 0.34 ± 0.03 logMAR at 4 weeks (n = 45; paired t44 = 4.93; P iPad games for ≥8 hours (≥50% compliance) had significantly more visual acuity improvement than children who played 0-4 hours (t43 = 4.21, P = 0.0001). Repeated binocular experience, provided by dichoptic iPad game play, was more effective than sham iPad game play as a treatment for amblyopia in preschool children. Copyright © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  15. The effect of amblyopia on fine motor skills in children.

    Science.gov (United States)

    Webber, Ann L; Wood, Joanne M; Gole, Glen A; Brown, Brian

    2008-02-01

    In an investigation of the functional impact of amblyopia in children, the fine motor skills of amblyopes and age-matched control subjects were compared. The influence of visual factors that might predict any decrement in fine motor skills was also explored. Vision and fine motor skills were tested in a group of children (n = 82; mean age, 8.2 +/- 1.7 [SD] years) with amblyopia of different causes (infantile esotropia, n = 17; acquired strabismus, n = 28; anisometropia, n = 15; mixed, n = 13; and deprivation n = 9), and age-matched control children (n = 37; age 8.3 +/- 1.3 years). Visual motor control (VMC) and upper limb speed and dexterity (ULSD) items of the Bruininks-Oseretsky Test of Motor Proficiency were assessed, and logMAR visual acuity (VA) and Randot stereopsis were measured. Multiple regression models were used to identify the visual determinants of fine motor skills performance. Amblyopes performed significantly poorer than control subjects on 9 of 16 fine motor skills subitems and for the overall age-standardized scores for both VMC and ULSD items (P multiple regression model that took into account the intercorrelation between visual characteristics, poorer fine motor skills performance was associated with strabismus (F(1,75) = 5.428; P = 0.022), but not with the level of binocular function, refractive error, or visual acuity in either eye. Fine motor skills were reduced in children with amblyopia, particularly those with strabismus, compared with control subjects. The deficits in motor performance were greatest on manual dexterity tasks requiring speed and accuracy.

  16. Clinical Course and Response to Therapy in Different Types of Amblyopia

    Directory of Open Access Journals (Sweden)

    Reşat Duman

    2013-10-01

    Full Text Available Purpose: We aimed to compare the demographic features, visual acuities before and after treatment, amblyopia and strabismus degrees and binocular visual functions in cases with anisometropic, strabismic and/or anisometropic amblyopia. Material and Method: The study included 50 anisometropic, 50 strabismic and 50 anisometropic and strabismic cases that were followed up with the diagnosis of amblyopia, in our clinic, between January 2007 - September 2010. Amblyopia criteria was defined as the best corrected visual acuity of ≤0.8 and at least 2 lines difference between the visual acuities of two eyes. Anisometropia was defined as ≥1D difference in the spherical and cylindrical value between two eyes. Results: The groups were statistically similar in means of age and sex distribution. Visual acuities in amblyopic eyes before and after treatment were also statistically similar. There were no significant difference between 3 groups in means of compliance to occlusion therapy. In anisometropic cases, anisometropic spherical values were found to have position correlation with amblyopia degree. In hypermetropic and myopic cases, a strong correlation was shown between anisometropia and amblyopia, especially in hypermetropic cases, amblyopia degree increased as the anisometropia increased. In all strabismus cases, a positive correlation between strabismus and amblyopia degrees was shown even though it was statistically insignificant. In strabismic cases, esotropia was significantly higher than exotropia. In anisometropia group, stereopsis and fusion was found to be preserved better in comparison to the strabismic cases. It was concluded that deviation had a more profound effect on binocular function loss than anisometropia. Discussion: We recommend to follow the hypermetropic anisometropic cases and especially cases with high degree strabismus and esotropia more closely. And also we emphasize that strabismus affects binocular function loss more than

  17. Study of the perception of visual motion in amblyopia using functional MRI

    International Nuclear Information System (INIS)

    Lu Guangming; Zhang Zhiqiang; Zhou Wenzhen; Zheng Ling; Yin Jie; Liang Ping

    2006-01-01

    Objective: To research the pathophysiological mechanism of anisometropic and strabismic amblyopia through observation of the cortex activation under the stimulus of visual motion using functional MRI (fMRI). Methods: Seven patients with anisometropic amblyopia and 10 patients with strabismic amblyopia were examined under the stimulus with the paradigm that task and control states were rotating and stationary grating with 1.5 T MR scanners. The data were processed using software of SPM offline, and the result was analyzed with single subject. An index of interocular difference of activation (IDA) was set for Mann-Whitney rank sum test to denote the extension of difference between activation of each eye. Results: There appeared activation on bilaterally occipital lobe in both group of amblyopia patients. There was mild activation on frontal lobe when amblyopic eyes were stimulated, but no activation when sound eyes. The MT area was regarded as region of interesting when analyzed, the activation of all sound eyes was stronger than amblyopic eyes in 7 anisometropic amblyopia patients. There were 5 patients whose level of activation of amblyopic eye's were lower than sound eye, and four were higher than sound eye, among the strabismic amblyopia patients except one patient's activation was none. There was statistical difference between IDA value of two groups (Z=2.382, P=0.017). Conclusion: There are more cortex areas activated of amblyopic eye than sound eye when single eye is stimulated. The function of visual motion maybe has been affected in anisometropic amblyopia. In strabismic amblyopia, the function of visual motion may relate to the underlying mechanism of strabismic, which suggests, as for the impairment of perception of visual motion, there is difference between two types of amblyopia. (authors)

  18. Visual functions and interocular interactions in anisometropic children with and without amblyopia.

    Science.gov (United States)

    Lai, Xin Jie; Alexander, Jack; He, Mingguang; Yang, Zhikuan; Suttle, Catherine

    2011-08-29

    In uncorrected anisometropia, protracted dichoptic stimulation may result in interocular inhibition, which may be a contributing factor in amblyopia development. This study investigates the relationship between interocular interactions and anisometropic amblyopia. Three visual functions (low-contrast acuity, contrast sensitivity, and alignment sensitivity) were measured in the nondominant eye of 44 children aged 5 to 11 years: 10 with normal vision, 17 with anisometropia without amblyopia, and 17 with anisometropic amblyopia. The dominant eye was either fully or partially occluded. The difference in nondominant eye visual function between the full-and partial-occlusion conditions was termed the interaction index. The index of each visual function was compared between subject groups. A higher index indicates stronger inhibition of nondominant eye function with partial occlusion of the dominant eye. Amblyopic children had 6 months of therapy (refractive correction and occlusion), and the reduction in interocular difference in high-contrast acuity was regarded as the treatment outcome. The relationships of the interaction index with the degree of anisometropia, the severity of amblyopia, and the treatment outcomes were examined. The acuity interaction index was significantly higher in anisometropic children with amblyopia than in those without (P = 0.003). It was positively correlated with the degree of anisometropia (r(s) = 0.35, P = 0.042) and the amblyopic treatment outcomes (r(s) = 0.54, P = 0.038). No such difference or association was found between the contrast sensitivity or alignment sensitivity interaction index and anisometropic amblyopia. Interocular interactions are associated with amblyopia, the degree of anisometropia, and amblyopia treatment outcomes, but these associations are visual function dependent.

  19. [Visual development and amblyopia prophylaxis in pediatric glaucoma].

    Science.gov (United States)

    Steffen, H

    2011-07-01

    In children with congenital glaucoma the functional long-term result is often disappointing even if the intraocular pressure is well controlled. The reason for this discrepancy is attributed to amblyogenic factors responsible for interfering with normal visual development. These amblyogenic factors are corneal edema, irregular astigmatism and non-corrected ametropia as monocular causes. Binocular causes are anisometropia-induced suppression and strabismus. Full ametropic correction and a very early prophylaxis and treatment of amblyopia with a close follow-up are mandatory to reduce amblyogenic visual impairment in children with congenital glaucoma.

  20. The prevalence of amblyopia in Germany: data from the prospective, population-based Gutenberg Health Study.

    Science.gov (United States)

    Elflein, Heike M; Fresenius, Susanne; Lamparter, Julia; Pitz, Susanne; Pfeiffer, Norbert; Binder, Harald; Wild, Philipp; Mirshahi, Alireza

    2015-05-08

    Amblyopia is due to insufficient development of the visual system in early childhood and is a major source of lifelong impairment of visual acuity. Too little is known about the prevalence of amblyopia in Germany and the frequency of its various causes. The Gutenberg Health Study of the University of Mainz Faculty of Medicine is an ongoing population-based, prospective, monocentric cohort study with 15 010 participants aged 35 to 74. All participants are examined for the presence of ocular, cardiovascular, neoplastic, metabolic, immunologic, and mental diseases. 3227 participants aged 35 to 44 underwent ophthalmological examination from 2007 to 2012. Amblyopia was defined as impaired visual acuity in the absence of any organic pathology capable of explaining the condition, and in the presence of a known risk factor for amblyopia. Amblyopia, when defined as a visual acuity less than or equal to 0.63, was present in 182 participants (5.6%, 95% confidence interval [CI] 4.9-6.5%), 120 of whom had a visual acuity less than or equal to 0.5 (3.7%, 95% CI 3.3-5.2%). A narrower definition of amblyopia requiring, in addition, an interocular difference in acuity of at least two lines yielded slightly lower prevalence figures: 5.0% (95% CI 4.2-5.8%) and 3.7% (95% CI 3.1-4.4%), respectively. The causes of amblyopia (visual acuity ≤ 0.63) were anisometropia (different refractive strengths of the two eyes) in 49% of participants, strabismus (a squint) in 23%, both of these factors in 17%, and visual deprivation in 2%. 3 patients (2%) had relative amblyopia due to a traumatic cataract sustained in early childhood. 7% of the participants with amblyopia had binocular amblyopia. This study yielded a prevalence figure of 5.6% for amblyopia in Germany-a higher figure than in other, comparable population-based studies, which have generally yielded figures of ca. 3% for visual acuity ≤ 0.63. The distribution of the causes of amblyopia is similar across studies.

  1. [A new hypothesis for the treatment of amblyopia: the flicker stimulator].

    Science.gov (United States)

    Parrozzani, A; Fedriga, P; Ferrari, E; De Vincentiis, L

    1984-01-01

    A variety of cells are involved in the pathogenesis of amblyopia : ON, OFF, ON-OFF cells, postsynaptic cells, neurons of striate cortex and the select interest of the macula. The need for stimulation of these cells in treating amblyopia forms the theoretical basis of the Flicker stimulator with red monochromatic light (LED, 655 nm). The authors present a clinical investigation on 35 subjects with anisometropic or strabismic amblyopia, before extensive treatment with classic anti-amblyopic techniques without satisfactory improvement obtaining significant statistical results (p less than 0,001).

  2. Neuroplasticity and amblyopia: vision at the balance point.

    Science.gov (United States)

    Tailor, Vijay K; Schwarzkopf, D Samuel; Dahlmann-Noor, Annegret H

    2017-02-01

    New insights into triggers and brakes of plasticity in the visual system are being translated into new treatment approaches which may improve outcomes not only in children, but also in adults. Visual experience-driven plasticity is greatest in early childhood, triggered by maturation of inhibitory interneurons which facilitate strengthening of synchronous synaptic connections, and inactivation of others. Normal binocular development leads to progressive refinement of monocular visual acuity, stereoacuity and fusion of images from both eyes. At the end of the 'critical period', structural and functional brakes such as dampening of acetylcholine receptor signalling and formation of perineuronal nets limit further synaptic remodelling. Imbalanced visual input from the two eyes can lead to imbalanced neural processing and permanent visual deficits, the commonest of which is amblyopia. The efficacy of new behavioural, physical and pharmacological interventions aiming to balance visual input and visual processing have been described in humans, and some are currently under evaluation in randomised controlled trials. Outcomes may change amblyopia treatment for children and adults, but the safety of new approaches will need careful monitoring, as permanent adverse events may occur when plasticity is re-induced after the end of the critical period.Video abstracthttp://links.lww.com/CONR/A42.

  3. A binocular approach to treating amblyopia: antisuppression therapy.

    Science.gov (United States)

    Hess, Robert F; Mansouri, Behzad; Thompson, Benjamin

    2010-09-01

    We developed a binocular treatment for amblyopia based on antisuppression therapy. A novel procedure is outlined for measuring the extent to which the fixing eye suppresses the fellow amblyopic eye. We hypothesize that suppression renders a structurally binocular system, functionally monocular. We demonstrate using three strabismic amblyopes that information can be combined normally between their eyes under viewing conditions where suppression is reduced. Also, we show that prolonged periods of viewing (under the artificial conditions of stimuli of different contrast in each eye) during which information from the two eyes is combined leads to a strengthening of binocular vision in such cases and eventual combination of binocular information under natural viewing conditions (stimuli of the same contrast in each eye). Concomitant improvement in monocular acuity of the amblyopic eye occurs with this reduction in suppression and strengthening of binocular fusion. Furthermore, in each of the three cases, stereoscopic function is established. This provides the basis for a new treatment of amblyopia, one that is purely binocular and aimed at reducing suppression as a first step.

  4. Interocular suppression in amblyopia for global orientation processing.

    Science.gov (United States)

    Zhou, Jiawei; Huang, Pi-Chun; Hess, Robert F

    2013-04-22

    We developed a dichoptic global orientation coherence paradigm to quantify interocular suppression in amblyopia. This task is biased towards ventral processing and allows comparison with two other techniques-global motion processing, which is more dorsally biased, and binocular phase combination, which most likely reflects striate function. We found a similar pattern for the relationship between coherence threshold and interocular contrast curves (thresholds vs. interocular contrast ratios or TvRs) in our new paradigm compared with those of the previous dichoptic global motion coherence paradigm. The effective contrast ratios at balance point (where the signals from the two eyes have equal weighting) in our new paradigm were larger than those of the dichoptic global motion coherence paradigm but less than those of the binocular phase combination paradigm. The measured effective contrast ratios in the three paradigms were also positively correlated with each other, with the two global coherence paradigms having the highest correlation. We concluded that: (a) The dichoptic global orientation coherence paradigm is effective in quantifying interocular suppression in amblyopia; and (b) Interocular suppression, while sharing a common suppression mechanism at the early stage in the pathway (e.g., striate cortex), may have additional extra-striate contributions that affect both dorsal and ventral streams differentially.

  5. Use of video games for the treatment of amblyopia.

    Science.gov (United States)

    Foss, Alexander J E

    2017-05-01

    To review the literature up to recent for the use of videos, videogames and dichoptic stimulation as a treatment for amblyopia. There have been three strategies explored. The first is to use videos and videogames monocularly with the normal eye covered. The second is dichoptic stimulation with a common background presented to both eyes and an enriched foreground to the amblyopic eye. The third are games specifically designed to generate stereopsis. Most work has focused on the second of these approaches but both of the first two approaches seem to give a similar improvement of 0.1-0.2 logMAR. One large randomized control trial (RCT) has published showing that dichoptic stimulation is not inferior to patching but no evidence that it was superior. It also showed that video games have their own compliance problems and a second smaller RCT did suggest that videogames, with a game designed by a gaming company, was superior. Most of the work done has had methodological issues and should be considered exploratory rather than definitive. Dichoptic stimulation is a viable treatment option for the treatment of amblyopia. The first trial results have shown results that are not superior to patching but they are not without methodological issues. There is sufficient encouragement to justify further research in this area.

  6. Risk factors for treatment failure and recurrence of anisometropic amblyopia.

    Science.gov (United States)

    Kirandi, Ece Uzun; Akar, Serpil; Gokyigit, Birsen; Onmez, Funda Ebru Aksoy; Oto, Sibel

    2017-08-01

    The aim of this study was to identify factors associated with failed vision improvement and recurrence following occlusion therapy for anisometropic amblyopia in children aged 7-9 years. We retrospectively reviewed the medical records of 64 children aged 7-9 years who had been diagnosed as having anisometropic amblyopia and were treated with patching. Functional treatment failure was defined as final visual acuity in the amblyopic eye of worse than 20/32. Improvement of fewer than two logMAR lines was considered relative treatment failure. Recurrence was defined as the reduction of at least two logMAR levels of visual acuity after decreased or discontinued patching. Functional and relative success rates were 51.6 and 62.5 %, respectively. The most important factor for functional treatment failure [adjusted odds ratio (OR) (95 % confidence interval, CI) 11.57 (1.4-95.74)] and the only risk factor for recurrence [adjusted OR (95 % CI) 3.04 (1.13-8.12)] were the same: high spherical equivalent (SE) of the amblyopic eye. A large interocular difference in the best-corrected visual acuity was found to be a risk factor for both functional and relative failure. High SE of the amblyopic eye was the most influential risk factor for treatment failure and recurrence in compliant children aged 7-9 years.

  7. CAM visual stimulation with conventional method of occlusion treatment in amblyopia: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Ali Reza Jafari

    2014-04-01

    Conclusion: Using of CAM visual stimulation along with conventional occlusion will further improve visual acuity and stereopsis in amblyopic children. These findings recommended the CAM visual stimulation as an accompanying and complementary method in amblyopia treatment.

  8. The Prevalence of Amblyopia and Its Determinants in a Population-based Study.

    Science.gov (United States)

    Faghihi, Mohammad; Hashemi, Hassan; Nabovati, Payam; Saatchi, Mohammad; Yekta, Abbasali; Rafati, Shokoofeh; Ostadimoghaddam, Hadi; Khabazkhoob, Mehdi

    2017-12-01

    To determine the prevalence of amblyopia and its determinants in a population-based study in Mashhad County, Iran. This cross-sectional, population-based study was conducted on the population of Mashhad County aged >1 year using randomized stratified cluster sampling. Examinations were performed after selection of the participants and their free transportation to the sampling site. The examinations included the measurement of uncorrected and corrected visual acuity, cycloplegic and non-cycloplegic refraction, cover testing, slit-lamp biomicroscopy, and ophthalmoscopy. In this study, amblyopia was defined as best corrected visual acuity (BCVA) of 20/30 or less or 2-line interocular optotype acuity differences with no pathology. After considering the exclusion criteria, the data of 2739 individuals, 65.6% of whom were women, were analyzed. The mean age of the participants was 29.5±17.5 years. The prevalence of amblyopia was 4.6% (95% CI: 3.77%-5.43%) in the total population. The lowest prevalence was 2.24% in the age group 5-15 years (95% CI: 0.99%-3.48%) and the highest prevalence was 7.14% in the age group 55-65 years (95% CI: 2.64%-11.56%). Anisometropic amblyopia was observed in 45.24% of the amblyopic participants. Isometropic, mixed (strabismic/anisometropic), and strabismic amblyopia were other common causes of amblyopia, with a prevalence of 24.6%, 16.67%, and 13.49% in amblyopic patients, respectively. The odds ratio (OR) of having amblyopia for each 1-year increase in age was 1.02 (95% CI: 1.01-1.03). Amblyopia was less common in people with better socioeconomic status. This study showed the prevalence of amblyopia in all age groups in a population-based study for the first time. The findings of this study regarding the relatively high prevalence of amblyopia in the older population and its lower prevalence in young people indicate attention to amblyopia in recent years.

  9. Rapid, high-accuracy detection of strabismus and amblyopia using the pediatric vision scanner

    OpenAIRE

    Loudon, Sjoukje; Rook, Caitlin; Nassif, Deborah; Piskun, Nadya; Hunter, David

    2011-01-01

    textabstractPurpose. The Pediatric Vision Scanner (PVS) detects strabismus by identifying ocular fixation in both eyes simultaneously. This study was undertaken to assess the ability of the PVS to identify patients with amblyopia or strabismus, particularly anisometropic amblyopia with no measurable strabismus. Methods. The PVS test, administered from 40 cm and requiring 2.5 seconds of attention, generated a binocularity score (BIN, 0%-100%). We tested 154 patients and 48 controls between the...

  10. A dichoptic custom-made action video game as a treatment for adult amblyopia

    OpenAIRE

    Vedamurthy, Indu; Nahum, Mor; Huang, Samuel J.; Zheng, Frank; Bayliss, Jessica; Bavelier, Daphne; Levi, Dennis M.

    2015-01-01

    © 2015 Elsevier Ltd. Previous studies have employed different experimental approaches to enhance visual function in adults with amblyopia including perceptual learning, videogame play, and dichoptic training. Here, we evaluated the efficacy of a novel dichoptic action videogame combining all three approaches. This experimental intervention was compared to a conventional, yet unstudied method of supervised occlusion while watching movies.Adults with unilateral amblyopia were assigned to either...

  11. A new form of rapid binocular plasticity in adult with amblyopia

    OpenAIRE

    Zhou, Jiawei; Thompson, Benjamin; Hess, Robert F.

    2013-01-01

    Amblyopia is a neurological disorder of binocular vision affecting up to 3% of the population resulting from a disrupted period of early visual development. Recently, it has been shown that vision can be partially restored by intensive monocular or dichoptic training (4?6 weeks). This can occur even in adults owing to a residual degree of brain plasticity initiated by repetitive and successive sensory stimulation. Here we show that the binocular imbalance that characterizes amblyopia can be r...

  12. Mechanisms of recovery of visual function in adult amblyopia through a tailored action video game

    OpenAIRE

    Indu Vedamurthy; Mor Nahum; Daphne Bavelier; Dennis M. Levi

    2015-01-01

    Amblyopia is a deficit in vision that arises from abnormal visual experience early in life. It was long thought to develop into a permanent deficit, unless properly treated before the end of the sensitive period for visual recovery. However, a number of studies now suggest that adults with long-standing amblyopia may at least partially recover visual acuity and stereopsis following perceptual training. Eliminating or reducing interocular suppression has been hypothesized to be at the root of ...

  13. A Limited Role for Suppression in the Central Field of Individuals with Strabismic Amblyopia

    OpenAIRE

    Barrett, Brendan T.; Panesar, Gurvinder K.; Scally, Andrew J.; Pacey, Ian E.

    2012-01-01

    BACKGROUND: Although their eyes are pointing in different directions, people with long-standing strabismic amblyopia typically do not experience double-vision or indeed any visual symptoms arising from their condition. It is generally believed that the phenomenon of suppression plays a major role in dealing with the consequences of amblyopia and strabismus, by preventing images from the weaker/deviating eye from reaching conscious awareness. Suppression is thus a highly sophisticated coping m...

  14. Neuronal Responses in Visual Area V2 (V2) of Macaque Monkeys with Strabismic Amblyopia

    OpenAIRE

    Bi, H.; Zhang, B.; Tao, X.; Harwerth, R. S.; Smith, E. L.; Chino, Y. M.

    2011-01-01

    Amblyopia, a developmental disorder of spatial vision, is thought to result from a cascade of cortical deficits over several processing stages beginning at the primary visual cortex (V1). However, beyond V1, little is known about how cortical development limits the visual performance of amblyopic primates. We quantitatively analyzed the monocular and binocular responses of V1 and V2 neurons in a group of strabismic monkeys exhibiting varying depths of amblyopia. Unlike in V1, the relative eff...

  15. Video Game Use in the Treatment of Amblyopia: Weighing the Risks of Addiction

    OpenAIRE

    Xu, Chaoying S.; Chen, Jessica S.; Adelman, Ron A.

    2015-01-01

    Video games have surged in popularity due to their entertainment factor and, with recent innovation, their use in health care. This review explores the dual facets of video games in treating vision impairment in amblyopia as well as their potential for overuse and addiction. Specifically, this review examines video game addiction from a biopsychosocial perspective and relates the addictive qualities of video games with their use as a therapeutic treatment for amblyopia. Current literature sup...

  16. [Results of therapy of children with amblyopia by scanning stimulating laser].

    Science.gov (United States)

    Chentsova, O B; Magaramova, M D; Grechanyĭ, M P

    1997-01-01

    A new effective method for the treatment of amblyopia was used in 113 children: stimulation with ophthalmological SLSO-208A scanning laser by two methods differing by the transmission coefficient and scanning pattern. Good results were attained, the best when laser exposure was combined with traditional therapy for amblyopia and in the patients with the central fixation. The results were assessed by the main parameters of visual functions and the stability of the effect.

  17. Pattern Visual Evoked Potential as a Predictor of Occlusion Therapy for Amblyopia

    OpenAIRE

    Chung, Woosuk; Hong, Samin; Lee, Jong Bok; Han, Sueng-Han

    2008-01-01

    Purpose This study was conducted to investigate the role of the pattern visual evoked potential (pVEP) as a predictor of occlusion therapy for patients with strabismic, anisometropic, and isometropic amblyopia. The secondary aim was to compare the characteristics of pVEP between strabismic and anisometropic amblyopia. Methods This retrospective comparative case series included 120 patients who had received occlusion therapy or a glasses prescription for correction of strabismic, anisometropic...

  18. Effect of occlusion amblyopia after prescribed full-time occlusion on long-term visual acuity outcomes.

    Science.gov (United States)

    Longmuir, Susannah; Pfeifer, Wanda; Scott, William; Olson, Richard

    2013-01-01

    To investigate the incidence and characteristics of occlusion amblyopia with prescribed full-time patching and determine its effect on long-term visual acuity outcomes. The records of patients younger than 10 years diagnosed as having amblyopia between 1970 and 2000 were retrospectively reviewed. Patients were prescribed full-time occlusion and observed until completion of therapy. Of 597 patients treated for amblyopia by full-time patching, 115 were diagnosed as having occlusion amblyopia (19.3%). Seventy-five percent (86 of 115) developed occlusion amblyopia during the first episode of full-time patching. Occlusion amblyopia occurred more frequently in children prescribed full-time patching at an earlier age (P = .0002), with an odds ratio of 8.56 (95% confidence interval: 2.73, 26.84) in children younger than 36 months and 2.66 (95% confidence interval: 0.96, 7.37) in children between 36 and 59 months old. Seven of the patients with occlusion amblyopia did not reverse fixation and continued to fixate with the initially amblyopic eye after treatment. Final visual acuity in these eyes with occlusion amblyopia was 20/30 or better. After cessation of treatment, the final interocular difference in visual acuity was less in patients with a history of occlusion amblyopia (P = .003). Occlusion amblyopia occurred at all ages, but the incidence decreased with increasing age. Patients who developed occlusion amblyopia with prescribed full-time occlusion had less interocular visual acuity difference than patients who did not, suggesting that development of occlusion amblyopia can indicate the potential for the development of better vision in the originally amblyopic eye. Copyright 2013, SLACK Incorporated.

  19. Smartphone Applications for Amblyopia Treatment: A Review of Current Apps and Professional Involvement.

    Science.gov (United States)

    Paudel, Nabin

    2018-01-18

    The objective of this study was to review games for amblyopia (lazy eye) that are commercially available in mobile applications (apps) stores and assess the involvement of eye care professionals in their development. The Google play store and the Apple iTunes store were searched in July 2017 and updated in September 2017 for amblyopia games using the terms amblyopia, lazy eye, amblyopia therapy, lazy eye therapy, lazy eye exercises, amblyopia exercises, lazy eye games, and amblyopia games. General ophthalmology or optometry apps and apps in languages other than English were excluded. A total of 42 games were identified, 12 Android only (28%), 20 iOS only (48%), and 10 (24%) both Android and iOS. Most of the games were available under the medical category (60%). Most of the games were released in 2015. The price of the games ranged from $0.00 to $32.00 (USD). Nearly half of the games (45%) were to be played binocularly either using red-green goggles (38%) or a virtual reality set (7%). Only 7% of the games had explicitly documented the involvement of eye care professionals during game development. Only one game (app) was developed in collaboration with a research group and a children's hospital. This study identified that most of the currently available games do not have eye care professional input. An establishment of the quality assurance by a body of qualified eye care professionals could enhance the confidence of patients and clinicians using the game.

  20. Altered spontaneous activity in anisometropic amblyopia subjects: revealed by resting-state FMRI.

    Directory of Open Access Journals (Sweden)

    Xiaoming Lin

    Full Text Available Amblyopia, also known as lazy eye, usually occurs during early childhood and results in poor or blurred vision. Recent neuroimaging studies have found cortical structural/functional abnormalities in amblyopia. However, until now, it was still not known whether the spontaneous activity of the brain changes in amblyopia subjects. In the present study, regional homogeneity (ReHo, a measure of the homogeneity of functional magnetic resonance imaging signals, was used for the first time to investigate changes in resting-state local spontaneous brain activity in individuals with anisometropic amblyopia. Compared with age- and gender-matched subjects with normal vision, the anisometropic amblyopia subjects showed decreased ReHo of spontaneous brain activity in the right precuneus, the left medial prefrontal cortex, the left inferior frontal gyrus, and the left cerebellum, and increased ReHo of spontaneous brain activity was found in the bilateral conjunction area of the postcentral and precentral gyri, the left paracentral lobule, the left superior temporal gyrus, the left fusiform gyrus, the conjunction area of the right insula, putamen and the right middle occipital gyrus. The observed decreases in ReHo may reflect decreased visuo-motor processing ability, and the increases in ReHo in the somatosensory cortices, the motor areas and the auditory area may indicate compensatory plasticity in amblyopia.

  1. Optimal Audiovisual Integration in the Ventriloquism Effect But Pervasive Deficits in Unisensory Spatial Localization in Amblyopia.

    Science.gov (United States)

    Richards, Michael D; Goltz, Herbert C; Wong, Agnes M F

    2018-01-01

    Classically understood as a deficit in spatial vision, amblyopia is increasingly recognized to also impair audiovisual multisensory processing. Studies to date, however, have not determined whether the audiovisual abnormalities reflect a failure of multisensory integration, or an optimal strategy in the face of unisensory impairment. We use the ventriloquism effect and the maximum-likelihood estimation (MLE) model of optimal integration to investigate integration of audiovisual spatial information in amblyopia. Participants with unilateral amblyopia (n = 14; mean age 28.8 years; 7 anisometropic, 3 strabismic, 4 mixed mechanism) and visually normal controls (n = 16, mean age 29.2 years) localized brief unimodal auditory, unimodal visual, and bimodal (audiovisual) stimuli during binocular viewing using a location discrimination task. A subset of bimodal trials involved the ventriloquism effect, an illusion in which auditory and visual stimuli originating from different locations are perceived as originating from a single location. Localization precision and bias were determined by psychometric curve fitting, and the observed parameters were compared with predictions from the MLE model. Spatial localization precision was significantly reduced in the amblyopia group compared with the control group for unimodal visual, unimodal auditory, and bimodal stimuli. Analyses of localization precision and bias for bimodal stimuli showed no significant deviations from the MLE model in either the amblyopia group or the control group. Despite pervasive deficits in localization precision for visual, auditory, and audiovisual stimuli, audiovisual integration remains intact and optimal in unilateral amblyopia.

  2. Factors influencing visual rehabilitation after occlusion therapy in unilateral amblyopia in children.

    Science.gov (United States)

    Menon, Vimla; Chaudhuri, Zia; Saxena, Rohit; Gill, Kulwant; Sachdeva, M M

    2005-12-01

    Amblyopia is one of the most common causes of visual impairment in adults and children, and visual loss may be permanent if not treated in time. Though many studies have been done on occlusion therapy which is the mainstay in the treatment of unilateral amblyopia, discrepancies exist in literature about quantification of treatment and follow up measures. The present study was undertaken to evaluate the factors responsible for the successful outcome of treatment and the optimum time required for the same in children with unilateral amblyopia. Baseline characteristics of 63 verbal patients with unilateral amblyopia (strabismic, anisometropic, mixed) referred to the Strabismus and Amblyopia Clinic at the Dr Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi between September 2001 to December 2002 who improved to the desired level of visual acuity after treatment for amblyopia in the mentioned time period, were analyzed to assess for factors that directly or indirectly influenced the optimum visual rehabilitation and the average duration of therapy required for the same. The evaluation included assessment of the baseline best-corrected visual acuity (BCVA) and refractive status in both eyes, the age at presentation, the type of amblyopia present, fixation pattern in the amblyopic eye, inter-eye visual acuity difference, and evaluation of compliance through a parental diary system. Baseline BCVA in the amblyopic eye was similar in all the three groups. Patients with anisometropic amblyopia showed a quicker response to therapy. Compliance to treatment was the major factor affecting the overall time required for a successful outcome in most cases. The overall time required for the treatment to be successful (including the period of maintenance) was about 1,089 h. This hospital-based study showed that the average duration of occlusion therapy to achieve stable isoacuity was 7.2 months with an average occlusion of 6-7 h/day. Compliance to therapy was the most

  3. Biometric relationships of ocular components in esotropic amblyopia

    Directory of Open Access Journals (Sweden)

    Iara Debert

    2012-02-01

    Full Text Available PURPOSE: To investigate the contribution of the individual ocular components, i.e. anterior chamber depth, lens thickness and vitreous chamber depth, to total axial length in patients with esotropic amblyopia. METHODS: The study population consisted of 74 children, aged between 5 and 8 years: thirty-seven patients with esotropic amblyopia and 37 healthy volunteers (control group. The participants underwent a comprehensive ophthalmological examination, including cycloplegic refraction and A-scan ultrasonography. Anterior chamber depth, lens thickness, vitreous chamber depth and total axial length were recorded. Paired Student's t-tests were used to compare biometric measurements between amblyopic eyes and their fellow eyes and between right and left eyes in the control group. To evaluate the contribution of the ocular components to the total axial length, we report the individual components as a percentage of total axial length. RESULTS: The comparison between amblyopic and fellow eyes regarding the individual contribution from ocular components to the total axial length revealed greater contribution from lens thickness (P=0.001 and smaller contribution from vitreous chamber depth (P=0.001 in amblyopic eyes, despite similar contribution from anterior chamber depth (P=0.434. The comparison between right and left eyes in the control group showed similar contributions from anterior chamber depth (P=0.620, lens thickness (P=0.721, and vitreous chamber depth (P=0.483. CONCLUSIONS: This study shows differences between amblyopic and non-amblyopic eyes when the total axial length is broken down into the individual contribution from the ocular components.

  4. Does compliance with amblyopia management improve following supervised occlusion treatment?

    Science.gov (United States)

    El-Ghrably, I A; Longville, D; Gnanaraj, L

    2007-01-01

    To demonstrate improvement in compliance following supervised occlusion therapy for amblyopia in children who had failed to respond to outpatient treatment. Retrospective review of the visual outcome of 30 children who were admitted to an ophthalmology ward for 1-day intensive supervised occlusion. These children had documented poor compliance and previously failed to respond to the outpatient occlusion treatment. During their stay a trained ophthalmology nurse educated parents regarding amblyopia and the benefits of occlusion therapy. Visual acuity (VA) of the amblyopic and fellow eyes was recorded on admission, discharge, and at each subsequent visit. The compliance was recorded from parent's history and also indirectly by noticing improvement in vision. The mean supervised occlusion was 7.4 hours (range 4-12 hours). The compliance with occlusion therapy improved in 23 children (77%) after discharge. The mean duration of occlusion after discharge improved to 4 hours (range 1-12 hours). The mean follow-up was 18 months (range 4-24 months). Though there was no dramatic improvement in VA at discharge there was a statistically significant improvement in VA between admission and last recorded VA (pocclusion following discharge, 21 (91%) gained at least one line of acuity in their amblyopic eye on the last assessment of their VA and five of them achieved 6/12. Of the seven children who did not comply with occlusion following discharge, only one patient gained one line improvement in his amblyopic eye. This study shows that supervised occlusion treatment and parental education was effective in children who had initially failed traditional outpatient treatment.

  5. New advances in amblyopia therapy I: binocular therapies and pharmacologic augmentation.

    Science.gov (United States)

    Kraus, Courtney L; Culican, Susan M

    2018-05-18

    Amblyopia therapy options have traditionally been limited to penalisation of the non-amblyopic eye with either patching or pharmaceutical penalisation. Solid evidence, mostly from the Pediatric Eye Disease Investigator Group, has validated both number of hours a day of patching and days per week of atropine use. The use of glasses alone has also been established as a good first-line therapy for both anisometropic and strabismic amblyopia. Unfortunately, visual acuity equalisation or even improvement is not always attainable with these methods. Additionally, non-compliance with prescribed therapies contributes to treatment failures, with data supporting difficulty adhering to full treatment sessions. Interest in alternative therapies for amblyopia treatment has long been a topic of interest among researchers and clinicians alike. Incorporating new technology with an understanding of the biological basis of amblyopia has led to enthusiasm for binocular treatment of amblyopia. Early work on perceptual learning as well as more recent enthusiasm for iPad-based dichoptic training have each generated interesting and promising data for vision improvement in amblyopes. Use of pharmaceutical augmentation of traditional therapies has also been investigated. Several different drugs with unique mechanisms of action are thought to be able to neurosensitise the brain and enhance responsiveness to amblyopia therapy. No new treatment has emerged from currently available evidence as superior to the traditional therapies in common practice today. But ongoing investigation into the use of both new technology and the understanding of the neural basis of amblyopia promises alternate or perhaps better cures in the future. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. The effect of Bangerter filters on binocular function in observers with amblyopia.

    Science.gov (United States)

    Chen, Zidong; Li, Jinrong; Thompson, Benjamin; Deng, Daming; Yuan, Junpeng; Chan, Lily; Hess, Robert F; Yu, Minbin

    2014-10-28

    We assessed whether partial occlusion of the nonamblyopic eye with Bangerter filters can immediately reduce suppression and promote binocular summation of contrast in observers with amblyopia. In Experiment 1, suppression was measured for 22 observers (mean age, 20 years; range, 14-32 years; 10 females) with strabismic or anisometropic amblyopia and 10 controls using our previously established "balance point" protocol. Measurements were made at baseline and with 0.6-, 0.4-, and 0.2-strength Bangerter filters placed over the nonamblyopic/dominant eye. In Experiment 2, psychophysical measurements of contrast sensitivity were made under binocular and monocular viewing conditions for 25 observers with anisometropic amblyopia (mean age, 17 years; range, 11-28 years; 14 females) and 22 controls (mean age, 24 years; range, 22-27; 12 female). Measurements were made at baseline, and with 0.4- and 0.2-strength Bangerter filters placed over the nonamblyopic/dominant eye. Binocular summation ratios (BSRs) were calculated at baseline and with Bangerter filters in place. Experiment 1: Bangerter filters reduced suppression in observers with amblyopia and induced suppression in controls (P = 0.025). The 0.2-strength filter eliminated suppression in observers with amblyopia and this was not a visual acuity effect. Experiment 2: Bangerter filters were able to induce normal levels of binocular contrast summation in the group of observers with anisometropic amblyopia for a stimulus with a spatial frequency of 3 cycles per degree (cpd, P = 0.006). The filters reduced binocular summation in controls. Bangerter filters can immediately reduce suppression and promote binocular summation for mid/low spatial frequencies in observers with amblyopia. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  7. Efficiency of occlusion therapy for management of amblyopia in older children

    Directory of Open Access Journals (Sweden)

    Brar Gagandeep

    2006-01-01

    Full Text Available Materials and Methods: This was a retrospective consecutive case series analysis of children treated for amblyopia at a tertiary care center. All children received full time occlusion (FTO for the dominant eye. Results: Eighty-eight children older than 6 years at the time of initiation of therapy were included. Age at initiation of therapy ranged from 6 to 20 years (9.45 ± 3.11 years. Forty-two children (47.7% had strabismic amblyopia, 37 (42.0% had anisometropic amblyopia and 9 (10.2% had a combination of strabismic and anisometropic amblyopia. Eighty out of 88 eyes (90.0% had improvement in visual acuity following FTO. Visual acuity (VA improved from 0.82 ± 0.34 at presentation to 0.42 ± 0.34 ( P < 0.001 after FTO. In children with strabismic amblyopia, VA improved from 0.81 ± 0.42 to 0.42 ± 0.39 ( P < 0.001. In children with anisometropic amblyopia, visual acuity of the amblyopic eye improved from 0.82 ± 0.24 to 0.36 ± 0.29 ( P < 0.001 following FTO. Out of 13 children older than 12 years, only 6 children (46.1% had improvement in VA. Mean follow-up after complete stoppage of occlusion was 8.37 ± 1.78 months. Conclusion: Occlusion therapy yields favorable results in strabismic and/or anisometropic amblyopia, even when initiated for the first time after 6 years of age. After 12 years of age, some children may still respond to occlusion of the dominant eye.

  8. Utility analysis of disability caused by amblyopia and/or strabismus in a population-based, historic cohort

    NARCIS (Netherlands)

    E.S. van de Graaf (Elizabeth); H. Kempen-du Saar (Hanneke); C.W.N. Looman (Caspar); H.J. Simonsz (Huib)

    2010-01-01

    textabstractBackground: Amblyopia (prevalence 3.4%) is in principle treatable, but approximately one quarter of children do not reach reading acuity in the amblyopic eye. Adults with persistent amblyopia and/or strabismus experience a decrease in quality of life. This was now quantified by

  9. Higher order aberrations in amblyopic children and their role in refractory amblyopia

    Directory of Open Access Journals (Sweden)

    Arnaldo Dias-Santos

    2014-12-01

    Full Text Available Objective: Some studies have hypothesized that an unfavourable higher order aberrometric profile could act as an amblyogenic mechanism and may be responsible for some amblyopic cases that are refractory to conventional treatment or cases of “idiopathic” amblyopia. This study compared the aberrometric profile in amblyopic children to that of children with normal visual development and compared the aberrometric profile in corrected amblyopic eyes and refractory amblyopic eyes with that of healthy eyes. Methods: Cross-sectional study with three groups of children – the CA group (22 eyes of 11 children with unilateral corrected amblyopia, the RA group (24 eyes of 13 children with unilateral refractory amblyopia and the C group (28 eyes of 14 children with normal visual development. Higher order aberrations were evaluated using an OPD-Scan III (NIDEK. Comparisons of the aberrometric profile were made between these groups as well as between the amblyopic and healthy eyes within the CA and RA groups. Results: Higher order aberrations with greater impact in visual quality were not significantly higher in the CA and RA groups when compared with the C group. Moreover, there were no statistically significant differences in the higher order aberrometric profile between the amblyopic and healthy eyes within the CA and RA groups. Conclusions: Contrary to lower order aberrations (e.g., myopia, hyperopia, primary astigmatism, higher order aberrations do not seem to be involved in the etiopathogenesis of amblyopia. Therefore, these are likely not the cause of most cases of refractory amblyopia.

  10. Mechanisms of recovery of visual function in adult amblyopia through a tailored action video game.

    Science.gov (United States)

    Vedamurthy, Indu; Nahum, Mor; Bavelier, Daphne; Levi, Dennis M

    2015-02-26

    Amblyopia is a deficit in vision that arises from abnormal visual experience early in life. It was long thought to develop into a permanent deficit, unless properly treated before the end of the sensitive period for visual recovery. However, a number of studies now suggest that adults with long-standing amblyopia may at least partially recover visual acuity and stereopsis following perceptual training. Eliminating or reducing interocular suppression has been hypothesized to be at the root of these changes. Here we show that playing a novel dichoptic video game indeed results in reduced suppression, improved visual acuity and, in some cases, improved stereopsis. Our relatively large cohort of adults with amblyopia, allowed us, for the first time, to assess the link between visual function recovery and reduction in suppression. Surprisingly, no significant correlation was found between decreased suppression and improved visual function. This finding challenges the prevailing view and suggests that while dichoptic training improves visual acuity and stereopsis in adult amblyopia, reduced suppression is unlikely to be at the root of visual recovery. These results are discussed in the context of their implication on recovery of amblyopia in adults.

  11. Alternations of functional connectivity in amblyopia patients: a resting-state fMRI study

    Science.gov (United States)

    Wang, Jieqiong; Hu, Ling; Li, Wenjing; Xian, Junfang; Ai, Likun; He, Huiguang

    2014-03-01

    Amblyopia is a common yet hard-to-cure disease in children and results in poor or blurred vision. Some efforts such as voxel-based analysis, cortical thickness analysis have been tried to reveal the pathogenesis of amblyopia. However, few studies focused on alterations of the functional connectivity (FC) in amblyopia. In this study, we analyzed the abnormalities of amblyopia patients by both the seed-based FC with the left/right primary visual cortex and the network constructed throughout the whole brain. Experiments showed the following results: (1)As for the seed-based FC analysis, FC between superior occipital gyrus and the primary visual cortex was found to significantly decrease in both sides. The abnormalities were also found in lingual gyrus. The results may reflect functional deficits both in dorsal stream and ventral stream. (2)Two increased functional connectivities and 64 decreased functional connectivities were found in the whole brain network analysis. The decreased functional connectivities most concentrate in the temporal cortex. The results suggest that amblyopia may be caused by the deficits in the visual information transmission.

  12. Therapeutic effects of the smartphones and pads on hyperopia amblyopia of children

    Directory of Open Access Journals (Sweden)

    Ze-Hong Dong

    2017-11-01

    Full Text Available AIM: To evaluate the therapeutic effects of the fine sight training with the smartphones and pads on hyperopia amblyopia of children.METHODS: One hundred and twenty children(120 eyeswith hyperopia amblyopia were randomly divided into two groups in this prospective study. All the children in these two groups received the basic treatments of spectacle correction, penalization therapy and amblyopia trainings. The treatments of red-light blinking and grating as well as traditional fine sight training were used for the children in the control group. However, the smartphones and pads were applied instead of the traditional performances for the fine sight training in the experimental group. Best corrected visual acuity of every child was tested for every 3mo, to observe the time for the visual improvement and efficacy.RESULTS: In comparison with the control group, significant shorter time(80.54±30.87d, PPZ=-2.37, P=0.02.CONCLUSION: The fine sight training with the smartphones and pads can improve vison faster than traditional methods and decrease the time of therapy in children with hyperopia amblyopia, thus providing a new strategy for the treatment of hyperopia amblyopia.

  13. [Importance of occlusion therapy for amblyopia in partial unilateral congenital cataracts that are discovered late].

    Science.gov (United States)

    Denion, E; Dedes, V; Bonne, M; Labalette, P; Berger, C; Guilbert, F; Bouckehove, S; Rouland, J-F

    2004-11-01

    The aim of this study is to investigate the importance of occlusion therapy for amblyopia in patients with partial unilateral congenital cataracts that were discovered after 24 months of age. A retrospective study was conducted on 11 patients, each of whom underwent a clinical examination including a cycloplegic refraction with atropine. The average age when the cataract was diagnosed was 35 months. The average distance visual acuity was 6/78 and the average near visual acuity was 35/175. Occlusion therapy using adhesive patches was started after refractive error correction. In two cases, observance was mediocre. Ametropia was found in every patient, with anisometropia in nine patients (alpha occlusion therapy for amblyopia, the average visual acuity significantly improved to 6/22 in distance vision (alpha Amblyopia is related to lens opacities as well as frequently associated anisometropia. Functional improvement is greater in near vision than in distance vision. With occlusion therapy for amblyopia, accommodation is preserved. This factor is of utmost importance as near vision is preferential in young children. This study provides an opportunity to recall the importance of refraction and occlusion therapy for amblyopia, which must be systematically attempted in cases of partial unilateral congenital cataracts before considering a surgical procedure.

  14. An audit of the outcome of amblyopia treatment: a retrospective analysis of 322 children.

    Science.gov (United States)

    Awan, M; Proudlock, F A; Grosvenor, D; Choudhuri, I; Sarvanananthan, N; Gottlob, I

    2010-08-01

    Little is known about the effectiveness of occlusion therapy in hospital settings. A retrospective analysis was conducted to assess modalities, outcome and hospital costs of children treated for amblyopia with patching in a UK clinic. Notes of 322 children with amblyopia discharged after occlusion treatment were selected consecutively and reviewed. Data collated included age at presentation, amblyopia type, visual acuity (VA; before/after occlusion and at discharge), number of prescribed hours of occlusion, duration of patching treatment, number of glasses prescribed and number of visits attended or failed to attend. Hospital treatment costs were estimated. Mixed amblyopes were prescribed the longest amount of patching (mean 2815 h over 23 months) followed by strabismic (1984 h) and anisometropic (1238 h) amblyopes. 319 amblyopes received glasses and five atropine treatment. The percentage of patients reaching VA of 6/12 was best in the anisometropic and strabismic groups (>75%) and worse in mixed amblyopia (64%). Average hospital costs were estimated at pound1365. Although the mean duration of treatment was long, involving many hospital visits, the visual outcome was variable, unsatisfactory (amblyopia treatment are needed, possibly by using educational/motivational intervention.

  15. The role of eye movement driven attention in functional strabismic amblyopia.

    Science.gov (United States)

    Wang, Hao; Crewther, Sheila Gillard; Yin, Zheng Qin

    2015-01-01

    Strabismic amblyopia "blunt vision" is a developmental anomaly that affects binocular vision and results in lowered visual acuity. Strabismus is a term for a misalignment of the visual axes and is usually characterized by impaired ability of the strabismic eye to take up fixation. Such impaired fixation is usually a function of the temporally and spatially impaired binocular eye movements that normally underlie binocular shifts in visual attention. In this review, we discuss how abnormal eye movement function in children with misaligned eyes influences the development of normal binocular visual attention and results in deficits in visual function such as depth perception. We also discuss how eye movement function deficits in adult amblyopia patients can also lead to other abnormalities in visual perception. Finally, we examine how the nonamblyopic eye of an amblyope is also affected in strabismic amblyopia.

  16. The Role of Eye Movement Driven Attention in Functional Strabismic Amblyopia

    Directory of Open Access Journals (Sweden)

    Hao Wang

    2015-01-01

    Full Text Available Strabismic amblyopia “blunt vision” is a developmental anomaly that affects binocular vision and results in lowered visual acuity. Strabismus is a term for a misalignment of the visual axes and is usually characterized by impaired ability of the strabismic eye to take up fixation. Such impaired fixation is usually a function of the temporally and spatially impaired binocular eye movements that normally underlie binocular shifts in visual attention. In this review, we discuss how abnormal eye movement function in children with misaligned eyes influences the development of normal binocular visual attention and results in deficits in visual function such as depth perception. We also discuss how eye movement function deficits in adult amblyopia patients can also lead to other abnormalities in visual perception. Finally, we examine how the nonamblyopic eye of an amblyope is also affected in strabismic amblyopia.

  17. Visual Acuity Improvement in Continuous vs Divided Occlusion in Anisometropic Amblyopia.

    Science.gov (United States)

    Irfani, Irawati; Feriyanto, Feri; Oktarima, Primawita; Kartasasmita, Arief

    2018-01-01

    To compare visual acuity improvement between continuous and split part-time occlusion for the treatment of moderate and severe anisometropic amblyopia. Randomised clinical trials in 6 - 13 y.o children with moderate and severe anisometropic amblyopia. Each patient was consecutively selected with continuous or split part-time occlusion. Best corrected visual acuity's improvement was followed up to six weeks and statistical data were analyzed using chi square and unpaired t-test. Best corrected visual acuity's improvement was comparable between continuous and split part-time occlusion (0.20±0.27 vs 0.21±0.25; p = 0.79). Split part-time occlusion may be considered as an alternative treatment for moderate and severe anisometropic amblyopia treatment.

  18. Modified iPad for treatment of amblyopia: a preliminary study.

    Science.gov (United States)

    Handa, Tomoya; Ishikawa, Hitoshi; Shoji, Nobuyuki; Ikeda, Tetsuya; Totuka, Satoru; Goseki, Toshiaki; Shimizu, Kimiya

    2015-12-01

    We report the results of a new amblyopia treatment device used in 7 children with anisometropic amblyopia. The Occlu-pad was created by removing the polarizing film layer from the liquid crystal display screen of an iPad Air (Apple Inc, Cupertino, CA). Patients were asked to wear special glasses that contained a polarizing filter for their amblyopic eye and a light reduction filter for their normal eye and instructed to play an amblyopia training game displayed only to the amblyopic eye. In 5 patients corrected distance visual acuities in the amblyopic eyes improved after 2 months' treatment on average by 0.38 (logarithm of the minimum angle of resolution). Copyright © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  19. Behavioral Training as New Treatment for Adult Amblyopia: A Meta-Analysis and Systematic Review.

    Science.gov (United States)

    Tsirlin, Inna; Colpa, Linda; Goltz, Herbert C; Wong, Agnes M F

    2015-06-01

    New behavioral treatment methods, including dichoptic training, perceptual learning, and video gaming, have been proposed to improve visual function in adult amblyopia. Here, we conducted a meta-analysis of these methods to investigate the factors involved in amblyopia recovery and their clinical significance. Mean and individual participant data meta-analyses were performed on 24 studies using the new behavioral methods in adults. Studies were identified using PubMed, Google Scholar, and published reviews. The new methods yielded a mean improvement in visual acuity of 0.17 logMAR with 32% participants achieving gains ≥ 0.2 logMAR, and a mean improvement in stereo sensitivity of 0.01 arcsec-1 with 42% of participants improving ≥2 octaves. The most significant predictor of treatment outcome was visual acuity at the onset of treatment. Participants with more severe amblyopia improved more on visual acuity and less on stereo sensitivity than those with milder amblyopia. Better initial stereo sensitivity was a predictor of greater gains in stereo sensitivity following treatment. Treatment type, amblyopia type, age, and training duration did not have any significant influence on visual and stereo acuity outcomes. Our analyses showed that some participants may benefit from the new treatments; however, clinical trials are required to confirm these findings. Despite the diverse nature of the new behavioral methods, the lack of significant differences in visual and stereo sensitivity outcomes among them suggests that visual attention-a common element among the varied treatment methods-may play an important role in amblyopia recovery.

  20. Perceptual Learning as a potential treatment for amblyopia: a mini-review

    Science.gov (United States)

    Levi, Dennis M.; Li, Roger W.

    2009-01-01

    Amblyopia is a developmental abnormality that results from physiological alterations in the visual cortex and impairs form vision. It is a consequence of abnormal binocular visual experience during the “sensitive period” early in life. While amblyopia can often be reversed when treated early, conventional treatment is generally not undertaken in older children and adults. A number of studies over the last twelve years or so suggest that Perceptual Learning (PL) may provide an important new method for treating amblyopia. The aim of this mini-review is to provide a critical review and “meta-analysis” of perceptual learning in adults and children with amblyopia, with a view to extracting principles that might make PL more effective and efficient. Specifically we evaluate: What factors influence the outcome of perceptual learning?Specificity and generalization – two sides of the coin.Do the improvements last?How does PL improve visual function?Should PL be part of the treatment armamentarium? A review of the extant studies makes it clear that practicing a visual task results in a long-lasting improvement in performance in an amblyopic eye. The improvement is generally strongest for the trained eye, task, stimulus and orientation, but appears to have a broader spatial frequency bandwidth than in normal vision. Importantly, practicing on a variety of different tasks and stimuli seems to transfer to improved visual acuity. Perceptual learning operates via a reduction of internal neural noise and/or through more efficient use of the stimulus information by retuning the weighting of the information. The success of PL raises the question of whether it should become a standard part of the armamentarium for the clinical treatment of amblyopia, and suggests several important principles for effective perceptual learning in amblyopia. PMID:19250947

  1. The iPod binocular home-based treatment for amblyopia in adults: efficacy and compliance.

    Science.gov (United States)

    Hess, Robert F; Babu, Raiju Jacob; Clavagnier, Simon; Black, Joanna; Bobier, William; Thompson, Benjamin

    2014-09-01

    Occlusion therapy for amblyopia is predicated on the idea that amblyopia is primarily a disorder of monocular vision; however, there is growing evidence that patients with amblyopia have a structurally intact binocular visual system that is rendered functionally monocular due to suppression. Furthermore, we have found that a dichoptic treatment intervention designed to directly target suppression can result in clinically significant improvement in both binocular and monocular visual function in adult patients with amblyopia. The fact that monocular improvement occurs in the absence of any fellow eye occlusion suggests that amblyopia is, in part, due to chronic suppression. Previously the treatment has been administered as a psychophysical task and more recently as a video game that can be played on video goggles or an iPod device equipped with a lenticular screen. The aim of this case-series study of 14 amblyopes (six strabismics, six anisometropes and two mixed) ages 13 to 50 years was to investigate: 1. whether the portable video game treatment is suitable for at-home use and 2. whether an anaglyphic version of the iPod-based video game, which is more convenient for at-home use, has comparable effects to the lenticular version. The dichoptic video game treatment was conducted at home and visual functions assessed before and after treatment. We found that at-home use for 10 to 30 hours restored simultaneous binocular perception in 13 of 14 cases along with significant improvements in acuity (0.11 ± 0.08 logMAR) and stereopsis (0.6 ± 0.5 log units). Furthermore, the anaglyph and lenticular platforms were equally effective. In addition, the iPod devices were able to record a complete and accurate picture of treatment compliance. The home-based dichoptic iPod approach represents a viable treatment for adults with amblyopia. © 2014 The Authors. Clinical and Experimental Optometry © 2014 Optometrists Association Australia.

  2. Beyond Screening for Risk Factors Objective Detection of Strabismus and Amblyopia

    Science.gov (United States)

    Jost, Reed M.; Yanni, Susan E.; Beauchamp, Cynthia L.; Stager, David R.; Stager, David; Dao, Lori; Birch, Eileen E.

    2015-01-01

    IMPORTANCE Commercially available automated vision screening devices assess refractive risk factors, not amblyopia or strabismus, underreferring affected children and overreferring healthy children. Nearly half of affected children are not identified until after age 5 years, when treatment is less effective. OBJECTIVES To determine the diagnostic accuracy of the Pediatric Vision Scanner (PVS), a binocular retinal birefringence scanner, to objectively identify strabismus and amblyopia, and to compare retinal birefringence screening with a widely used automated pediatric screening device. DESIGN, SETTING, AND PARTICIPANTS Three hundred consecutive preschool children (aged 2-6 years) were screened using the PVS and the SureSight Autorefractor at 2 pediatric ophthalmology private practices. A masked comprehensive pediatric ophthalmic examination provided the gold standard for determining sensitivity and specificity for each screening device. MAIN OUTCOMES AND MEASURES The primary outcome was sensitivity and specificity of the PVS for detecting the targeted conditions, strabismus and amblyopia, in children aged 2 to 6 years. Secondary outcomes included the positive and negative likelihood ratios of the PVS for identifying the targeted conditions. In addition, sensitivity, specificity, and positive and negative likelihood ratios of the SureSight Autorefractor for the targeted conditions were assessed in the same cohort of children. RESULTS Of the 300 patients, 188 had strabismus only, amblyopia only, or both, and 112 had no strabismus or amblyopia. The sensitivity of the PVS to detect strabismus and amblyopia (0.97; 95% CI, 0.94-1.00) was significantly higher than that of the SureSight Autorefractor (0.74; 95% CI, 0.66-0.83). Specificity of the PVS for strabismus and amblyopia (0.87; 95% CI, 0.80-0.95) was significantly higher than that of the SureSight Autorefractor (0.62; 95% CI, 0.50-0.73). CONCLUSIONS AND RELEVANCE The PVS identified children with strabismus and

  3. Reading strategies in mild to moderate strabismic amblyopia: an eye movement investigation.

    Science.gov (United States)

    Kanonidou, Evgenia; Proudlock, Frank A; Gottlob, Irene

    2010-07-01

    PURPOSE. To investigate oculomotor strategies in strabismic amblyopia and evaluate abnormalities during monocular and binocular reading. METHODS. Eye movements were recorded with a head-mounted infrared video eye-tracker (250 Hz, amblyopia, reading is impaired, not only during monocular viewing with the amblyopic eye, but also with the nonamblyopic eye and binocularly, even though normal visual acuity pertains to the latter two conditions. The impaired reading performance is associated with differences in both the saccadic and fixational patterns, most likely as adaptation strategies to abnormal sensory experiences such as crowding and suppression.

  4. The characteristics of cortical glucose metabolism in amblyopia

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    Ahn, Ji Young [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of); Lee, Dong Soo; Chung, June Key; Shin, Seung Ai; Lee, Myung Chul [College of Medicine, Ewha Womans Univ., Seoul (Korea, Republic of)

    2000-07-01

    Cortical metabolism of amblyopia patients was investigated with F-18-FDG PET and Statistical Parametric Mapping (SPM) and quantificiation based on volume of interest (VOI) by statistical probabilistic anatomical map (SPAM). In 9 amblyopic patients (12{+-}7 years ) and 20 normal subjects (23{+-}2 years), F-18-FDG PET scans were peformed in amblyopic patients after amblyopic eye or sound eye was patch-closed during PET studies. SPM was done with SPM96. By multiplying SPAM to FDG images, counts of 98 VOI's were calculated and compared with 3 S. D. range of those of normal subjects. On SPM, cortical metabolism decreased (p<0.05) in occipital lobe (Ba 17, 18, 19), superior partietal lobe (Ba 7), and inferior temporal lobe (BA 37, 20). FDG uptake of gyri of occuipital lobe was decreased in 2 and increased in 2, and was normal in the other 5. FDG uptake of gyri of parietal, frontal, and temporal lobes were decreased in FDG uptake on these VOIs. We conclude that cortical metabolism in occipital lobe and extraoccipital lobes was variable but was consistent regardless of visual input during PET studies in amblyopic patients. SPM and quantification of functional images using SPAM could reveal subtle differences or changes according to visual input. The significance of metabolic changes of extraoccipital lobes should be studies further.

  5. The characteristics of cortical glucose metabolism in amblyopia

    International Nuclear Information System (INIS)

    Ahn, Ji Young; Lee, Dong Soo; Chung, June Key; Shin, Seung Ai; Lee, Myung Chul

    2000-01-01

    Cortical metabolism of amblyopia patients was investigated with F-18-FDG PET and Statistical Parametric Mapping (SPM) and quantificiation based on volume of interest (VOI) by statistical probabilistic anatomical map (SPAM). In 9 amblyopic patients (12±7 years ) and 20 normal subjects (23±2 years), F-18-FDG PET scans were peformed in amblyopic patients after amblyopic eye or sound eye was patch-closed during PET studies. SPM was done with SPM96. By multiplying SPAM to FDG images, counts of 98 VOI's were calculated and compared with 3 S. D. range of those of normal subjects. On SPM, cortical metabolism decreased (p<0.05) in occipital lobe (Ba 17, 18, 19), superior partietal lobe (Ba 7), and inferior temporal lobe (BA 37, 20). FDG uptake of gyri of occuipital lobe was decreased in 2 and increased in 2, and was normal in the other 5. FDG uptake of gyri of parietal, frontal, and temporal lobes were decreased in FDG uptake on these VOIs. We conclude that cortical metabolism in occipital lobe and extraoccipital lobes was variable but was consistent regardless of visual input during PET studies in amblyopic patients. SPM and quantification of functional images using SPAM could reveal subtle differences or changes according to visual input. The significance of metabolic changes of extraoccipital lobes should be studies further

  6. Relating binocular and monocular vision in strabismic and anisometropic amblyopia.

    Science.gov (United States)

    Agrawal, Ritwick; Conner, Ian P; Odom, J V; Schwartz, Terry L; Mendola, Janine D

    2006-06-01

    To examine deficits in monocular and binocular vision in adults with amblyopia and to test the following 2 hypotheses: (1) Regardless of clinical subtype, the degree of impairment in binocular integration predicts the pattern of monocular acuity deficits. (2) Subjects who lack binocular integration exhibit the most severe interocular suppression. Seven subjects with anisometropia, 6 subjects with strabismus, and 7 control subjects were tested. Monocular tests included Snellen acuity, grating acuity, Vernier acuity, and contrast sensitivity. Binocular tests included Titmus stereo test, binocular motion integration, and dichoptic contrast masking. As expected, both groups showed deficits in monocular acuity, with subjects with strabismus showing greater deficits in Vernier acuity. Both amblyopic groups were then characterized according to the degree of residual stereoacuity and binocular motion integration ability, and 67% of subjects with strabismus compared with 29% of subjects with anisometropia were classified as having "nonbinocular" vision according to our criterion. For this nonbinocular group, Vernier acuity is most impaired. In addition, the nonbinocular group showed the most dichoptic contrast masking of the amblyopic eye and the least dichoptic contrast masking of the fellow eye. The degree of residual binocularity and interocular suppression predicts monocular acuity and may be a significant etiological mechanism of vision loss.

  7. Prevalence of amblyopia and its association with refraction in Chinese preschool children aged 36-48 months.

    Science.gov (United States)

    Huang, Dan; Chen, Xuejuan; Zhu, Hui; Ding, Hui; Bai, Jing; Chen, Ji; Fu, Zhujun; Pan, Chen-Wei; Liu, Hu

    2018-06-01

    To determine the prevalence of amblyopia and its association with refraction in Chinese preschool children. The Yuhuatai Pediatric Eye Disease Study, a cross-sectional, population-based study, was conducted in children aged 36-48 months in Yuhuatai District, Nanjing, China, in 2015. Visual acuity was measured in 1695 eligible children. Of the 1695 subjects, manifested amblyopia was detected in 25 children (1.47%, 95% CI 0.90% to 2.05%), including 11 and 14 with bilateral and unilateral amblyopia, respectively. Amblyopia prevalence did not differ by gender (p=0.77). Significant refractive errors were found in 22 (88.0%) of children with amblyopia, and strabismus was found in 6 (24.0%) children with amblyopia. In multivariate analysis, amblyopia was significantly associated with hyperopia (≥+2.00 dioptres (D); OR 8.81, 95% CI 3.27 to 23.69, p<0.0001), astigmatism (≥2.00 D; OR 17.90, 95% CI 6.78 to 47.21, p<0.0001) and anisometropia (≥2.00 D; OR 5.87, 95% CI 1.52 to 22.77, p<0.05). The prevalence of amblyopia in children 36-48 months old in Eastern China was 1.47%. The refractive error is a major risk factor for amblyopia. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. The Rotterdam AMblyopia Screening Effectiveness Study (RAMSES): compliance and predictive value in the first 2 years

    NARCIS (Netherlands)

    R.E. Juttmann (Rikard)

    2001-01-01

    textabstractBACKGROUND: RAMSES is a 7 year follow up study, aiming at the evaluation of the effectiveness and the efficiency of screening for amblyopia. In this first report, concerning the first 2 years of life, the compliance with the prevention programme and the positive

  9. Macular and peripapillary retinal nerve fiber layer thickness in children with hyperopic anisometropic amblyopia

    Directory of Open Access Journals (Sweden)

    Shuang-Qing Wu

    2013-02-01

    Full Text Available AIM:To compare the retinal nerve fiber layer (RNFL thickness and macular thickness in the amblyopic eye with that in the sound eye of children with hyperopic anisometropic amblyopia using optical coherence tomography (OCT.METHODS: A prospective, nonrandom, intraindividual comparative cohort study includes 72 children with hyperopic anisometropic amblyopia in a single center. Macular thickness, macular foveola thickness, and peripapillary RNFL thickness were compared between the amblyopia eyes and the contralateral sound eyes.RESULTS:There were 38 male and 34 female patients, with a mean age as 9.7±1.9 years (range, 5–16 years. Hyperopic was +3.62±1.16D (range +2.00D to +6.50D in the amblyopic eyes, which was significantly higher in the control eyes with +0.76±0.90D (range 0D to +2.00D (P P = 0.02. The mean macular foveola thickness was significantly thicker in the amblyopic eyes than the contralateral sound eyes (181.4±14.2µm vs 175.2±13.3µm, P CONCLUSION:Eyes with hyperopic anisometropic amblyopia are found thicker macular foveola and peripapillary RNFL than the contralateral eyes in children.

  10. Treatment of amblyopia in the adult: insights from a new rodent model of visual perceptual learning.

    Science.gov (United States)

    Bonaccorsi, Joyce; Berardi, Nicoletta; Sale, Alessandro

    2014-01-01

    Amblyopia is the most common form of impairment of visual function affecting one eye, with a prevalence of about 1-5% of the total world population. Amblyopia usually derives from conditions of early functional imbalance between the two eyes, owing to anisometropia, strabismus, or congenital cataract, and results in a pronounced reduction of visual acuity and severe deficits in contrast sensitivity and stereopsis. It is widely accepted that, due to a lack of sufficient plasticity in the adult brain, amblyopia becomes untreatable after the closure of the critical period in the primary visual cortex. However, recent results obtained both in animal models and in clinical trials have challenged this view, unmasking a previously unsuspected potential for promoting recovery even in adulthood. In this context, non invasive procedures based on visual perceptual learning, i.e., the improvement in visual performance on a variety of simple visual tasks following practice, emerge as particularly promising to rescue discrimination abilities in adult amblyopic subjects. This review will survey recent work regarding the impact of visual perceptual learning on amblyopia, with a special focus on a new experimental model of perceptual learning in the amblyopic rat.

  11. Predicting adherence to eye patching in children with amblyopia: an application of protection motivation theory.

    Science.gov (United States)

    Norman, Paul; Searle, Aidan; Harrad, Richard; Vedhara, Kav

    2003-02-01

    This study reports an application of protection motivation theory (PMT) to the prediction of parental adherence to eye patching recommendations for children with amblyopia over a 2-month period. The study also considered the role of past behaviour in PMT. A total of 151 parents of children with amblyopia who were attending follow-up appointments for orthoptic treatment participated. They completed questionnaires based on PMT to assess their beliefs about amblyopia and eye patching. Of the parents, 105 were contacted again at 2-month follow-up to obtain a measure of adherence to the recommended treatment for their child. PMT was found to be predictive of adherence intentions and behaviour at 2-month follow-up. Regression analyses revealed perceived vulnerability, response efficacy and self-efficacy to be significant predictors of protection motivation, whereas perceived vulnerability and response costs were significant predictors of adherence behaviour. Past adherence behaviour was found to have a direct effect on future adherence behaviour over and above the influence of PMT. The results are discussed in relation to the sufficiency of PMTas a model of adherence behaviour. The practical implications for attempts to increase adherence to eye patching among children with amblyopia are outlined.

  12. Neuronal responses in visual area V2 (V2) of macaque monkeys with strabismic amblyopia.

    Science.gov (United States)

    Bi, H; Zhang, B; Tao, X; Harwerth, R S; Smith, E L; Chino, Y M

    2011-09-01

    Amblyopia, a developmental disorder of spatial vision, is thought to result from a cascade of cortical deficits over several processing stages beginning at the primary visual cortex (V1). However, beyond V1, little is known about how cortical development limits the visual performance of amblyopic primates. We quantitatively analyzed the monocular and binocular responses of V1 and V2 neurons in a group of strabismic monkeys exhibiting varying depths of amblyopia. Unlike in V1, the relative effectiveness of the affected eye to drive V2 neurons was drastically reduced in the amblyopic monkeys. The spatial resolution and the orientation bias of V2, but not V1, neurons were subnormal for the affected eyes. Binocular suppression was robust in both cortical areas, and the magnitude of suppression in individual monkeys was correlated with the depth of their amblyopia. These results suggest that the reduced functional connections beyond V1 and the subnormal spatial filter properties of V2 neurons might have substantially limited the sensitivity of the amblyopic eyes and that interocular suppression was likely to have played a key role in the observed alterations of V2 responses and the emergence of amblyopia.

  13. Spatial and Global Sensory Suppression Mapping Encompassing the Central 10° Field in Anisometropic Amblyopia.

    Science.gov (United States)

    Li, Jingjing; Li, Jinrong; Chen, Zidong; Liu, Jing; Yuan, Junpeng; Cai, Xiaoxiao; Deng, Daming; Yu, Minbin

    2017-01-01

    We investigate the efficacy of a novel dichoptic mapping paradigm in evaluating visual function of anisometropic amblyopes. Using standard clinical measures of visual function (visual acuity, stereo acuity, Bagolini lenses, and neutral density filters) and a novel quantitative mapping technique, 26 patients with anisometropic amblyopia (mean age = 19.15 ± 4.42 years) were assessed. Two additional psychophysical interocular suppression measurements were tested with dichoptic global motion coherence and binocular phase combination tasks. Luminance reduction was achieved by placing neutral density filters in front of the normal eye. Our study revealed that suppression changes across the central 10° visual field by mean luminance modulation in amblyopes as well as normal controls. Using simulation and an elimination of interocular suppression, we identified a novel method to effectively reflect the distribution of suppression in anisometropic amblyopia. Additionally, the new quantitative mapping technique was in good agreement with conventional clinical measures, such as interocular acuity difference (P suppression with dichoptic mapping paradigm and the results of the other two psychophysical methods (suppression mapping versus binocular phase combination, P suppression mapping versus global motion coherence, P = 0.005). The dichoptic suppression mapping technique is an effective method to represent impaired visual function in patients with anisometropic amblyopia. It offers a potential in "micro-"antisuppression mapping tests and therapies for amblyopia.

  14. Analysis of retinal nerve fibre layer changes in anisometropic amblyopia by Heidelberg retina tomograph

    International Nuclear Information System (INIS)

    Tayyab, A.; Afzal, F.

    2013-01-01

    Objective: To identify if anisometropic amblyopia is associated with changes in optic disk morphology. Methods: The study comprised a total of 80 eyes recruited from Shifa Foundation Community Health Centre and the Pakistan Institute of Medical Sciences, Islamabad between May and October 2012. Anisometropic amblyopia was the only cause of disability (visual acuity >6/12) in amblyopic eyes whereas normal eyes had a best corrected visual acuity of 6/6 and no morbidities. Patients with other causes of amblyopia, co-morbid ocular diseases, and in whom a good-quality image could not be obtained were excluded. Mean retinal nerve fiber layer thickness was analysed using Heidelberg retina tomograph. Analysis of frequency distribution, probability and regression were run on the data collected during the study using SPSS version 15.0. Results: The mean age of the patients was 23.85+-5.85 years. The retinal nerve fibre layer thickness ranged between 0.09mm and 0.35 mm (mean: 0.23mm+-0.07) in amblyopic eyes, and between 0.18mm and 0.36mm (mean: 0.25mm+-0.05) in normal eyes. The difference was not statistically significant (p=0.087). No association was found between the retinal nerve fiber layer thickness or the age and refractive error of patients. Conclusion: The optic disk does not appear to be the site of morphological changes in amblyopia. (author)

  15. Sociocultural and psychological determinants in migrants for noncompliance with occlusion therapy for amblyopia

    NARCIS (Netherlands)

    A.M. Tjiam (Angela); H. Akcan (Hilal); F. Ziylan (Fatma); E. Vukovic; S.E. Loudon (Sjoukje); C.W.N. Looman (Caspar); J. Passchier (Jan); H.J. Simonsz (Huib)

    2011-01-01

    textabstractBackground: Compliance with occlusion therapy for amblyopia in children is low when their parents have a low level of education, speak Dutch poorly, or originate from another country. We determined how sociocultural and psychological determinants affect compliance. Methods: Included were

  16. Research on spontaneous activity in adult anisometropic amblyopia with regional homogeneity

    Science.gov (United States)

    Huang, Yufeng; Zhou, Yifeng

    2017-06-01

    Amblyopia usually occurs in early childhood and results in monocular visual impairment. The functional magnetic resonance imaging (fMRI) studies have reflected functional anomaly in amblyopia. In resting-state fMRI study, spontaneous activity changes abnormally in anisometropic amblyopia could be revealed by the regional homogeneity (ReHo). Twenty two adult anisometropic amblyopes and Twenty one normal controls participated in this fMRI study. Two sample T test was carried out to analysis ReHo within the whole brain for the inter groups. Compare with normal group, our study found that the amblyopia’s ReHo mainly increased in the left frontal lobe, while decreased in the left cerebellum, the temporal lobe (left and right), and the left parietal lobe. And the ReHo values in middle and inferior temporal lobe, the prefrontal lobe, frontal lobe (positive) and parietal lobe and medial frontal gyrus (negative) could be correlated with the acuity deficit of amblyopia. The results increased in ReHo may indicate compensatory plasticity in higher vision information process, while the decreased in ReHo may reflect decreased ability in eye movement, spatial sense and visuo-motor coordination. The correlation revealed that the vision deficit may correspond to the spontaneous in certain brain area.

  17. Treatment of amblyopia in the adult: insights from a new rodent model of visual perceptual learning

    Science.gov (United States)

    Bonaccorsi, Joyce; Berardi, Nicoletta; Sale, Alessandro

    2014-01-01

    Amblyopia is the most common form of impairment of visual function affecting one eye, with a prevalence of about 1–5% of the total world population. Amblyopia usually derives from conditions of early functional imbalance between the two eyes, owing to anisometropia, strabismus, or congenital cataract, and results in a pronounced reduction of visual acuity and severe deficits in contrast sensitivity and stereopsis. It is widely accepted that, due to a lack of sufficient plasticity in the adult brain, amblyopia becomes untreatable after the closure of the critical period in the primary visual cortex. However, recent results obtained both in animal models and in clinical trials have challenged this view, unmasking a previously unsuspected potential for promoting recovery even in adulthood. In this context, non invasive procedures based on visual perceptual learning, i.e., the improvement in visual performance on a variety of simple visual tasks following practice, emerge as particularly promising to rescue discrimination abilities in adult amblyopic subjects. This review will survey recent work regarding the impact of visual perceptual learning on amblyopia, with a special focus on a new experimental model of perceptual learning in the amblyopic rat. PMID:25076874

  18. The effect of recent amblyopia research on current practice in the UK.

    Science.gov (United States)

    Newsham, D

    2010-10-01

    Several studies have recently provided insights into how amblyopia may be most effectively managed. Despite the new evidence, a US study reported that a recent randomised controlled trial had made little influence on clinical practice. The aims of this research are to assess current practice of amblyopia management in the UK and to determine the comparability with the evidence-based recommendations. A questionnaire was constructed to assess current amblyopia management practice, particularly in relation to areas investigated by recent research and emailed to every head orthoptist within the UK. There was a great deal of variability in the amount of occlusion that was prescribed for moderate and severe amblyopia. Sixty per cent of clinicians indicated that the maximum they would prescribe was in excess of the 6 h recommended by research. Atropine was rarely recommended as a first-line treatment, with occlusion generally being considered to be more effective. Despite recommendations regarding education as a means of reducing non-compliance, only 39% of clinicians always gave written information, although various other methods of enhancing compliance were used. A period of refractive adaptation was allowed by most clinicians but often far less than recommended. The uptake of recent research evidence into clinical practice is sporadic and incomplete with one-third of respondents indicating that following the studies, they had made no changes whatsoever to their practice. This is similar to other areas of medicine; the reasons are likely to be varied, and is an area that would benefit from greater attention.

  19. The effect of video game training on the vision of adults with bilateral deprivation amblyopia.

    Science.gov (United States)

    Jeon, Seong Taek; Maurer, Daphne; Lewis, Terri L

    2012-01-01

    Amblyopia is a condition involving reduced acuity caused by abnormal visual input during a critical period beginning shortly after birth. Amblyopia is typically considered to be irreversible during adulthood. Here we provide the first demonstration that video game training can improve at least some aspects of the vision of adults with bilateral deprivation amblyopia caused by a history of bilateral congenital cataracts. Specifically, after 40 h of training over one month with an action video game, most patients showed improvement in one or both eyes on a wide variety of tasks including acuity, spatial contrast sensitivity, and sensitivity to global motion. As well, there was evidence of improvement in at least some patients for temporal contrast sensitivity, single letter acuity, crowding, and feature spacing in faces, but not for useful field of view. The results indicate that, long after the end of the critical period for damage, there is enough residual plasticity in the adult visual system to effect improvements, even in cases of deep amblyopia caused by early bilateral deprivation.

  20. Binocular treatment of amblyopia using videogames (BRAVO): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Guo, Cindy X; Babu, Raiju J; Black, Joanna M; Bobier, William R; Lam, Carly S Y; Dai, Shuan; Gao, Tina Y; Hess, Robert F; Jenkins, Michelle; Jiang, Yannan; Kowal, Lionel; Parag, Varsha; South, Jayshree; Staffieri, Sandra Elfride; Walker, Natalie; Wadham, Angela; Thompson, Benjamin

    2016-10-18

    Amblyopia is a common neurodevelopmental disorder of vision that is characterised by visual impairment in one eye and compromised binocular visual function. Existing evidence-based treatments for children include patching the nonamblyopic eye to encourage use of the amblyopic eye. Currently there are no widely accepted treatments available for adults with amblyopia. The aim of this trial is to assess the efficacy of a new binocular, videogame-based treatment for amblyopia in older children and adults. We hypothesise that binocular treatment will significantly improve amblyopic eye visual acuity relative to placebo treatment. The BRAVO study is a double-blind, randomised, placebo-controlled multicentre trial to assess the effectiveness of a novel videogame-based binocular treatment for amblyopia. One hundred and eight participants aged 7 years or older with anisometropic and/or strabismic amblyopia (defined as ≥0.2 LogMAR interocular visual acuity difference, ≥0.3 LogMAR amblyopic eye visual acuity and no ocular disease) will be recruited via ophthalmologists, optometrists, clinical record searches and public advertisements at five sites in New Zealand, Canada, Hong Kong and Australia. Eligible participants will be randomised by computer in a 1:1 ratio, with stratification by age group: 7-12, 13-17 and 18 years and older. Participants will be randomised to receive 6 weeks of active or placebo home-based binocular treatment. Treatment will be in the form of a modified interactive falling-blocks game, implemented on a 5th generation iPod touch device viewed through red/green anaglyphic glasses. Participants and those assessing outcomes will be blinded to group assignment. The primary outcome is the change in best-corrected distance visual acuity in the amblyopic eye from baseline to 6 weeks post randomisation. Secondary outcomes include distance and near visual acuity, stereopsis, interocular suppression, angle of strabismus (where applicable) measured at

  1. Patient-reported utilities in bilateral visual impairment from amblyopia and age-related macular degeneration.

    Science.gov (United States)

    van de Graaf, Elizabeth S; Despriet, Dominiek D G; Klaver, Caroline C W; Simonsz, Huibert J

    2016-05-17

    Utility of visual impairment caused by amblyopia is important for the cost-effectiveness of screening for amblyopia (lazy eye, prevalence 3-3.5 %). We previously measured decrease of utility in 35-year-old persons with unilateral persistent amblyopia. The current observational case-control study aimed to measure loss of utility in patients with amblyopia with recent decrease of vision in their better eye. As these patients are rare, the sample was supplemented by patients with bilateral age-related macular degeneration with similar decrease of vision. From our out-patient department, two groups of patients with recent deterioration to bilateral visual acuity less than Snellen 0.5 (bilateral visual impairment, BVI) were recruited, with either persistent amblyopia and age-related macular degeneration (AMB + AMD), or with bilateral age-related macular degeneration (BAMD). To measure utility, the time trade-off method and the standard gamble method were applied through interviews. Correlations were sought between utility values and visual acuity, age and Visual Function Questionnaire-25 scores. Seventeen AMB + AMD patients (mean age 72.9 years), and 63 BAMD patients (mean age 79.6 years) were included in the study. Among AMB + AMD, 80 % were willing to trade lifetime in exchange for cure. The overall mean time trade-off utility was 0.925. Among BAMD, 75 % were willing to trade, utility was 0.917. Among AMB + AMD, 38 % accepted risk of death in exchange for cure, overall mean standard gamble utility was 0.999. Among BAMD, 49 % accepted risk of death, utility was 0.998. Utility was not related to visual acuity but it was to age (p = 0.02). Elderly patients with BVI, caused by persistent amblyopia and age-related macular degeneration (AMD) or by bilateral AMD, had an approximately 8 % loss of TTO utility. Notably, the 8 % loss in elderly with BVI differs little from the 3.7 % loss we found previously in 35-year-old persons with unilateral

  2. Can perceptual learning be used to treat amblyopia beyond the critical period of visual development?

    Science.gov (United States)

    Astle, Andrew T; Webb, Ben S; McGraw, Paul V

    2011-11-01

    Amblyopia presents early in childhood and affects approximately 3% of western populations. The monocular visual acuity loss is conventionally treated during the 'critical periods' of visual development by occluding or penalising the fellow eye to encourage use of the amblyopic eye. Despite the measurable success of this approach in many children, substantial numbers of people still suffer with amblyopia later in life because either they were never diagnosed in childhood, did not respond to the original treatment, the amblyopia was only partially remediated, or their acuity loss returned after cessation of treatment. In this review, we consider whether the visual deficits of this largely overlooked amblyopic group are amenable to conventional and innovative therapeutic interventions later in life, well beyond the age at which treatment is thought to be effective. There is a considerable body of evidence that residual plasticity is present in the adult visual brain and this can be harnessed to improve function in adults with amblyopia. Perceptual training protocols have been developed to optimise visual gains in this clinical population. Results thus far are extremely encouraging; marked visual improvements have been demonstrated, the perceptual benefits transfer to new visual tasks and appear to be relatively enduring. The essential ingredients of perceptual training protocols are being incorporated into video game formats, facilitating home-based interventions. Many studies support perceptual training as a tool for improving vision in amblyopes beyond the critical period. Should this novel form of treatment stand up to the scrutiny of a randomised controlled trial, clinicians may need to re-evaluate their therapeutic approach to adults with amblyopia. Ophthalmic & Physiological Optics © 2011 The College of Optometrists.

  3. A limited role for suppression in the central field of individuals with strabismic amblyopia.

    Science.gov (United States)

    Barrett, Brendan T; Panesar, Gurvinder K; Scally, Andrew J; Pacey, Ian E

    2012-01-01

    Although their eyes are pointing in different directions, people with long-standing strabismic amblyopia typically do not experience double-vision or indeed any visual symptoms arising from their condition. It is generally believed that the phenomenon of suppression plays a major role in dealing with the consequences of amblyopia and strabismus, by preventing images from the weaker/deviating eye from reaching conscious awareness. Suppression is thus a highly sophisticated coping mechanism. Although suppression has been studied for over 100 years the literature is equivocal in relation to the extent of the retina that is suppressed, though the method used to investigate suppression is crucial to the outcome. There is growing evidence that some measurement methods lead to artefactual claims that suppression exists when it does not. Here we present the results of an experiment conducted with a new method to examine the prevalence, depth and extent of suppression in ten individuals with strabismic amblyopia. Seven subjects (70%) showed no evidence whatsoever for suppression and in the three individuals who did (30%), the depth and extent of suppression was small. Suppression may play a much smaller role in dealing with the negative consequences of strabismic amblyopia than previously thought. Whereas recent claims of this nature have been made only in those with micro-strabismus our results show extremely limited evidence for suppression across the central visual field in strabismic amblyopes more generally. Instead of suppressing the image from the weaker/deviating eye, we suggest the visual system of individuals with strabismic amblyopia may act to maximise the possibilities for binocular co-operation. This is consistent with recent evidence from strabismic and amblyopic individuals that their binocular mechanisms are intact, and that, just as in visual normals, performance with two eyes is better than with the better eye alone in these individuals.

  4. A limited role for suppression in the central field of individuals with strabismic amblyopia.

    Directory of Open Access Journals (Sweden)

    Brendan T Barrett

    Full Text Available BACKGROUND: Although their eyes are pointing in different directions, people with long-standing strabismic amblyopia typically do not experience double-vision or indeed any visual symptoms arising from their condition. It is generally believed that the phenomenon of suppression plays a major role in dealing with the consequences of amblyopia and strabismus, by preventing images from the weaker/deviating eye from reaching conscious awareness. Suppression is thus a highly sophisticated coping mechanism. Although suppression has been studied for over 100 years the literature is equivocal in relation to the extent of the retina that is suppressed, though the method used to investigate suppression is crucial to the outcome. There is growing evidence that some measurement methods lead to artefactual claims that suppression exists when it does not. METHODOLOGY/RESULTS: Here we present the results of an experiment conducted with a new method to examine the prevalence, depth and extent of suppression in ten individuals with strabismic amblyopia. Seven subjects (70% showed no evidence whatsoever for suppression and in the three individuals who did (30%, the depth and extent of suppression was small. CONCLUSIONS: Suppression may play a much smaller role in dealing with the negative consequences of strabismic amblyopia than previously thought. Whereas recent claims of this nature have been made only in those with micro-strabismus our results show extremely limited evidence for suppression across the central visual field in strabismic amblyopes more generally. Instead of suppressing the image from the weaker/deviating eye, we suggest the visual system of individuals with strabismic amblyopia may act to maximise the possibilities for binocular co-operation. This is consistent with recent evidence from strabismic and amblyopic individuals that their binocular mechanisms are intact, and that, just as in visual normals, performance with two eyes is better than

  5. Can perceptual learning be used to treat amblyopia beyond the critical period of visual development?

    Science.gov (United States)

    Astle, Andrew T.; Webb, Ben S.; McGraw, Paul V.

    2012-01-01

    Background Amblyopia presents early in childhood and affects approximately 3% of western populations. The monocular visual acuity loss is conventionally treated during the “critical periods” of visual development by occluding or penalising the fellow eye to encourage use of the amblyopic eye. Despite the measurable success of this approach in many children, substantial numbers of people still suffer with amblyopia later in life because either they were never diagnosed in childhood, did not respond to the original treatment, the amblyopia was only partially remediated, or their acuity loss returned after cessation of treatment. Purpose In this review, we consider whether the visual deficits of this largely overlooked amblyopic group are amenable to conventional and innovative therapeutic interventions later in life, well beyond the age at which treatment is thought to be effective. Recent findings There is a considerable body of evidence that residual plasticity is present in the adult visual brain and this can be harnessed to improve function in adults with amblyopia. Perceptual training protocols have been developed to optimise visual gains in this clinical population. Results thus far are extremely encouraging: marked visual improvements have been demonstrated, the perceptual benefits transfer to new visual tasks and appear to be relatively enduring. The essential ingredients of perceptual training protocols are being incorporated into video game formats, facilitating home-based interventions. Summary Many studies support perceptual training as a tool for improving vision in amblyopes beyond the critical period. Should this novel form of treatment stand up to the scrutiny of a randomised controlled trial, clinicians may need to re-evaluate their therapeutic approach to adults with amblyopia. PMID:21981034

  6. Quantitative measurement of interocular suppression in anisometropic amblyopia: a case-control study.

    Science.gov (United States)

    Li, Jinrong; Hess, Robert F; Chan, Lily Y L; Deng, Daming; Yang, Xiao; Chen, Xiang; Yu, Minbin; Thompson, Benjamin

    2013-08-01

    The aims of this study were to assess (1) the relationship between interocular suppression and visual function in patients with anisometropic amblyopia, (2) whether suppression can be simulated in matched controls using monocular defocus or neutral density filters, (3) the effects of spectacle or rigid gas-permeable contact lens correction on suppression in patients with anisometropic amblyopia, and (4) the relationship between interocular suppression and outcomes of occlusion therapy. Case-control study (aims 1-3) and cohort study (aim 4). Forty-five participants with anisometropic amblyopia and 45 matched controls (mean age, 8.8 years for both groups). Interocular suppression was assessed using Bagolini striated lenses, neutral density filters, and an objective psychophysical technique that measures the amount of contrast imbalance between the 2 eyes that is required to overcome suppression (dichoptic motion coherence thresholds). Visual acuity was assessed using a logarithm minimum angle of resolution tumbling E chart and stereopsis using the Randot preschool test. Interocular suppression assessed using dichoptic motion coherence thresholds. Patients exhibited significantly stronger suppression than controls, and stronger suppression was correlated significantly with poorer visual acuity in amblyopic eyes. Reducing monocular acuity in controls to match that of cases using neutral density filters (luminance reduction) resulted in levels of interocular suppression comparable with that in patients. This was not the case for monocular defocus (optical blur). Rigid gas-permeable contact lens correction resulted in less suppression than spectacle correction, and stronger suppression was associated with poorer outcomes after occlusion therapy. Interocular suppression plays a key role in the visual deficits associated with anisometropic amblyopia and can be simulated in controls by inducing a luminance difference between the eyes. Accurate quantification of suppression

  7. Crowded letter and crowded picture logMAR acuity in children with amblyopia: a quantitative comparison.

    Science.gov (United States)

    O'Boyle, Cathy; Chen, Sean I; Little, Julie-Anne

    2017-04-01

    Clinically, picture acuity tests are thought to overestimate visual acuity (VA) compared with letter tests, but this has not been systematically investigated in children with amblyopia. This study compared VA measurements with the LogMAR Crowded Kay Picture test to the LogMAR Crowded Keeler Letter acuity test in a group of young children with amblyopia. 58 children (34 male) with amblyopia (22 anisometropic, 18 strabismic and 18 with both strabismic/anisometropic amblyopia) aged 4-6 years (mean=68.7, range=48-83 months) underwent VA measurements. VA chart testing order was randomised, but the amblyopic eye was tested before the fellow eye. All participants wore up-to-date refractive correction. The Kay Picture test significantly overestimated VA by 0.098 logMAR (95% limits of agreement (LOA), 0.13) in the amblyopic eye and 0.088 logMAR (95% LOA, 0.13) in the fellow eye, respectively (pocclusion therapy, refractive correction or type of amblyopia on VA results (p>0.23). For both the amblyopic and fellow eyes, Bland-Altman plots demonstrated a systematic and predictable difference between Kay Picture and Keeler Letter charts across the range of acuities tested (Keeler acuity: amblyopic eye 0.75 to -0.05 logMAR; fellow eye 0.45 to -0.15 logMAR). Linear regression analysis (pamblyopia. Due to the predictable difference found between both crowded logMAR acuity tests, it is reasonable to adjust Kay Picture acuity thresholds by +0.10 logMAR to compute expected Keeler Letter acuity scores. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. Part-time versus full-time occlusion therapy for treatment of amblyopia: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Negareh Yazdani

    2017-06-01

    Conclusions: This meta-analysis shows no statistically significant difference between PTO and FTO in treatment of amblyopia. However, our results suggest that the minimum effective PTO duration, to observe maximal improvement in visual acuity is six hours per day.

  9. Toxic Amblyopia (Nutritional Amblyopia)

    Science.gov (United States)

    ... Generic and Brand Natural Products, Search Drug Interactions Pill Identifier Commonly searched drugs Aspirin Metformin Warfarin Tramadol Lactulose Ranitidine News & Commentary Recent News Strict Gun Laws Spare Young Lives: Study 'Smart Dresser' Might Help Alzheimer's Patients Clothe Themselves AHA: ...

  10. An action video game for the treatment of amblyopia in children: A feasibility study.

    Science.gov (United States)

    Gambacorta, Christina; Nahum, Mor; Vedamurthy, Indu; Bayliss, Jessica; Jordan, Josh; Bavelier, Daphne; Levi, Dennis M

    2018-05-12

    The gold-standard treatment for childhood amblyopia remains patching or penalizing the fellow eye, resulting in an average of about a one line (0.1 logMAR) improvement in visual acuity following ≈120 h of patching in children 3-8 years old. However, compliance with patching and other treatment options is often poor. In contrast, fast-paced action video games can be highly engaging, and have been shown to yield broad-based improvements in vision and attention in adult amblyopia. Here, we pilot-tested a custom-made action video game to treat children with amblyopia. Twenty-one (n = 21) children (mean age 9.95 ± 3.14 [se]) with unilateral amblyopia (n = 12 anisometropic and n = 9 strabismic) completed 20 h of game play either monocularly, with the fellow eye patched (n = 11), or dichoptically, with reduced contrast to the fellow eye (n = 10). Participants were assessed for visual acuity (VA), stereo acuity and reading speed at baseline, and following 10 and 20 h of play. Additional exploratory analyses examined improvements after 6-10 weeks of completion of training (follow-up). Following 20 h of training, VA improved, on average, by 0.14 logMAR (≈38%) for the dichoptic group and by 0.06 logMAR (≈15%) for the monocular group. Similarly, stereoacuity improved by 0.07 log arcsec (≈17%) following dichoptic training, and by 0.06 log arcsec (≈15%) following monocular training. Across both treatment groups, 7 of the 12 individuals with anisometropic amblyopia showed improvement in stereoacuity, whereas only 1 of the 9 strabismic individuals improved. Most improvements were largely retained at follow-up. Our feasibility study therefore suggests that the action video game approach may be used as an effective adjunct treatment for amblyopia in children, achieving results similar to those of the gold-standard treatment in shorter duration. Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. Video Game Use in the Treatment of Amblyopia: Weighing the Risks of Addiction

    Science.gov (United States)

    Xu, Chaoying S.; Chen, Jessica S.; Adelman, Ron A.

    2015-01-01

    Video games have surged in popularity due to their entertainment factor and, with recent innovation, their use in health care. This review explores the dual facets of video games in treating vision impairment in amblyopia as well as their potential for overuse and addiction. Specifically, this review examines video game addiction from a biopsychosocial perspective and relates the addictive qualities of video games with their use as a therapeutic treatment for amblyopia. Current literature supports both the identification of video game addiction as a disease, as well as the therapeutic potential of video games in clinical trials. We show the need for clinicians to be aware of the dangers associated with video game overuse and the need for future studies to examine the risks associated with their health care benefits. PMID:26339215

  12. A new form of rapid binocular plasticity in adult with amblyopia.

    Science.gov (United States)

    Zhou, Jiawei; Thompson, Benjamin; Hess, Robert F

    2013-01-01

    Amblyopia is a neurological disorder of binocular vision affecting up to 3% of the population resulting from a disrupted period of early visual development. Recently, it has been shown that vision can be partially restored by intensive monocular or dichoptic training (4-6 weeks). This can occur even in adults owing to a residual degree of brain plasticity initiated by repetitive and successive sensory stimulation. Here we show that the binocular imbalance that characterizes amblyopia can be reduced by occluding the amblyopic eye with a translucent patch for as little as 2.5 hours, suggesting a degree of rapid binocular plasticity in adults resulting from a lack of sensory stimulation. The integrated binocular benefit is larger in our amblyopic group than in our normal control group. We propose that this rapid improvement in function, as a result of reduced sensory stimulation, represents a new form of plasticity operating at a binocular site.

  13. Brain plasticity in the adult: modulation of function in amblyopia with rTMS.

    Science.gov (United States)

    Thompson, Benjamin; Mansouri, Behzad; Koski, Lisa; Hess, Robert F

    2008-07-22

    Amblyopia is a cortically based visual disorder caused by disruption of vision during a critical early developmental period. It is often thought to be a largely intractable problem in adult patients because of a lack of neuronal plasticity after this critical period [1]; however, recent advances have suggested that plasticity is still present in the adult amblyopic visual cortex [2-6]. Here, we present data showing that repetitive transcranial magnetic stimulation (rTMS) of the visual cortex can temporarily improve contrast sensitivity in the amblyopic visual cortex. The results indicate continued plasticity of the amblyopic visual system in adulthood and open the way for a potential new therapeutic approach to the treatment of amblyopia.

  14. Video Game Use in the Treatment of Amblyopia: Weighing the Risks of Addiction.

    Science.gov (United States)

    Xu, Chaoying S; Chen, Jessica S; Adelman, Ron A

    2015-09-01

    Video games have surged in popularity due to their entertainment factor and, with recent innovation, their use in health care. This review explores the dual facets of video games in treating vision impairment in amblyopia as well as their potential for overuse and addiction. Specifically, this review examines video game addiction from a biopsychosocial perspective and relates the addictive qualities of video games with their use as a therapeutic treatment for amblyopia. Current literature supports both the identification of video game addiction as a disease, as well as the therapeutic potential of video games in clinical trials. We show the need for clinicians to be aware of the dangers associated with video game overuse and the need for future studies to examine the risks associated with their health care benefits.

  15. From motor cortex to visual cortex: the application of noninvasive brain stimulation to amblyopia.

    Science.gov (United States)

    Thompson, Benjamin; Mansouri, Behzad; Koski, Lisa; Hess, Robert F

    2012-04-01

    Noninvasive brain stimulation is a technique for inducing changes in the excitability of discrete neural populations in the human brain. A current model of the underlying pathological processes contributing to the loss of motor function after stroke has motivated a number of research groups to investigate the potential therapeutic application of brain stimulation to stroke rehabilitation. The loss of motor function is modeled as resulting from a combination of reduced excitability in the lesioned motor cortex and an increased inhibitory drive from the nonlesioned hemisphere over the lesioned hemisphere. This combination of impaired neural function and pathological suppression resonates with current views on the cause of the visual impairment in amblyopia. Here, we discuss how the rationale for using noninvasive brain stimulation in stroke rehabilitation can be applied to amblyopia, review a proof-of-principle study demonstrating that brain stimulation can temporarily improve amblyopic eye function, and propose future research avenues. Copyright © 2010 Wiley Periodicals, Inc.

  16. Development assessment of natural latex membranes: a new proposal for the treatment of amblyopia

    Energy Technology Data Exchange (ETDEWEB)

    Ribeiro, Jaqueline Alves; Rosa, Suelia Rodrigues Fleury, E-mail: jackalvesribeiro@gmail.com [Laboratorio de Engenharia e Biomaterial (BioEngLab), Faculdade Gama, Universidade de Brasilia (UnB), DF (Brazil); Leite, Cicilia Raquel Maia; Vasconcelos, Claudio Lopes; Soares, Joao Maria [Universidade do Estado do Rio Grande do Norte (UERN), Mossoro, RN (Brazil)

    2017-05-15

    The ophthalmic dysfunction amblyopia, commonly known as lazy eye, is characterized by decreased vision in one eye due to improper development in childhood. The aim of this study was to obtain and characterize natural rubber membranes and to assess their utility as an eye film capable of altering the passage of light. The latex membranes were produced using the Van Gogh method and the deposition technique and were analyzed by physical and chemical methods to determine the properties of latex in natura and of natural rubber membranes. The materials were characterized by X-ray diffractometry, scanning electron microscopy, thermogravimetry, differential scanning calorimetry, analysis of water sorption and light crossing analysis. We report here a new approach to the treatment of patients with amblyopia using latex membranes. (author)

  17. Development assessment of natural latex membranes: a new proposal for the treatment of amblyopia

    International Nuclear Information System (INIS)

    Ribeiro, Jaqueline Alves; Rosa, Suelia Rodrigues Fleury; Leite, Cicilia Raquel Maia; Vasconcelos, Claudio Lopes; Soares, Joao Maria

    2017-01-01

    The ophthalmic dysfunction amblyopia, commonly known as lazy eye, is characterized by decreased vision in one eye due to improper development in childhood. The aim of this study was to obtain and characterize natural rubber membranes and to assess their utility as an eye film capable of altering the passage of light. The latex membranes were produced using the Van Gogh method and the deposition technique and were analyzed by physical and chemical methods to determine the properties of latex in natura and of natural rubber membranes. The materials were characterized by X-ray diffractometry, scanning electron microscopy, thermogravimetry, differential scanning calorimetry, analysis of water sorption and light crossing analysis. We report here a new approach to the treatment of patients with amblyopia using latex membranes. (author)

  18. Reversal of myopic anisometropic amblyopia with occlusion therapy in a 25 year old.

    Science.gov (United States)

    Megbelayin, E; Ekpenyong, S M; Azunobi, J; Ejiro, G

    2014-03-01

    To report a reversal of myopic anisometropic amblyopia with occlusion therapy in a 25 year old. Case report. Eye clinic of a University Teaching Hospital in a metropolitan city. an index patient. Occlusion therapy. Post occlusion visual acuity. Presenting unaided visual acuity of right eye: 6/6, left eye: 4/60. Refraction result was: right eye: -0.50DS (6/6), left eye: -3.50DS (6/18). Following day time occlusion therapy of at least 6 hours for about 4 weeks, subjective refraction was: right eye: -0.5DS (6/5), left eye: -3.50DS (6/6(+3)). The remarkable improvement in vision at age 25 years of a patient with myopic anisometropic amblyopia shows that occlusion therapy might still be useful long after amblyogenic period.

  19. A dichoptic custom-made action video game as a treatment for adult amblyopia.

    Science.gov (United States)

    Vedamurthy, Indu; Nahum, Mor; Huang, Samuel J; Zheng, Frank; Bayliss, Jessica; Bavelier, Daphne; Levi, Dennis M

    2015-09-01

    Previous studies have employed different experimental approaches to enhance visual function in adults with amblyopia including perceptual learning, videogame play, and dichoptic training. Here, we evaluated the efficacy of a novel dichoptic action videogame combining all three approaches. This experimental intervention was compared to a conventional, yet unstudied method of supervised occlusion while watching movies. Adults with unilateral amblyopia were assigned to either play the dichoptic action game (n=23; 'game' group), or to watch movies monocularly while the fellow eye was patched (n=15; 'movies' group) for a total of 40hours. Following training, visual acuity (VA) improved on average by ≈0.14logMAR (≈28%) in the game group, with improvements noted in both anisometropic and strabismic patients. This improvement is similar to that obtained following perceptual learning, video game play or dichoptic training. Surprisingly, patients with anisometropic amblyopia in the movies group showed similar improvement, revealing a greater impact of supervised occlusion in adults than typically thought. Stereoacuity, reading speed, and contrast sensitivity improved more for game group participants compared with movies group participants. Most improvements were largely retained following a 2-month no-contact period. This novel video game, which combines action gaming, perceptual learning and dichoptic presentation, results in VA improvements equivalent to those previously documented with each of these techniques alone. Our game intervention led to greater improvement than control training in a variety of visual functions, thus suggesting that this approach has promise for the treatment of adult amblyopia. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Monocular perceptual learning of contrast detection facilitates binocular combination in adults with anisometropic amblyopia

    OpenAIRE

    Chen, Zidong; Li, Jinrong; Liu, Jing; Cai, Xiaoxiao; Yuan, Junpeng; Deng, Daming; Yu, Minbin

    2016-01-01

    Perceptual learning in contrast detection improves monocular visual function in adults with anisometropic amblyopia; however, its effect on binocular combination remains unknown. Given that the amblyopic visual system suffers from pronounced binocular functional loss, it is important to address how the amblyopic visual system responds to such training strategies under binocular viewing conditions. Anisometropic amblyopes (n?=?13) were asked to complete two psychophysical supra-threshold binoc...

  1. Astigmatism and Amblyopia among Native American Children (AANAC): design and methods.

    Science.gov (United States)

    Miller, J M; Dobson, V M; Harvey, E M; Sherrill, D L

    2000-09-01

    The overall goal of the AANAC study is to improve detection of astigmatism and prevention of amblyopia in populations with a high prevalence of astigmatism. To meet this goal, the study will evaluate four methods of screening for astigmatism in preschool children and will assess both the short-term and long-term benefits of early correction of astigmatism in improving acuity and preventing amblyopia. This paper presents an overview of the design and methodology of the AANAC study. Subjects are members of the Tohono O'Odham Nation, a Native American tribe with a high prevalence of astigmatism. Preschool-age children who attend Head Start are screened with four tools: the Marco Nidek KM-500 autokeratometer, the MTI photoscreener, the Nikon Retinomax K-Plus autorefractor, and the Lea Symbols acuity chart. Sensitivity and specificity for detection of significant astigmatism, as measured by a technique that uses both cycloplegic retinoscopy and cycloplegic autorefraction, is determined for each of the four screening tools. Presence of amblyopia is evaluated by measurement of best-corrected recognition acuity and acuity for orthogonal gratings. Spectacles are provided to all 3-year-old children with > or =2.00 diopters (D) of astigmatism and all 4- and 5-year-old children with > or =1.50 D of astigmatism. Persistence of amblyopia after glasses wearing is evaluated by follow-up measurement of best-corrected recognition acuity and acuity for orthogonal gratings, conducted 2-5 months after glasses are prescribed. Long-term effectiveness of early screening and glasses prescription is evaluated through measurement of recognition acuity in two groups of first-grade children: one group who participated in the Head Start program before the intensive vision screening program was initiated, and a second group who participated in the study's Head Start vision screening program.

  2. Binocular Therapy for Childhood Amblyopia Improves Vision Without Breaking Interocular Suppression.

    Science.gov (United States)

    Bossi, Manuela; Tailor, Vijay K; Anderson, Elaine J; Bex, Peter J; Greenwood, John A; Dahlmann-Noor, Annegret; Dakin, Steven C

    2017-06-01

    Amblyopia is a common developmental visual impairment characterized by a substantial difference in acuity between the two eyes. Current monocular treatments, which promote use of the affected eye by occluding or blurring the fellow eye, improve acuity, but are hindered by poor compliance. Recently developed binocular treatments can produce rapid gains in visual function, thought to be as a result of reduced interocular suppression. We set out to develop an effective home-based binocular treatment system for amblyopia that would engage high levels of compliance but that would also allow us to assess the role of suppression in children's response to binocular treatment. Balanced binocular viewing therapy (BBV) involves daily viewing of dichoptic movies (with "visibility" matched across the two eyes) and gameplay (to monitor compliance and suppression). Twenty-two children (3-11 years) with anisometropic (n = 7; group 1) and strabismic or combined mechanism amblyopia (group 2; n = 6 and 9, respectively) completed the study. Groups 1 and 2 were treated for a maximum of 8 or 24 weeks, respectively. The treatment elicited high levels of compliance (on average, 89.4% ± 24.2% of daily dose in 68.23% ± 12.2% of days on treatment) and led to a mean improvement in acuity of 0.27 logMAR (SD 0.22) for the amblyopic eye. Importantly, acuity gains were not correlated with a reduction in suppression. BBV is a binocular treatment for amblyopia that can be self-administered at home (with remote monitoring), producing rapid and substantial benefits that cannot be solely mediated by a reduction in interocular suppression.

  3. [Occlusion treatment for amblyopia. Age dependence and dose-response relationship].

    Science.gov (United States)

    Fronius, M

    2016-04-01

    Based on clinical experience and studies on animal models the age of 6-7 years was regarded as the limit for treatment of amblyopia, although functional improvement was also occasionally reported in older patients. New technical developments as well as insights from clinical studies and the neurosciences have attracted considerable attention to this topic. Various aspects of the age dependence of amblyopia treatment are discussed in this article, e. g. prescription, electronic monitoring of occlusion dosage, calculation of indicators for age-dependent plasticity of the visual system, and novel, alternative treatment approaches. Besides a discussion of the recent literature, results of studies by our "Child Vision Research Unit" in Frankfurt are presented: results of a questionnaire about prescription habits concerning age limits of patching, electronic recording of occlusion in patients beyond the conventional treatment age, calculation of dose-response function and efficiency of patching and their age dependence. The results of the questionnaire illustrate the uncertainty about age limits of prescription with significant deviations from the guideline of the German Ophthalmological Society (DOG). Electronic recording of occlusion allowed the quantification of declining dose-response function and treatment efficiency between 5 and 16 years of age. Reports about successful treatment with conventional and novel methods in adults are at variance with the notion of a rigid adult visual system lacking plasticity. Electronic recording of patching allowed new insights into the age-dependent susceptibility of the visual system and contributes to a more evidence-based treatment of amblyopia. Alternative approaches for adults challenge established notions about age limits of amblyopia therapy. Further studies comparing different treatment options are urgently needed.

  4. Treatment of Amblyopia Using Personalized Dosing Strategies: Statistical Modelling and Clinical Implementation.

    Science.gov (United States)

    Wallace, Michael P; Stewart, Catherine E; Moseley, Merrick J; Stephens, David A; Fielder, Alistair R

    2016-12-01

    To generate a statistical model for personalizing a patient's occlusion therapy regimen. Statistical modelling was undertaken on a combined data set of the Monitored Occlusion Treatment of Amblyopia Study (MOTAS) and the Randomized Occlusion Treatment of Amblyopia Study (ROTAS). This exercise permits the calculation of future patients' total effective dose (TED)-that predicted to achieve their best attainable visual acuity. Daily patching regimens (hours/day) can be calculated from the TED. Occlusion data for 149 study participants with amblyopia (anisometropic in 50, strabismic in 43, and mixed in 56) were analyzed. Median time to best observed visual acuity was 63 days (25% and 75% quartiles; 28 and 91 days). Median visual acuity in the amblyopic eye at start of occlusion was 0.40 logMAR (quartiles 0.22 and 0.68 logMAR) and at end of occlusion was 0.12 (quartiles 0.025 and 0.32 logMAR). Median lower and upper estimates of TED were 120 hours (quartiles 34 and 242 hours), and 176 hours (quartiles 84 and 316 hours). The data suggest a piecewise linear relationship (P = 0.008) between patching dose-rate (hours/day) and TED with a single breakpoint estimated at 2.16 (standard error 0.51) hours/day, suggesting doses below 2.16 hours/day are less effective. We introduce the concept of TED of occlusion. Predictors for TED are visual acuity deficit, amblyopia type, and age at start of occlusion therapy. Dose-rates prescribed within the model range from 2.5 to 12 hours/day and can be revised dynamically throughout treatment in response to recorded patient compliance: a personalized dosing strategy.

  5. Outcomes of 6 hour part-time occlusion treatment combined with near activities for unilateral amblyopia.

    Science.gov (United States)

    Park, Kyoung Soo; Chang, Yoon Hee; Na, Kyung Doo; Hong, Samin; Han, Sueng Han

    2008-03-01

    To evaluate the outcome of the part-time occlusion therapy with near activities in monocular amblyopic patients according to gender, age, severity of amblyopia, and the cause of amblyopia. Fifty eight patients who were prescribed part-time occlusion therapy with near activity from July 1998 to October 2004, were included in this retrospective study. All patients were divided into groups by gender, age, severity of amblyopia, and the cause of amblyopia. Main outcome measures were best corrected visual acuity, line improvement, and success rate. At the end of patch therapy, visual acuity improved from baseline by an average of 3.2+/-2.5 lines (0.33+/-0.26 log MAR), and follow-up period was 19.71+/-14.61 months (1.62+/-1.20 years). At the last follow-up, visual acuity improved from baseline by an average of 3.7+/-2.4 lines (0.38+/-0.26 log MAR), and follow-up period was 37.41+/-25.83 months (3.08+/-2.12 years). The success rate was 86% (50 patients) at the end of patch therapy. In 44 patients out of 50 patients (88%), the visual acuity was maintained. While 43 patients out of 47 patients who were less than 7 years old (91%) achieved success, 7 patients out of 11 patients 7 years or older (64%) achieved success (p=0.035). Six-hour part-time occlusion treatment combined with near activities appears to be favorable in treating 58 children during follow-up of mean 3.08 years. The significant factor was the age at initial treatment.

  6. Visual impairment and amblyopia in Malaysian pre-school children - The SEGPAEDS study.

    Science.gov (United States)

    Chew, F L M; Thavaratnam, L K; Shukor, I N C; Ramasamy, S; Rahmat, J; Reidpath, D D; Allotey, P; Alagaratnam, J

    2018-02-01

    Little is known regarding the extent of visual impairment amongst pre-school children in Malaysia. To determine the prevalence of visual impairment and amblyopia in Malaysian preschool children. A cross-sectional, population-based study was conducted on children aged four to six years from 51 participating kindergartens in the district of Segamat, Johor, Malaysia from 20 March 2016 to 6 April 2016. All subjects had initial eye screening consisting of LogMar visual acuity, orthoptics examination and Spot vision screener assessment. Subjects who failed the initial eye screening were invited for a formal eye assessment consisting of cycloplegic refraction and a comprehensive ocular examination. Definitions of visual impairment and amblyopia were based on the Multi-Ethnic Pediatric Eye Disease Study criteria. A total of 1287 children were recruited. Mean subject age was 5.03 (SD:0.77) and males represented 52.3% of subjects. Subjects by ethnicity were Malay (54.8%), Chinese (27.7%), Indian (15.6%) and Orang Asli (1.9%). Formal eye assessment was required for 221 subjects and 88.8% required ophthalmic intervention. Refractive error, representing 95.4% of diagnosed ocular disorders, comprised of astigmatism (84%), myopia (9%) and hypermetropia (6.9%). With-the-rule astigmatism was present in 93.4% of the subjects with astigmatism. Visual impairment was present in 12.5% of our subjects, with 61% having bilateral visual impairment. Of the subjects with visual impairment, 59.1% had moderate visual impairment. The prevalence of amblyopia was 7.53%, and 66% of the amblyopic subjects had bilateral amblyopia. Our study highlights an urgent need for initiation of preschool vision screening in Malaysia.

  7. A dichoptic custom-made action video game as a treatment for adult amblyopia

    Science.gov (United States)

    Vedamurthy, Indu; Nahum, Mor; Huang, Samuel J.; Zheng, Frank; Bayliss, Jessica; Bavelier, Daphne; Levi, Dennis M.

    2015-01-01

    Previous studies have employed different experimental approaches to enhance visual function in adults with amblyopia including perceptual learning, videogame play, and dichoptic training. Here, we evaluated the efficacy of a novel dichoptic action videogame combining all three approaches. This experimental intervention was compared to a conventional, yet unstudied method of supervised occlusion while watching movies. Adults with unilateral amblyopia were assigned to either playing the dichoptic action game (n = 23; ‘game’ group), or to watching movies monocularly while the fellow eye was patched (n = 15; ‘movies’ group) for a total of 40 h. Following training, visual acuity (VA) improved on average by ≈0.14 logMAR (≈27%) in the game group, with improvements noted in both anisometropic and strabismic patients. This improvement is similar to that described after perceptual learning, video game play or dichoptic training. Surprisingly, patients with anisometropic amblyopia in the movies group showed similar improvement, revealing a greater impact of supervised occlusion in adults than typically thought. Stereoacuity, reading speed, and contrast sensitivity improved more for game group participants compared with movies group participants. Most improvements were largely retained following a 2-month no-contact period. This novel video game, which combines action gaming, perceptual learning and dichoptic presentation, results in VA improvements equivalent to those previously documented with each of these techniques alone. Interestingly, however, our game intervention led to greater improvement than control training in a variety of visual functions, thus suggesting that this approach has promise for the treatment of adult amblyopia. PMID:25917239

  8. A computer-based anaglyphic system for the treatment of amblyopia

    Directory of Open Access Journals (Sweden)

    Rastegarpour A

    2011-09-01

    Full Text Available Ali Rastegarpour Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Purpose: Virtual reality (VR-based treatment has been introduced as a potential option for amblyopia management, presumably without involving the problems of occlusion and penalization, including variable and unsatisfactory outcomes, long duration of treatment, poor compliance, psychological impact, and complications. However, VR-based treatment is costly and not accessible for most children. This paper introduces a method that encompasses the advantages of VR-based treatment at a lower cost. Methods: The presented system consists of a pair of glasses with two color filters and software for use on a personal computer. The software is designed such that some active graphic components can only be seen by the amblyopic eye and are filtered out for the other eye. Some components would be seen by both to encourage fusion. The result is that the patient must use both eyes, and specifically the amblyopic eye, to play the games. Results: A prototype of the system, the ABG InSight, was found capable of successfully filtering out elements of a certain color and therefore, could prove to be a viable alternative to VR-based treatment for amblyopia. Conclusion: The anaglyphic system maintains most of the advantages of VR-based systems, but is less costly and highly accessible. It fulfills the means that VR-based systems are designed to achieve, and warrants further investigation. Keywords: amblyopia, computer-based, open source, virtual reality, color filters, 3-D

  9. Study on efficacy and visual sensitivity of long - term masking therapy for children with ametropic amblyopia

    Directory of Open Access Journals (Sweden)

    Xiao Chen

    2017-11-01

    Full Text Available AIM: To investigate the efficacy and visual sensitivity of occlusion therapy combined training for children with ametropic amblyopia. METHODS: Totally 85 children(85 eyeswith anisometropic amblyopia treated in our hospital from January 2013 to January 2015 were selected. All patients were given occlusion therapy combined training. Statistical analysis of clinical efficacy and visual sensitivity changes were taken, and the changes of visual acuity, AULCSF, Smax, Frmax were analyzed. RESULTS: The visual acuity after therapy was significantly better than that before treatment(1.12±0.29 vs 0.45±0.25, Pmax and Frmax all increased, the difference between the two groups was statistically significant(PPP=0.001. Mild group and moderate group had no significant difference on the total clinical efficiency difference(χ2=3.091, P=0.079; between mild group and severe group total effective rate was significantly different(χ2=11.471, P=0.001; the moderate and severe groups total clinical efficiency were no significantly different(χ2=3.359, P=0.067. In addition, the total efficiency rate of wearing glasses under the age of 6 was significantly higher than that after 6 years old(95% vs 77%, statistical difference between the two groups was significant(PCONCLUSION: Masking therapy combined with comprehensive training, in the treatment of children with ametropic amblyopia, and wearing a corrective spectacles, is desirable, especially for children under 7 years of age.

  10. Occlusion properties of prosthetic contact lenses for the treatment of amblyopia.

    Science.gov (United States)

    Collins, Randall S; McChesney, Megan E; McCluer, Craig A; Schatz, Martha P

    2008-12-01

    The efficacy of opaque contact lenses as occlusion therapy for amblyopia has been established in the literature. Prosthetic contact lenses use similar tints to improve cosmesis in scarred or deformed eyes and may be an alternative in occlusion therapy. To test this idea, we determined the degree of vision penalization elicited by prosthetic contact lenses and their effect on peripheral fusion. We tested 19 CIBA Vision DuraSoft 3 Prosthetic soft contact lenses with varying iris prints, underprints, and opaque pupil sizes in 10 volunteers with best-corrected Snellen distance visual acuity of 20/20 or better in each eye. Snellen visual acuity and peripheral fusion using the Worth 4-Dot test at near were measured on each subject wearing each of the 19 lenses. Results were analyzed with 3-factor analysis of variance. Mean visual acuity through the various lenses ranged from 20/79 to 20/620. Eight lenses allowed preservation of peripheral fusion in 50% or more of the subjects tested. Iris print pattern and opaque pupil size were significant factors in determining visual acuity (p occlusion with prosthetic contact lenses a viable therapy for amblyopia. The degree of penalization can be varied and different iris print patterns and pupil sizes, using peripheral fusion, can be preserved with some lenses. Prosthetic contact lenses can be more cosmetically appealing and more tolerable than other amblyopia treatment modalities. These factors may improve compliance in occlusion therapy.

  11. Reduction of deviation angle during occlusion therapy: in partially accommodative esotropia with moderate amblyopia.

    Science.gov (United States)

    Chun, Bo Young; Kwon, Soon Jae; Chae, Sun Hwa; Kwon, Jung Yoon

    2007-09-01

    To evaluate changes in ocular alignment in partially accommodative esotropic children age ranged from 3 to 8 years during occlusion therapy for amblyopia. Angle measurements of twenty-two partially accommodative esotropic patients with moderate amblyopia were evaluated before and at 2 years after occlusion therapy. Mean deviation angle with glasses at the start of occlusion treatment was 19.45+/-5.97 PD and decreased to 12.14+/-12.96 PD at 2 years after occlusion therapy (pocclusion therapy, 9 (41%) cases were indications of surgery for residual deviation but if we had planned surgery before occlusion treatment, 18 (82%) of patients would have had surgery. There was a statistical relationship between increase of visual acuity ratio and decrease of deviation angle (r=-0.479, p=0.024). There was a significant reduction of deviation angle of partially accommodative esotropic patients at 2 years after occlusion therapy. Our results suggest that occlusion therapy has an influence on ocular alignment in partially accommodative esotropic patients with amblyopia.

  12. Low-level laser therapy improves visual acuity in adolescent and adult patients with amblyopia.

    Science.gov (United States)

    Ivandic, Boris T; Ivandic, Tomislav

    2012-03-01

    The purpose of this study was to examine the effects of low-level laser therapy (LLLT) on visual acuity in adolescent and adult patients with amblyopia. Currently, amblyopia can be treated successfully only in children. In this single-blinded, placebo-controlled study, 178 patients (mean age 46.8 years) with amblyopia caused by ametropia (110 eyes) or strabismus (121 eyes) were included. For LLLT, the area of the macula was irradiated through the conjunctiva from 1 cm distance for 30 sec with laser light (780 nm, 292 Hz, 1:1 duty cycle; average power 7.5 mW; spot area 3 mm(2)). The treatment was repeated on average 3.5 times, resulting in a mean total dose of 0.77 J/cm(2). No occlusion was applied, and no additional medication was administered. Best corrected distant visual acuity was determined using Snellen projection optotypes. In 12 patients (12 eyes), the multifocal visual evoked potential (M-VEP) was recorded. A control group of 20 patients (20 eyes) received mock treatment. Visual acuity improved in ∼90% of the eyes treated with LLLT (pamblyopia caused by ametropia and strabismus, respectively. The treatment effect was maintained for at least 6 months. The mean M-VEP amplitude increased by 1207 nV (pamblyopia caused by ametropia or strabismus.

  13. Amblyopia and refractive errors among school-aged children with low socioeconomic status in southeastern Turkey.

    Science.gov (United States)

    Caca, Ihsan; Cingu, Abdullah Kursat; Sahin, Alparslan; Ari, Seyhmus; Dursun, Mehmet Emin; Dag, Umut; Balsak, Selahattin; Alakus, Fuat; Yavuz, Abdullah; Palanci, Yilmaz

    2013-01-01

    To investigate the prevalence of refractive errors and other eye diseases, incidence and types of amblyopia in school-aged children, and their relation to gender, age, parental education, and socioeconomic factors. A total of 21,062 children 6 to 14 years old were screened. The examination included visual acuity measurements and ocular motility evaluation. Autorefraction under cycloplegia and examination of the external eye, anterior segment, media, and fundus were performed. There were 11,118 females and 9,944 males. The average age was 10.56 ± 3.59 years. When all of the children were evaluated, 3.2% had myopia and 5.9% had hyperopia. Astigmatism 0.50 D or greater was present in 14.3% of children. Myopia was associated with older age, female gender, and higher parental education. Hyperopia was inversely proportional with older age. Spectacles were needed in 4,476 (22.7%) children with refractive errors, and 10.6% of children were unaware of their spectacle needs. Amblyopia was detected in 2.6% of all children. The most common causes of amblyopia were anisometropia (1.2%) and strabismus (0.9%). Visual impairment is a common disorder in school-aged children. Eye health screening programs are beneficial in early detection and proper treatment of refractive errors. Copyright 2013, SLACK Incorporated.

  14. Anodal transcranial direct current stimulation transiently improves contrast sensitivity and normalizes visual cortex activation in individuals with amblyopia.

    Science.gov (United States)

    Spiegel, Daniel P; Byblow, Winston D; Hess, Robert F; Thompson, Benjamin

    2013-10-01

    Amblyopia is a neurodevelopmental disorder of vision that is associated with abnormal patterns of neural inhibition within the visual cortex. This disorder is often considered to be untreatable in adulthood because of insufficient visual cortex plasticity. There is increasing evidence that interventions that target inhibitory interactions within the visual cortex, including certain types of noninvasive brain stimulation, can improve visual function in adults with amblyopia. We tested the hypothesis that anodal transcranial direct current stimulation (a-tDCS) would improve visual function in adults with amblyopia by enhancing the neural response to inputs from the amblyopic eye. Thirteen adults with amblyopia participated and contrast sensitivity in the amblyopic and fellow fixing eye was assessed before, during and after a-tDCS or cathodal tDCS (c-tDCS). Five participants also completed a functional magnetic resonance imaging (fMRI) study designed to investigate the effect of a-tDCS on the blood oxygen level-dependent response within the visual cortex to inputs from the amblyopic versus the fellow fixing eye. A subgroup of 8/13 participants showed a transient improvement in amblyopic eye contrast sensitivity for at least 30 minutes after a-tDCS. fMRI measurements indicated that the characteristic cortical response asymmetry in amblyopes, which favors the fellow eye, was reduced by a-tDCS. These preliminary results suggest that a-tDCS deserves further investigation as a potential tool to enhance amblyopia treatment outcomes in adults.

  15. A special role for binocular visual input during development and as a component of occlusion therapy for treatment of amblyopia.

    Science.gov (United States)

    Mitchell, Donald E

    2008-01-01

    To review work on animal models of deprivation amblyopia that points to a special role for binocular visual input in the development of spatial vision and as a component of occlusion (patching) therapy for amblyopia. The studies reviewed employ behavioural methods to measure the effects of various early experiential manipulations on the development of the visual acuity of the two eyes. Short periods of concordant binocular input, if continuous, can offset much longer daily periods of monocular deprivation to allow the development of normal visual acuity in both eyes. It appears that the visual system does not weigh all visual input equally in terms of its ability to impact on the development of vision but instead places greater weight on concordant binocular exposure. Experimental models of patching therapy for amblyopia imposed on animals in which amblyopia had been induced by a prior period of early monocular deprivation, indicate that the benefits of patching therapy may be only temporary and decline rapidly after patching is discontinued. However, when combined with critical amounts of binocular visual input each day, the benefits of patching can be both heightened and made permanent. Taken together with demonstrations of retained binocular connections in the visual cortex of monocularly deprived animals, a strong argument is made for inclusion of specific training of stereoscopic vision for part of the daily periods of binocular exposure that should be incorporated as part of any patching protocol for amblyopia.

  16. Video-game play induces plasticity in the visual system of adults with amblyopia.

    Directory of Open Access Journals (Sweden)

    Roger W Li

    2011-08-01

    Full Text Available UNLABELLED: Abnormal visual experience during a sensitive period of development disrupts neuronal circuitry in the visual cortex and results in abnormal spatial vision or amblyopia. Here we examined whether playing video games can induce plasticity in the visual system of adults with amblyopia. Specifically 20 adults with amblyopia (age 15-61 y; visual acuity: 20/25-20/480, with no manifest ocular disease or nystagmus were recruited and allocated into three intervention groups: action videogame group (n = 10, non-action videogame group (n = 3, and crossover control group (n = 7. Our experiments show that playing video games (both action and non-action games for a short period of time (40-80 h, 2 h/d using the amblyopic eye results in a substantial improvement in a wide range of fundamental visual functions, from low-level to high-level, including visual acuity (33%, positional acuity (16%, spatial attention (37%, and stereopsis (54%. Using a cross-over experimental design (first 20 h: occlusion therapy, and the next 40 h: videogame therapy, we can conclude that the improvement cannot be explained simply by eye patching alone. We quantified the limits and the time course of visual plasticity induced by video-game experience. The recovery in visual acuity that we observed is at least 5-fold faster than would be expected from occlusion therapy in childhood amblyopia. We used positional noise and modelling to reveal the neural mechanisms underlying the visual improvements in terms of decreased spatial distortion (7% and increased processing efficiency (33%. Our study had several limitations: small sample size, lack of randomization, and differences in numbers between groups. A large-scale randomized clinical study is needed to confirm the therapeutic value of video-game treatment in clinical situations. Nonetheless, taken as a pilot study, this work suggests that video-game play may provide important principles for treating amblyopia

  17. Optical treatment reduces amblyopia in astigmatic children who receive spectacles before kindergarten.

    Science.gov (United States)

    Dobson, Velma; Clifford-Donaldson, Candice E; Green, Tina K; Miller, Joseph M; Harvey, Erin M

    2009-05-01

    To examine the effect of spectacle correction of astigmatism during preschool on best-corrected recognition visual acuity (VA), grating VA, and meridional amblyopia (difference between acuity for vertical versus horizontal gratings) once the children reach kindergarten. Comparative case series. Seventy-three astigmatic (right eye > or =1.50 diopters [D] cylinder) Native American (Tohono O'odham) children 5 to 7 years of age. All had with-the-rule astigmatism. In 28 children, the astigmatism was simple myopic, compound myopic, or mixed (M/MA), and in 45 children, it was simple or compound hyperopic (HA). Thirty-nine children (Treated Group) had spectacle correction of refractive error, prescribed for full-time wear, in preschool (0.8-2.4 years before testing). Thirty-four children (Untreated Group) had no prior correction. Comparison of Treated versus Untreated Groups for mean best-corrected right-eye recognition VA, measured with the Early Treatment Diabetic Retinopathy Study (ETDRS) chart and the Lea Symbols chart, for grating VA, measured with modified Teller acuity card stimuli, and for meridional amblyopia, based on grating acuity results. Mean ETDRS VA was significantly better in the Treated Group (20/37) than in the Untreated Group (20/48; P<0.003), but the difference between mean Lea Symbols VA in the Treated Group (20/33) and in the Untreated Group (20/38) was not significant. No significant Treated versus Untreated Group differences were found for either vertical or horizontal grating acuity. Meridional amblyopia differed between the M/MA group, which showed better acuity for vertical than for horizontal gratings, and the HA group, which showed better acuity for horizontal than for vertical gratings. However, in neither the M/MA group nor the HA group was there a significant difference in magnitude of meridional amblyopia in the Treated versus the Untreated Group. Spectacle correction during the preschool years results in a significant improvement in best

  18. Video-game play induces plasticity in the visual system of adults with amblyopia.

    Science.gov (United States)

    Li, Roger W; Ngo, Charlie; Nguyen, Jennie; Levi, Dennis M

    2011-08-01

    Abnormal visual experience during a sensitive period of development disrupts neuronal circuitry in the visual cortex and results in abnormal spatial vision or amblyopia. Here we examined whether playing video games can induce plasticity in the visual system of adults with amblyopia. Specifically 20 adults with amblyopia (age 15-61 y; visual acuity: 20/25-20/480, with no manifest ocular disease or nystagmus) were recruited and allocated into three intervention groups: action videogame group (n = 10), non-action videogame group (n = 3), and crossover control group (n = 7). Our experiments show that playing video games (both action and non-action games) for a short period of time (40-80 h, 2 h/d) using the amblyopic eye results in a substantial improvement in a wide range of fundamental visual functions, from low-level to high-level, including visual acuity (33%), positional acuity (16%), spatial attention (37%), and stereopsis (54%). Using a cross-over experimental design (first 20 h: occlusion therapy, and the next 40 h: videogame therapy), we can conclude that the improvement cannot be explained simply by eye patching alone. We quantified the limits and the time course of visual plasticity induced by video-game experience. The recovery in visual acuity that we observed is at least 5-fold faster than would be expected from occlusion therapy in childhood amblyopia. We used positional noise and modelling to reveal the neural mechanisms underlying the visual improvements in terms of decreased spatial distortion (7%) and increased processing efficiency (33%). Our study had several limitations: small sample size, lack of randomization, and differences in numbers between groups. A large-scale randomized clinical study is needed to confirm the therapeutic value of video-game treatment in clinical situations. Nonetheless, taken as a pilot study, this work suggests that video-game play may provide important principles for treating amblyopia, and perhaps other

  19. Video-Game Play Induces Plasticity in the Visual System of Adults with Amblyopia

    Science.gov (United States)

    Li, Roger W.; Ngo, Charlie; Nguyen, Jennie; Levi, Dennis M.

    2011-01-01

    Abnormal visual experience during a sensitive period of development disrupts neuronal circuitry in the visual cortex and results in abnormal spatial vision or amblyopia. Here we examined whether playing video games can induce plasticity in the visual system of adults with amblyopia. Specifically 20 adults with amblyopia (age 15–61 y; visual acuity: 20/25–20/480, with no manifest ocular disease or nystagmus) were recruited and allocated into three intervention groups: action videogame group (n = 10), non-action videogame group (n = 3), and crossover control group (n = 7). Our experiments show that playing video games (both action and non-action games) for a short period of time (40–80 h, 2 h/d) using the amblyopic eye results in a substantial improvement in a wide range of fundamental visual functions, from low-level to high-level, including visual acuity (33%), positional acuity (16%), spatial attention (37%), and stereopsis (54%). Using a cross-over experimental design (first 20 h: occlusion therapy, and the next 40 h: videogame therapy), we can conclude that the improvement cannot be explained simply by eye patching alone. We quantified the limits and the time course of visual plasticity induced by video-game experience. The recovery in visual acuity that we observed is at least 5-fold faster than would be expected from occlusion therapy in childhood amblyopia. We used positional noise and modelling to reveal the neural mechanisms underlying the visual improvements in terms of decreased spatial distortion (7%) and increased processing efficiency (33%). Our study had several limitations: small sample size, lack of randomization, and differences in numbers between groups. A large-scale randomized clinical study is needed to confirm the therapeutic value of video-game treatment in clinical situations. Nonetheless, taken as a pilot study, this work suggests that video-game play may provide important principles for treating amblyopia, and perhaps

  20. Association Between Adherence to Glasses Wearing During Amblyopia Treatment and Improvement in Visual Acuity.

    Science.gov (United States)

    Maconachie, Gail D E; Farooq, Shegufta; Bush, Glen; Kempton, Julie; Proudlock, Frank A; Gottlob, Irene

    2016-12-01

    Occlusion dose monitors have helped establish that better adherence to occlusion is associated with improved visual outcomes in patients undergoing amblyopia treatment. However, the role of adherence to glasses wearing is unknown. To establish the feasibility and reliability of objectively monitoring adherence to glasses wearing using age-based norms, establish the association between adherence to glasses wearing and improvement in visual acuity (VA) after optical treatment and occlusion therapy, and analyze the effect of age, sex, refractive errors, type of amblyopia, and adherence to glasses wearing on improvement in VA. A prospective, observational, nonmasked, cohort study was conducted between June 8, 2008, and June 30, 2013, among patients at a pediatric ophthalmology clinic of a tertiary care hospital who were newly diagnosed with anisometropic and/or strabismic amblyopia and had not undergone previous treatment. The study consisted of a glasses phase (18 weeks) and a patching phase (glasses and occlusion for 10 hours per day for 12 weeks). Reliability of the glasses monitors was assessed by comparing diary entries and monitor recordings in adults. Objective monitoring of glasses wearing and occlusion. Adherence to glasses wearing (hours per day) and effect on VA. Among 20 children with anisometropia (mean [SD] age, 6.20 [2.16] years; 11 boys and 9 girls) and 20 with strabismic or mixed amblyopia (mean [SD] age, 4.90 [1.36] years; 10 boys and 10 girls), adherence to glasses wearing was successfully monitored in all but 1 patient. Agreement between diaries and monitored times wearing glasses in adults was high (intraclass correlation coefficient, 1.00; 95% CI, 0.999-1.00). Median (SD) adherence to glasses wearing was 70% (25.3%). A moderate correlation was observed between adherence to glasses wearing and percentage improvement in VA during the glasses phase (r = 0.462; P = .003). Multiple regression revealed that age (β = -0.535; P = .001

  1. The Effect of Sensory Uncertainty Due to Amblyopia (Lazy Eye) on the Planning and Execution of Visually-Guided 3D Reaching Movements

    Science.gov (United States)

    Niechwiej-Szwedo, Ewa; Goltz, Herbert C.; Chandrakumar, Manokaraananthan; Wong, Agnes M. F.

    2012-01-01

    Background Impairment of spatiotemporal visual processing in amblyopia has been studied extensively, but its effects on visuomotor tasks have rarely been examined. Here, we investigate how visual deficits in amblyopia affect motor planning and online control of visually-guided, unconstrained reaching movements. Methods Thirteen patients with mild amblyopia, 13 with severe amblyopia and 13 visually-normal participants were recruited. Participants reached and touched a visual target during binocular and monocular viewing. Motor planning was assessed by examining spatial variability of the trajectory at 50–100 ms after movement onset. Online control was assessed by examining the endpoint variability and by calculating the coefficient of determination (R2) which correlates the spatial position of the limb during the movement to endpoint position. Results Patients with amblyopia had reduced precision of the motor plan in all viewing conditions as evidenced by increased variability of the reach early in the trajectory. Endpoint precision was comparable between patients with mild amblyopia and control participants. Patients with severe amblyopia had reduced endpoint precision along azimuth and elevation during amblyopic eye viewing only, and along the depth axis in all viewing conditions. In addition, they had significantly higher R2 values at 70% of movement time along the elevation and depth axes during amblyopic eye viewing. Conclusion Sensory uncertainty due to amblyopia leads to reduced precision of the motor plan. The ability to implement online corrections depends on the severity of the visual deficit, viewing condition, and the axis of the reaching movement. Patients with mild amblyopia used online control effectively to compensate for the reduced precision of the motor plan. In contrast, patients with severe amblyopia were not able to use online control as effectively to amend the limb trajectory especially along the depth axis, which could be due to their

  2. Analysis the macular ganglion cell complex thickness in monocular strabismic amblyopia patients by Fourier-domain OCT

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    Hong-Wei Deng

    2014-11-01

    Full Text Available AIM: To detect the macular ganglion cell complex thickness in monocular strabismus amblyopia patients, in order to explore the relationship between the degree of amblyopia and retinal ganglion cell complex thickness, and found out whether there is abnormal macular ganglion cell structure in strabismic amblyopia. METHODS: Using a fourier-domain optical coherence tomography(FD-OCTinstrument iVue®(Optovue Inc, Fremont, CA, Macular ganglion cell complex(mGCCthickness was measured and statistical the relation rate with the best vision acuity correction was compared Gman among 26 patients(52 eyesincluded in this study. RESULTS: The mean thickness of the mGCC in macular was investigated into three parts: centrial, inner circle(3mmand outer circle(6mm. The mean thicknesses of mGCC in central, inner and outer circle was 50.74±21.51μm, 101.4±8.51μm, 114.2±9.455μm in the strabismic amblyopia eyes(SAE, and 43.79±11.92μm,92.47±25.01μm, 113.3±12.88μm in the contralateral sound eyes(CSErespectively. There was no statistically significant difference among the eyes(P>0.05. But the best corrected vision acuity had a good correlation rate between mGcc thicknesses, which was better relative for the lower part than the upper part.CONCLUSION:There is a relationship between the amblyopia vision acuity and the mGCC thickness. Although there has not statistically significant difference of the mGCC thickness compared with the SAE and CSE. To measure the macular center mGCC thickness in clinic may understand the degree of amblyopia.

  3. Altered interhemispheric functional connectivity in patients with anisometropic and strabismic amblyopia: a resting-state fMRI study

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    Liang, Minglong; Xie, Bing; Yin, Xuntao; Wang, Jian [Third Military Medical University, Department of Radiology, Southwest Hospital, 30 Gaotanyan Street, Shapingba District, Chongqing (China); Yang, Hong; Wang, Hao [Third Military Medical University, Ophthalmology Research Center, Southwest Eye Hospital/Southwest Hospital, Chongqing (China); Yu, Longhua [Third Military Medical University, Department of Radiology, Southwest Hospital, 30 Gaotanyan Street, Shapingba District, Chongqing (China); 401st Hospital of PLA, Department of Radiology, Qingdao (China); He, Sheng [University of Minnesota Twin Cities, Department of Psychology, Minneapolis, MN (United States)

    2017-05-15

    Altered brain functional connectivity has been reported in patients with amblyopia by recent neuroimaging studies. However, relatively little is known about the alterations in interhemispheric functional connectivity in amblyopia. The present study aimed to investigate the functional connectivity patterns between homotopic regions across hemispheres in patients with anisometropic and strabismic amblyopia under resting state. Nineteen monocular anisometropic amblyopia (AA), 18 strabismic amblyopia (SA), and 20 normal-sight controls (NC) were enrolled in this study. After a comprehensive ophthalmologic examination, resting-state fMRI scanning was performed in all participants. The pattern of the interhemispheric functional connectivity was measured with the voxel-mirrored homotopic connectivity (VMHC) approach. VMHC values differences within and between three groups were compared, and correlations between VMHC values and each the clinical variable were also analyzed. Altered VMHC was observed in AA and SA patients in lingual gyrus and fusiform gyrus compared with NC subjects. The altered VMHC of lingual gyrus showed a pattern of AA > SA > NC, while the altered VMHC of fusiform gyrus showed a pattern of AA > NC > SA. Moreover, the VMHC values of lingual gyrus were positively correlated with the stereoacuity both in AA and SA patients, and the VMHC values of fusiform gyrus were positively correlated with the amount of anisometropia just in AA patients. These findings suggest that interhemispheric functional coordination between several homotopic visual-related brain regions is impaired both in AA and SA patients under resting state and revealed the similarities and differences in interhemispheric functional connectivity between the anisometropic and strabismic amblyopia. (orig.)

  4. In vivo optical imaging of amblyopia: Digital subtraction autofluorescence and split-spectrum amplitude-decorrelation angiography.

    Science.gov (United States)

    Guo, Lei; Tao, Jun; Xia, Fan; Yang, Zhi; Ma, Xiaoli; Hua, Rui

    2016-09-01

    Amblyopia is a visual impairment that is attributed to either abnormal binocular interactions or visual deprivation. The retina and choroids have been shown to be involved in the development of amblyopia. The purpose of this study was to investigate the retinal and choroidal microstructural abnormalities of amblyopia using digital subtraction autofluorescence and split-spectrum amplitude-decorrelation angiography (SSADA) approaches. This prospective study included 44 eyes of 22 patients with unilateral amblyopia. All patients who received indirect ophthalmoscopy, combined depth imaging spectral domain optical coherence tomography (OCT), SSADA-OCT, and macular blue light (BL-) and near-infrared (NIR-) autofluorescences underwent pupil dilation. The subfoveal choroidal thickness (SFCT) was measured. BL- and NIR-autofluorescences were determined for all patients and used to generate subtraction images with ImageJ software. The superficial, deep layers of the retina, and inner choroid layer were required for SSADA-OCT. For the normal eyes, a regularly increasing signal was observed in the central macula based on the subtraction images. In contrast, a decreased signal for the central patch or a reduced peak was detected in 16 of 22 amblyopic eyes (72.7%). The mean SFCT of the amblyopic eyes was greater than that of the fellow normal eyes (399.25 ± 4.944 µm vs. 280.58 ± 6.491 µm, respectively, P autofluorescence. The mechanistic relationship of a thicker choroid and choroidal capillary atrophy with amblyopia remains to be described. The digital subtraction image confirmed the changes in the microstructure of the amblyopic retina as a supplementary approach to detect the progression of amblyopia. Lasers Surg. Med. 48:660-667, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  5. Altered interhemispheric functional connectivity in patients with anisometropic and strabismic amblyopia: a resting-state fMRI study

    International Nuclear Information System (INIS)

    Liang, Minglong; Xie, Bing; Yin, Xuntao; Wang, Jian; Yang, Hong; Wang, Hao; Yu, Longhua; He, Sheng

    2017-01-01

    Altered brain functional connectivity has been reported in patients with amblyopia by recent neuroimaging studies. However, relatively little is known about the alterations in interhemispheric functional connectivity in amblyopia. The present study aimed to investigate the functional connectivity patterns between homotopic regions across hemispheres in patients with anisometropic and strabismic amblyopia under resting state. Nineteen monocular anisometropic amblyopia (AA), 18 strabismic amblyopia (SA), and 20 normal-sight controls (NC) were enrolled in this study. After a comprehensive ophthalmologic examination, resting-state fMRI scanning was performed in all participants. The pattern of the interhemispheric functional connectivity was measured with the voxel-mirrored homotopic connectivity (VMHC) approach. VMHC values differences within and between three groups were compared, and correlations between VMHC values and each the clinical variable were also analyzed. Altered VMHC was observed in AA and SA patients in lingual gyrus and fusiform gyrus compared with NC subjects. The altered VMHC of lingual gyrus showed a pattern of AA > SA > NC, while the altered VMHC of fusiform gyrus showed a pattern of AA > NC > SA. Moreover, the VMHC values of lingual gyrus were positively correlated with the stereoacuity both in AA and SA patients, and the VMHC values of fusiform gyrus were positively correlated with the amount of anisometropia just in AA patients. These findings suggest that interhemispheric functional coordination between several homotopic visual-related brain regions is impaired both in AA and SA patients under resting state and revealed the similarities and differences in interhemispheric functional connectivity between the anisometropic and strabismic amblyopia. (orig.)

  6. Survey of Nerve Fiber Layer Thickness in Anisometropic and Strabismic Amblyopia

    Directory of Open Access Journals (Sweden)

    Reza Soltani Moghaddam

    2017-02-01

    Full Text Available . To investigate the effect of anisometropic and strabismic amblyopia on the nerve fiber layer thickness. This cross-sectional study was done on 54 amblyopic subjects, equally in both strabismic and anisometropic groups. The thickness otonerve fiber layer measured in superior, inferior, nasal, temporal quadrants and as a whole in both eyes of both groups. The means of thickness were compared in amblyopic and sound eyes. In strabismus group, the average nerve fiber layer thickness of the sound eye , in superior, inferior, nasal and temporal quadrants and as a whole were 113.23±14, 117.37±25, 68.96±6, 69.55±14 and 93.40±8 microns respectively. In amblyopic eyes of the same group, these measurements were 103.11±18, 67.74±11, and 69.59±16 and 89.59±12 microns in superior, inferior, nasal, temporal quadrants and as whole respectively. In anisometropic groups, the sound eye measurements were as 130.96±22, 129.07±29, 80.62±12, and 83.88±20 and 107.7±13 microns in superior, inferior, nasal and temporal quadrants and as a whole orderly. In amblyopic eyes of this group the mean thicknesses were 115.63±29, 133.15±25, 78.8±15, 80.2±16 and 109.17±21 microns in superior, inferior, nasal, temporal quadrants and as a whole respectively. Statistically, there were no significant differences between amblyopic and sound eyes (P>0.5. Our study did not support any significant change in a nerve fiber layer thickness of amblyopic patients; however, decreased thickness in superior and nasal quadrants of strabismic amblyopia and except inferior quadrant and as a whole. These measurements may be a clue for management and prognosis of amblyopia in old age.

  7. A novel apparatus for interocular interaction evaluation in children with and without anisometropic amblyopia.

    Science.gov (United States)

    Lai, Xin Jie Angela; Alexander, Jack; He, Ming Guang; Yang, Zhi Kuan; Suttle, Catherine

    2012-07-01

    Dichoptic visual stimulation may be achieved using shutter goggles and mirror systems. These methods vary in their feasibility for use in children. This study aims to investigate the feasibility of use of a simple trial frame-based system to evaluate interactions in children. Low contrast acuity, contrast sensitivity and alignment sensitivity were measured in the non-dominant eye of 10 normally-sighted children, 14 anisometropic children without amblyopia and 14 anisometropic amblyopic children (aged 5-11 years) using goggles and a trial frame apparatus (TFA). The dominant eye was either fully or partially occluded. The difference in visual functions in the non-dominant eye between the full and partial occlusion conditions was termed the 'interaction index'. Agreement between the TFA and goggles in terms of visual functions and interactions was assessed in anisometropic children with and without amblyopia using the Bland-Altman method and t-test. Training sessions allowed subjects to become accustomed to the systems and tasks. The duration of training, the number of breaks requested by subjects and their willingness to attend further experiments were recorded in 10 subjects from each group and were compared between groups and between systems. Both Bland-Altman and t-test methods indicated acceptable agreement between the TFA and goggles in visual function and interaction measures (p > 0.05), except for contrast sensitivity measured in anisometropic children without amblyopia (p = 0.042). For all subject groups, contrast sensitivity training was significantly longer using goggles than using the TFA (p ≤ 0.001). Significantly more breaks were requested in acuity and contrast sensitivity testing, when goggles were used than when the TFA was used (p amblyopia showed a significantly greater willingness to attend more experiments using the TFA than using goggles (p = 0.025). The TFA may be a useful tool in studies of interactions in amblyopes, particularly in studies

  8. [The possibility for using the phenomenon of polarized light interference in treating amblyopia].

    Science.gov (United States)

    Abramov, V G; Vakurina, A E; Kashchenko, T P; Pargina, N M

    1996-01-01

    A new method for treating amblyopia is proposed, making use of the phenomenon of polarized light interference. It helps act simultaneously on the brightness, contrast frequency, and color sensitivity in response to patterns. The method was used in the treatment of 36 children. In group 1 (n = 20) it was combined with the traditional methods. Such treatment was more effective than in controls treated routinely. Group 2 consisted of 16 children in whom previous therapy was of no avail. Visual function was improved in 7 of them.

  9. Improving visual functions in adult amblyopia with combined perceptual training and transcranial random noise stimulation (tRNS

    Directory of Open Access Journals (Sweden)

    Gianluca eCampana

    2014-12-01

    Full Text Available Amblyopia is a visual disorder due to an abnormal pattern of functional connectivity of the visual cortex and characterized by several visual deficits of spatial vision including impairments of visual acuity (VA and of the contrast sensitivity function (CSF. Despite being a developmental disorder caused by reduced visual stimulation during early life (critical period, several studies have shown that extensive visual perceptual training can improve VA and CSF in people with amblyopia even in adulthood. With the present study we assessed whether a much shorter perceptual training regime, in association with high-frequency transcranial electrical stimulation (hf-tRNS, was able to improve visual functions in a group of adult participants with amblyopia. Results show that, in comparison with previous studies where a large number sessions with a similar training regime were used (Polat, Ma-Naim, Belkin & Sagi, 2004, here just eight sessions of training in contrast detection under lateral masking conditions combined with hf-tRNS, were able to substantially improve VA and CSF in adults with amblyopia.

  10. Differences in quality-of-life dimensions of Adult Strabismus Quality of Life and Amblyopia & Strabismus Questionnaires

    NARCIS (Netherlands)

    E.S. van de Graaf (Elizabeth); G.J.J.M. Borsboom (Gerard); G.W. van der Sterre (Geertje); J. Felius (Joost); H.J. Simonsz (Huib); H. Kelderman (Henk)

    2017-01-01

    textabstractPurpose: The Adult Strabismus Quality of Life Questionnaire (AS-20) and the Amblyopia & Strabismus Questionnaire (A&SQ) both measure health-related quality of life in strabismus patients. We evaluated to what extent these instruments cover similar domains by identifying the underlying

  11. Outcomes of 3 hours part-time occlusion treatment combined with near activities among children with unilateral amblyopia.

    Science.gov (United States)

    Alotaibi, Abdullah G; Fawazi, Samah M; Alenazy, Badriah R; Abu-Amero, Khaled K

    2012-04-01

    To evaluate the outcome of part-time occlusion therapy with or without near activities in monocular amblyopic patients. One hundred and thirty patients who prescribed daily occlusion therapy (part-time occlusion) were followed-up for a 12-week period. The study was carried out in the Pediatric Ophthalmology and Orthoptics Clinics of King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia for the period from January to November 2010. Sixty-five patients were recommended to undertake the 3 hours of near visual activities (such as reading a book during patching) while the other 65 patients were not advised to do any near activity. Main outcome measures were best corrected visual acuity (VA) for both groups and line improvement. The total line of VA improved from baseline by an average of 6.7+/-2.37 line log MAR (logarithm of the minimum angle of resolution) units in the group of patching with near activities and by an average of 5.3+/- 2.04 line log MAR units in the group of patching without near activities. All type of amblyopia (strabismic, anisometropic, and mixed types of amblyopia) improved significantly after patching with near activities. Both moderate and severe amblyopia improved significantly in the group of near activities compared with the group without near activities. Performing near activities while patching in the treatment of anisometropic, stabismic, or combined amblyopia improves the VA outcome more than patching alone.

  12. The effect of transcranial direct current stimulation on contrast sensitivity and visual evoked potential amplitude in adults with amblyopia.

    Science.gov (United States)

    Ding, Zhaofeng; Li, Jinrong; Spiegel, Daniel P; Chen, Zidong; Chan, Lily; Luo, Guangwei; Yuan, Junpeng; Deng, Daming; Yu, Minbin; Thompson, Benjamin

    2016-01-14

    Amblyopia is a neurodevelopmental disorder of vision that occurs when the visual cortex receives decorrelated inputs from the two eyes during an early critical period of development. Amblyopic eyes are subject to suppression from the fellow eye, generate weaker visual evoked potentials (VEPs) than fellow eyes and have multiple visual deficits including impairments in visual acuity and contrast sensitivity. Primate models and human psychophysics indicate that stronger suppression is associated with greater deficits in amblyopic eye contrast sensitivity and visual acuity. We tested whether transcranial direct current stimulation (tDCS) of the visual cortex would modulate VEP amplitude and contrast sensitivity in adults with amblyopia. tDCS can transiently alter cortical excitability and may influence suppressive neural interactions. Twenty-one patients with amblyopia and twenty-seven controls completed separate sessions of anodal (a-), cathodal (c-) and sham (s-) visual cortex tDCS. A-tDCS transiently and significantly increased VEP amplitudes for amblyopic, fellow and control eyes and contrast sensitivity for amblyopic and control eyes. C-tDCS decreased VEP amplitude and contrast sensitivity and s-tDCS had no effect. These results suggest that tDCS can modulate visual cortex responses to information from adult amblyopic eyes and provide a foundation for future clinical studies of tDCS in adults with amblyopia.

  13. Predictors and a remedy for noncompliance with amblyopia therapy in children measured with the occlusion dose monitor

    NARCIS (Netherlands)

    S.E. Loudon (Sjoukje); M. Fronius; C.W.N. Looman (Caspar); M. Awan (Musarat); B. Simonsz-Tóth (Brigitte); P.J. van der Maas (Paul)

    2006-01-01

    textabstractPURPOSE. Noncompliance is one of the limiting factors in the success of occlusion therapy for amblyopia. Electronic monitoring was used to investigate predictors of noncompliance, and, in a prospective randomized clinical trial, determined the effectiveness of an educational program.

  14. Clinical analysis of retinal nerve fiber layer thickness and macular fovea in hyperopia children with anisometropia amblyopia

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    Fei-Fei Li

    2017-10-01

    Full Text Available AIM:To analyze the clinical significance of axial length, diopter and retinal nerve fiber layer thickness in hyperopia children with anisometropia amblyopia. METHODS: From January 2015 to January 2017 in our hospital for treatment, 103 cases, all unilateral, were diagnosed as hyperopia anisometropia amblyopia. The eyes with amblyopia were as experimental group(103 eyes, another normal eye as control group(103 eyes. We took the detection with axial length, refraction, foveal thickness, corrected visual acuity, diopter and the average thickness of retinal nerve fiber layer. RESULTS: Differences in axial length and diopter and corrected visual acuity were statistically significant between the two groups(PP>0.05. There was statistical significance difference on the foveal thickness(PP>0.05. The positive correlation between diopter with nerve fiber layer thickness of foveal and around the optic disc were no statistically significant difference(P>0.05. CONCLUSION: Retinal thickness of the fovea in the eye with hyperopic anisometropia amblyopia were thicker than those in normal eyes; the nerve fiber layer of around the optic disc was not significantly different between the amblyopic eyes and contralateral eyes. The refraction and axial length had no significant correlation with optic nerve fiber layer and macular foveal thickness.

  15. Optical treatment of amblyopia in older children and adults is essential prior to enrolment in a clinical trial.

    Science.gov (United States)

    Gao, Tina Y; Anstice, Nicola; Babu, Raiju J; Black, Joanna M; Bobier, William R; Dai, Shuan; Guo, Cindy X; Hess, Robert F; Jenkins, Michelle; Jiang, Yannan; Kearns, Lisa; Kowal, Lionel; Lam, Carly S Y; Pang, Peter C K; Parag, Varsha; South, Jayshree; Staffieri, Sandra Elfride; Wadham, Angela; Walker, Natalie; Thompson, Benjamin

    2018-03-01

    Optical treatment alone can improve visual acuity (VA) in children with amblyopia, thus clinical trials investigating additional amblyopia therapies (such as patching or videogames) for children require a preceding optical treatment phase. Emerging therapies for adult patients are entering clinical trials. It is unknown whether optical treatment is effective for adults with amblyopia and whether an optical correction phase is required for trials involving adults. We examined participants who underwent optical treatment in the Binocular Treatment for Amblyopia using Videogames (BRAVO) clinical trial (ANZCTR ID: ACTRN12613001004752). Participants were recruited in three age groups (7 to 12, 13 to 17, or ≥18 years), and had unilateral amblyopia due to anisometropia and/or strabismus, with amblyopic eye VA of 0.30-1.00 logMAR (6/12 to 6/60, 20/40 to 20/200). Corrective lenses were prescribed based on cycloplegic refraction to fully correct any anisometropia. VA was assessed using the electronic visual acuity testing algorithm (e-ETDRS) test and near stereoacuity was assessed using the Randot Preschool Test. Participants were assessed every four weeks up to 16 weeks, until either VA was stable or until amblyopic eye VA improved to better than 0.30 logMAR, rendering the participant ineligible for the trial. Eighty participants (mean age 24.6 years, range 7.6-55.5 years) completed four to 16 weeks of optical treatment. A small but statistically significant mean improvement in amblyopic eye VA of 0.05 logMAR was observed (S.D. 0.08 logMAR; paired t-test p < 0.0001). Twenty-five participants (31%) improved by ≥1 logMAR line and of these, seven (9%) improved by ≥2 logMAR lines. Stereoacuity improved in 15 participants (19%). Visual improvements were not associated with age, presence of strabismus, or prior occlusion treatment. Two adult participants withdrew due to intolerance to anisometropic correction. Sixteen out of 80 participants (20%) achieved better than 0

  16. The challenges of developing a contrast-based video game for treatment of amblyopia.

    Science.gov (United States)

    Hussain, Zahra; Astle, Andrew T; Webb, Ben S; McGraw, Paul V

    2014-01-01

    Perceptual learning of visual tasks is emerging as a promising treatment for amblyopia, a developmental disorder of vision characterized by poor monocular visual acuity. The tasks tested thus far span the gamut from basic psychophysical discriminations to visually complex video games. One end of the spectrum offers precise control over stimulus parameters, whilst the other delivers the benefits of motivation and reward that sustain practice over long periods. Here, we combined the advantages of both approaches by developing a video game that trains contrast sensitivity, which in psychophysical experiments, is associated with significant improvements in visual acuity in amblyopia. Target contrast was varied adaptively in the game to derive a contrast threshold for each session. We tested the game on 20 amblyopic subjects (10 children and 10 adults), who played at home using their amblyopic eye for an average of 37 sessions (approximately 11 h). Contrast thresholds from the game improved reliably for adults but not for children. However, logMAR acuity improved for both groups (mean = 1.3 lines; range = 0-3.6 lines). We present the rationale leading to the development of the game and describe the challenges of incorporating psychophysical methods into game-like settings.

  17. An exploratory study: prolonged periods of binocular stimulation can provide an effective treatment for childhood amblyopia.

    Science.gov (United States)

    Knox, Pamela J; Simmers, Anita J; Gray, Lyle S; Cleary, Marie

    2012-02-21

    The purpose of the present study was to explore the potential for treating childhood amblyopia with a binocular stimulus designed to correlate the visual input from both eyes. Eight strabismic, two anisometropic, and four strabismic and anisometropic amblyopes (mean age, 8.5 ± 2.6 years) undertook a dichoptic perceptual learning task for five sessions (each lasting 1 hour) over the course of a week. The training paradigm involved a simple computer game, which required the subject to use both eyes to perform the task. A statistically significant improvement (t(₁₃) = 5.46; P = 0.0001) in the mean visual acuity (VA) of the amblyopic eye (AE) was demonstrated, from 0.51 ± 0.27 logMAR before training to 0.42 ± 0.28 logMAR after training with six subjects gaining 0.1 logMAR or more of improvement. Measurable stereofunction was established for the first time in three subjects with an overall significant mean improvement in stereoacuity after training (t(₁₃) =2.64; P = 0.02). The dichoptic-based perceptual learning therapy employed in the present study improved both the monocular VA of the AE and stereofunction, verifying the feasibility of a binocular approach in the treatment of childhood amblyopia.

  18. Dichoptic training in adults with amblyopia: Additional stereoacuity gains over monocular training.

    Science.gov (United States)

    Liu, Xiang-Yun; Zhang, Jun-Yun

    2017-08-04

    Dichoptic training is a recent focus of research on perceptual learning in adults with amblyopia, but whether and how dichoptic training is superior to traditional monocular training is unclear. Here we investigated whether dichoptic training could further boost visual acuity and stereoacuity in monocularly well-trained adult amblyopic participants. During dichoptic training the participants used the amblyopic eye to practice a contrast discrimination task, while a band-filtered noise masker was simultaneously presented in the non-amblyopic fellow eye. Dichoptic learning was indexed by the increase of maximal tolerable noise contrast for successful contrast discrimination in the amblyopic eye. The results showed that practice tripled maximal tolerable noise contrast in 13 monocularly well-trained amblyopic participants. Moreover, the training further improved stereoacuity by 27% beyond the 55% gain from previous monocular training, but unchanged visual acuity of the amblyopic eyes. Therefore our dichoptic training method may produce extra gains of stereoacuity, but not visual acuity, in adults with amblyopia after monocular training. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. The challenges of developing a contrast-based video game for treatment of amblyopia

    Directory of Open Access Journals (Sweden)

    Zahra eHussain

    2014-11-01

    Full Text Available Perceptual learning of visual tasks is emerging as a promising treatment for amblyopia, a developmental disorder of vision characterized by poor monocular visual acuity. The tasks tested thus far span the gamut from basic psychophysical discriminations to visually complex video games. One end of the spectrum offers precise control over stimulus parameters, whilst the other delivers the benefits of motivation and reward that sustain practice over long periods. Here, we combined the advantages of both approaches by developing a video game that trains contrast sensitivity, which in psychophysical experiments, is associated with significant improvements in visual acuity in amblyopia. Target contrast was varied adaptively in the game to derive a contrast threshold for each session. We tested the game on twenty amblyopic subjects (ten children and ten adults, who played at home using their amblyopic eye for an average of 37 sessions (approximately 11 hours. Contrast thresholds from the game improved reliably for adults but not for children. However, LogMAR acuity improved for both groups (mean: 1.3 lines; range: 0-3.6 lines. We present the rationale leading to the development of the game and describe the challenges of incorporating psychophysical methods into game-like settings.

  20. The use of choline in association with the Bangerter filters for the treatment of amblyopia

    Directory of Open Access Journals (Sweden)

    Lelio Sabetti

    2017-11-01

    Full Text Available The study investigated the effects of choline combined with Bangerter filter in the treatment of amblyopia. All amblyopic subjects used a Bangerter filter on the corrective spectacle lens (1d over the left eye, 1d over the right eye. Choline was then administered orally to 39 patients once daily, five days per week for the entire study period. Subjects treated with the Bangerter filter showed a mean visual acuity of 0.27 logMAR; at 12mo of treatment, the mean visual acuity reached 0.09 logMAR. Patients treated with the Bangerter filter and citicoline showed a mean visual acuity of 0.35 logMAR; at 12mo of treatment, the mean visual acuity reached 0.01 logMAR. No significant changes in the angle of deviation were observed in both groups. Subjects in both forms of amblyopia therapies demonstrated an increase in visual acuity. However, these effects were markedly enhanced when coupled with the administration of choline. Findings suggest that the effects are particularly relevant in the more severe amblyopic cases.

  1. MRI study on the cortical thickness of occipital lobe in children with ametropic amblyopia

    International Nuclear Information System (INIS)

    Du Hanjian; Wang Jian; Li Chuan; Zhang Jiuquan; Chen Li; Liu Bo

    2008-01-01

    Objective: To study cortical thickness of the occipital lobe in children with ametropic amblyopia by using MRI technique and the FreeSurfer software. Methods: Nine children with ametropic amblyopia were included in the amblyopic group and 8 normal children were included in the control group. All the children underwent brain MRI on the Siemens Avanto 1.5 T scanner. For the cortical thickness analysis, 3-demensional MPRAGE images were collected and analyzed with FreeSurfer software package. Cortical thickness of related regions in the occipital lobe (including the cuneus, later occipital, lingual, and pericalcarine gyri) were recorded and compared. Results: The cortical thickness of the lingual, pericalcarine gyri on the left hemisphere and the cuneus, lateraloccipital, lingual gyri on the right hemisphere in amblyopic group were lower than the control group (P<0.05). Conclusion: Morphological changes existed in the occipital lobe in ametropic amblyopic children. The analysis technique with the FreeSurfer package has a potential value in the clinical application. (authors)

  2. Effect of visual perception training combined with total nutrition meal sequential therapy on myopic amblyopia in preschool children

    Directory of Open Access Journals (Sweden)

    Hong Chen

    2017-12-01

    Full Text Available AIM: To observe the therapeutic effect of visual perception training combined with total nutrition meal sequential therapy in the treatment of myopic amblyopia. METHODS: Totally 73 children(135 eyeswith myopic amblyopia were divided into control group(36 cases, 67 eyesand treatment group(37 cases, 68 eyesaccording to random number table. The control group were treated with traditional spectaculars and grating covering combined with fine eyesight training; the treatment group were treated with visual perception training combined with total nutrient meal sequential therapy. The visual acuity, diopter and average diopter of two groups were compared before and after treatment at 3, 6mo and 1a. The curative effect of two groups of children was compared after 1a treatment. And the adverse reactions were recorded in two groups during the treatment period. The recurrence rate of amblyopia in 1a follow-up was compared between two groups. RESULTS: The difference of visual acuity between two groups was not significant at 3mo(P>0.05. The visual acuity of the treatment group was significantly higher than that of the control group at 6mo and 1a(PP>0.05, but the average annual refractive changes in the treatment group were significantly lower than that in the control group(PPPCONCLUSION: Visual perception training combined with total nutrition meal sequential therapy in the treatment of myopic amblyopia in preschool children can significantly improve patients' visual acuity, reduce the average annual diopter changes, improve the therapeutic effect, reduce the recurrence rate of amblyopia.

  3. Randomised controlled trial of video clips and interactive games to improve vision in children with amblyopia using the I-BiT system

    OpenAIRE

    Herbison, Nicola; MacKeith, Daisy; Vivian, Anthony; Purdy, Jon; Fakis, Apostolos; Ash, Isabel M.; Cobb, Sue V.; Eastgate, Richard M.; Haworth, Stephen M.; Gregson, Richard M.; Foss, Alexander J.E.

    2016-01-01

    Background Traditional treatment of amblyopia involves either wearing a patch or atropine penalisation of the better eye. A new treatment is being developed on the basis of virtual reality technology allowing either DVD footage or computer games which present a common background to both eyes and the foreground, containing the imagery of interest, only to the amblyopic eye. Methods A randomised control trial was performed on patients with amblyopia aged 4?8?years with three arms. All three arm...

  4. Electronic monitoring of occlusion treatment for amblyopia in patients aged 7 to 16 years.

    Science.gov (United States)

    Fronius, Maria; Bachert, Iris; Lüchtenberg, Marc

    2009-10-01

    Age limits for the prescription of amblyopia treatment have been debated and challenged recently, due to results of studies from ophthalmology and the neurosciences. Lack of knowledge about compliance with prescribed treatment is still a major factor for the uncertainty about the amount of plasticity in the visual system of older children and adolescents. The development of devices for the electronic recording of patching (Occlusion Dose Monitor, ODM) has allowed the collection of objective data about daily occlusion. In a prospective study, occlusion dose rates were recorded continuously during 4 months by means of the ODM developed in the Netherlands [1] in nine amblyopic patients between 7 and 16 years of age who were prescribed between 5 and 7 hours of daily patching. Visual acuity was assessed every 3 to 6 weeks. The electronic monitoring showed objective occlusion between 2 and 6.25 hours/day (mean 4.61 h/d) during the first month and 0 to 6.5 hours/day (mean 3.47 h/d) during the following 3 months of treatment. The total acuity gain in the amblyopic eye amounted to between -0.1 and 0.4 log units (mean 0.19) for crowded optotypes. Differences to initial acuities were statistically significant. The calculated average dose-response relationship (cumulated hours occlusion*0.1/acuity gain) for 4 months of occlusion was 234 hours of occlusion per 0.1 log unit of acuity gain. This study presents for the first time objective treatment and dose response data in amblyopic patients beyond the "classical" treatment age. Electronic monitoring of occlusion and considerable amounts of patching were shown to be feasible. The acuity results indicate that there is a potential for improvement, yet treatment seemed to be less efficient than shown by previous studies in younger patients. Continuation of this research may advance the discussion about age-dependent evidence-based amblyopia treatment, about preschool screening for amblyopia and about plasticity of the visual system.

  5. Prescribed computer games in addition to occlusion versus standard occlusion treatment for childhood amblyopia: a pilot randomised controlled trial.

    Science.gov (United States)

    Tailor, Vijay K; Glaze, Selina; Khandelwal, Payal; Davis, Alison; Adams, Gillian G W; Xing, Wen; Bunce, Catey; Dahlmann-Noor, Annegret

    2015-01-01

    Amblyopia ("lazy eye") is the commonest vision deficit in children. If not fully corrected by glasses, amblyopia is treated by patching or blurring the better-seeing eye. Compliance with patching is often poor. Computer-based activities are increasingly topical, both as an adjunct to standard treatment and as a platform for novel treatments. Acceptability by families has not been explored, and feasibility of a randomised controlled trial (RCT) using computer games in terms of recruitment and treatment acceptability is uncertain. We carried out a pilot RCT to test whether computer-based activities are acceptable and accessible to families and to test trial methods such as recruitment and retention rates, randomisation, trial-specific data collection tools and analysis. The trial had three arms: standard near activity advice, Eye Five, a package developed for children with amblyopia, and an off-the-shelf handheld games console with pre-installed games. We enrolled 60 children age 3-8 years with moderate or severe amblyopia after completion of optical treatment. This trial was registered as UKCRN-ID 11074. Pre-screening of 3600 medical notes identified 189 potentially eligible children, of whom 60 remained eligible after optical treatment, and were enrolled between April 2012 and March 2013. One participant was randomised twice and withdrawn from the study. Of the 58 remaining, 37 were boys. The mean (SD) age was 4.6 (1.7) years. Thirty-seven had moderate and 21 severe amblyopia. Three participants were withdrawn at week 6, and in total, four were lost to follow-up at week 12. Most children and parents/carers found the study procedures, i.e. occlusion treatment, usage of the allocated near activity and completion of a study diary, easy. The prescribed cumulative dose of near activity was 84 h at 12 weeks. Reported near activity usage numbers were close to prescribed numbers in moderate amblyopes (94 % of prescribed) but markedly less in severe amblyopes (64

  6. Monocular perceptual learning of contrast detection facilitates binocular combination in adults with anisometropic amblyopia.

    Science.gov (United States)

    Chen, Zidong; Li, Jinrong; Liu, Jing; Cai, Xiaoxiao; Yuan, Junpeng; Deng, Daming; Yu, Minbin

    2016-02-01

    Perceptual learning in contrast detection improves monocular visual function in adults with anisometropic amblyopia; however, its effect on binocular combination remains unknown. Given that the amblyopic visual system suffers from pronounced binocular functional loss, it is important to address how the amblyopic visual system responds to such training strategies under binocular viewing conditions. Anisometropic amblyopes (n = 13) were asked to complete two psychophysical supra-threshold binocular summation tasks: (1) binocular phase combination and (2) dichoptic global motion coherence before and after monocular training to investigate this question. We showed that these participants benefited from monocular training in terms of binocular combination. More importantly, the improvements observed with the area under log CSF (AULCSF) were found to be correlated with the improvements in binocular phase combination.

  7. Interactive stereo games to improve vision in children with amblyopia using dichoptic stimulation

    Science.gov (United States)

    Herbison, Nicola; Ash, Isabel M.; MacKeith, Daisy; Vivian, Anthony; Purdy, Jonathan H.; Fakis, Apostolos; Cobb, Sue V.; Hepburn, Trish; Eastgate, Richard M.; Gregson, Richard M.; Foss, Alexander J. E.

    2015-03-01

    Amblyopia is a common condition affecting 2% of all children and traditional treatment consists of either wearing a patch or penalisation. We have developed a treatment using stereo technology, not to provide a 3D image but to allow dichoptic stimulation. This involves presenting an image with the same background to both eyes but with features of interest removed from the image presented to the normal eye with the aim to preferentially stimulated visual development in the amblyopic, or lazy, eye. Our system, called I-BiT can use either a game or a video (DVD) source as input. Pilot studies show that this treatment is effective with short treatment times and has proceeded to randomised controlled clinical trial. The early indications are that the treatment has a high degree of acceptability and corresponding good compliance.

  8. Occlusion dose monitoring in amblyopia therapy: status, insights, and future directions.

    Science.gov (United States)

    Stewart, Catherine E; Moseley, Merrick J; Georgiou, Pantelis; Fielder, Alistair R

    2017-10-01

    Occlusion therapy remains the mainstay treatment of amblyopia, but its outcome is not assured or universally excellent. Many factors are known to influence treatment outcome, among which compliance is foremost. The occlusion dose monitor (ODM) removes one variable from the treatment equation, because it records the occlusion actually received by-rather than prescribed for-the child. Improvement observed can thus be quantitatively related to the patching received. This review summarizes the insights the ODM has provided to date particularly in elucidating the dose-response relationship. We are entering the era of personalized ophthalmology in which treatments will be tailored to the needs of the individual child and facilitated by the use of wearable monitors. Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  9. An iPod treatment of amblyopia: an updated binocular approach.

    Science.gov (United States)

    Hess, Robert F; Thompson, B; Black, J M; Machara, G; Zhang, P; Bobier, W R; Cooperstock, J

    2012-02-15

    We describe the successful translation of computerized and space-consuming laboratory equipment for the treatment of suppression to a small handheld iPod device (Apple iPod; Apple Inc., Cupertino, California). A portable and easily obtainable Apple iPod display, using current video technology offers an ideal solution for the clinical treatment of suppression. The following is a description of the iPod device and illustrates how a video game has been adapted to provide the appropriate stimulation to implement our recent antisuppression treatment protocol. One to 2 hours per day of video game playing under controlled conditions for 1 to 3 weeks can improve acuity and restore binocular function, including stereopsis in adults, well beyond the age at which traditional patching is used. This handheld platform provides a convenient and effective platform for implementing the newly proposed binocular treatment of amblyopia in the clinic, home, or elsewhere. American Optometric Association.

  10. Assessment of cortical dysfunction in human strabismic amblyopia using magnetoencephalography (MEG)

    International Nuclear Information System (INIS)

    Anderson, S.J.; Holliday, I.E.; Harding, G.F.A.

    1999-01-01

    The aim of this study was to use the technique of magnetoencephalography (MEG) to determine the effects of strabismic amblyopia on the processing of spatial information within the occipital cortex of humans. We recorded evoked magnetic responses to the onset of a chromatic (red/green) sinusoidal grating of periodicity 0.5-4.0 c deg -1 using a 19-channel SQUID-based neuromagnetometer. Evoked responses were recorded monocularly on six amblyopes and six normally-sighted controls, the stimuli being positioned near the fovea in the lower right visual field of each observer. For comparison, the spatial contrast sensitivity function (CSF) for the detection of chromatic gratings was measured for one amblyope and one control using a two alternate forced-choice psychophysical procedure. We chose red/green sinusoids as our stimuli because they evoke strong magnetic responses from the occipital cortex in adult humans (Fylan, Holliday, Singh, Anderson and Harding. (1997). Neuroimage, 6, 47-57). Magnetic field strength was plotted as a function of stimulus spatial frequency for each eye of each subject. Interocular differences were only evident within the amblyopic group: for stimuli of 1-2 c deg -1 , the evoked responses had significantly longer latencies and reduced amplitudes through the amblyopic eye (P<0.05). Importantly, the extent of the deficit was uncorrelated with either Snellen acuity or contrast sensitivity. Localization of the evoked responses was performed using a single equivalent current dipole model. Source localizations, for both normal and amblyopic subjects, were consistent with neural activity at the occipital pole near the V1/V2 border. We conclude that MEG is sensitive to the deficit in cortical processing associated with human amblyopia, and can be used to make quantitative neurophysiological measurements. The nature of the cortical deficit is discussed. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

  11. Contrasting effects of strabismic amblyopia on metabolic activity in superficial and deep layers of striate cortex.

    Science.gov (United States)

    Adams, Daniel L; Economides, John R; Horton, Jonathan C

    2015-05-01

    To probe the mechanism of visual suppression, we have raised macaques with strabismus by disinserting the medial rectus muscle in each eye at 1 mo of age. Typically, this operation produces a comitant, alternating exotropia with normal acuity in each eye. Here we describe an unusual occurrence: the development of severe amblyopia in one eye of a monkey after induction of exotropia. Shortly after surgery, the animal demonstrated a strong fixation preference for the left eye, with apparent suppression of the right eye. Later, behavioral testing showed inability to track or to saccade to targets with the right eye. With the left eye occluded, the animal demonstrated no visually guided behavior. Optokinetic nystagmus was absent in the right eye. Metabolic activity in striate cortex was assessed by processing the tissue for cytochrome oxidase (CO). Amblyopia caused loss of CO in one eye's rows of patches, presumably those serving the blind eye. Layers 4A and 4B showed columns of reduced CO, in register with pale rows of patches in layer 2/3. Layers 4C, 5, and 6 also showed columns of CO activity, but remarkably, comparison with more superficial layers showed a reversal in contrast. In other words, pale CO staining in layers 2/3, 4A, and 4B was aligned with dark CO staining in layers 4C, 5, and 6. No experimental intervention or deprivation paradigm has been reported previously to produce opposite effects on metabolic activity in layers 2/3, 4A, and 4B vs. layers 4C, 5, and 6 within a given eye's columns. Copyright © 2015 the American Physiological Society.

  12. Frequent Evaluation To Improve Compliance In Patients Treated With Occlusion For Amblyopia: A Randomized controlled Trial.

    Science.gov (United States)

    Iturriaga, Hernan; Zanolli, Mario; Damm, Constanza; Oporto, Jorge; Acuna, Olga; Valenzuela, Felipe

    2012-01-01

    The benefits of occlusion treatment for amblyopia are well established.True compliance can be difficult to assess and is usually based on patient history. We hypothesize that more visits to the physician provides more chances to improve compliance. We conducted a prospective, comparative, blind trial in which 30 children with amblyopia were randomly assigned to be followed up more frequently (every 4 to 6 weeks) (study group) or as established on our standard regular basis (month intervals based on age in years) (control group). The primary outcome was to study differences in treatment compliance between these groups. The secondary outcome was to report compliance in a group of Chilean children and to compare survey results with adherence, to assess concordance between them. Baseline clinical characteristics were similar in the two groups. 30 patients were recruited. Mean compliance for all patients was 82%. Study group compliance was 83% versus 76% in control group (p = 0.5). Without epidemiology, intention to treat analysis (ITT), study group compliance was 97% compared to 76% in control group (p = 0.049). Pearson correlation between negative responses to a parental survey after treatment, of the percentage of adherence and compliance, was -0.57 and statistically significant (p = 0.013). There were no differences in patient compliance comparing more frequent evaluation versus a follow up evaluation based in an age according scheme. There is a high compliance to occlusion therapy in this group of Chilean children. If parents reported more negative adherence aspects in the survey, the worse the compliance.

  13. Randomized evaluation of spectacles plus alternate-day occlusion to treat amblyopia.

    Science.gov (United States)

    Agervi, Pia; Kugelberg, Ulla; Kugelberg, Maria; Simonsson, Gunnela; Fornander, Monica; Zetterström, Charlotta

    2010-02-01

    To compare spectacles plus patching >or=8 hours daily 6 days a week with spectacles plus patching >or=8 hours on alternate days to treat amblyopia in children 4 to 5 years of age. Prospective, randomized clinical trial. Forty children (median age, 4.3 years) with untreated amblyopia and a median best-corrected visual acuity (BCVA) in the amblyopic eye of 0.9 (range, 0.3-1.5) logarithm of the minimum angle of resolution. Refractive correction was provided, and the children were randomized to patching >or=8 hours daily 6 days a week or patching >or=8 hours on alternate days. The BCVA, binocular function, and refractive errors were measured repeatedly during the study. Median change in BCVA of the amblyopic eye after 1 year. The median change in BCVA of the amblyopic eye did not differ significantly between the 2 groups (0.6 log units for daily occlusion; 0.8 log unit for alternate-day occlusion). The final median BCVA in the amblyopic eyes was 0.1 logarithm of the minimum angle of resolution in both groups. Binocular function improved in both groups with no significant differences between the groups at 1 year. The median spherical equivalent refractive error did not change significantly during the study period in the amblyopic eyes in either group; however, a significant increase was found in the fellow eyes in both groups (daily occlusion, Pocclusion, Pamblyopia in children 4 to 5 years old. The effect of patching was not separate from that of optical correction with a period of refractive adaptation. Thus, the improvement in visual acuity is a combined effect of spectacle wear and occlusion therapy. Copyright (c) 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  14. Amblyopia treatment of adults with dichoptic training using the virtual reality oculus rift head mounted display: preliminary results

    OpenAIRE

    Žiak, Peter; Holm, Anders; Halička, Juraj; Mojzis, Peter; Piñero, David P.

    2017-01-01

    Background The gold standard treatments in amblyopia are penalizing therapies, such as patching or blurring vision with atropine that are aimed at forcing the use of the amblyopic eye. However, in the last years, new therapies are being developed and validated, such as dichoptic visual training, aimed at stimulating the amblyopic eye and eliminating the interocular supression. Purpose To evaluate the effect of dichoptic visual training using a virtual reality head mounted display in a sample ...

  15. Associations between anisometropia, amblyopia, and reduced stereoacuity in a school-aged population with a high prevalence of astigmatism.

    Science.gov (United States)

    Dobson, Velma; Miller, Joseph M; Clifford-Donaldson, Candice E; Harvey, Erin M

    2008-10-01

    To describe the relation between magnitude of anisometropia and interocular acuity difference (IAD), stereoacuity (SA), and the presence of amblyopia in school-aged members of a Native American tribe with a high prevalence of astigmatism. Refractive error (cycloplegic autorefraction confirmed by retinoscopy), best corrected monocular visual acuity (VA; Early Treatment Diabetic Retinopathy Study logMAR charts), and best corrected SA (Randot Preschool Stereoacuity Test) were measured in 4- to 13-year-old Tohono O'odham children (N = 972). Anisometropia was calculated in clinical notation (spherical equivalent and cylinder) and in two forms of vector notation that take into account interocular differences in both axis and cylinder magnitude. Astigmatism >or= 1.00 D was present in one or both eyes of 415 children (42.7%). Significant increases in IAD and presence of amblyopia (IAD >or= 2 logMAR lines) occurred, with >or=1 D of hyperopic anisometropia and >or=2 to 3 D of cylinder anisometropia. Significant decreases in SA occurred with >or=0.5 D of hyperopic, myopic, or cylinder anisometropia. Results for vector notation depended on the analysis used, but also showed disruption of SA at lower values of anisometropia than were associated with increases in IAD and presence of amblyopia. Best corrected IAD and presence of amblyopia are related to amount and type of refractive error difference (hyperopic, myopic, or cylindrical) between eyes. Disruption of best corrected random dot SA occurs with smaller interocular differences than those producing an increase in IAD, suggesting that the development of SA is particularly dependent on similarity of the refractive error between eyes.

  16. The effect of transcranial direct current stimulation on contrast sensitivity and visual evoked potential amplitude in adults with amblyopia

    OpenAIRE

    Ding, Zhaofeng; Li, Jinrong; Spiegel, Daniel P.; Chen, Zidong; Chan, Lily; Luo, Guangwei; Yuan, Junpeng; Deng, Daming; Yu, Minbin; Thompson, Benjamin

    2016-01-01

    Amblyopia is a neurodevelopmental disorder of vision that occurs when the visual cortex receives decorrelated inputs from the two eyes during an early critical period of development. Amblyopic eyes are subject to suppression from the fellow eye, generate weaker visual evoked potentials (VEPs) than fellow eyes and have multiple visual deficits including impairments in visual acuity and contrast sensitivity. Primate models and human psychophysics indicate that stronger suppression is associated...

  17. Personalized versus standardized dosing strategies for the treatment of childhood amblyopia: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Moseley, Merrick J; Wallace, Michael P; Stephens, David A; Fielder, Alistair R; Smith, Laura C; Stewart, Catherine E

    2015-04-25

    Amblyopia is the commonest visual disorder of childhood in Western societies, affecting, predominantly, spatial visual function. Treatment typically requires a period of refractive correction ('optical treatment') followed by occlusion: covering the nonamblyopic eye with a fabric patch for varying daily durations. Recent studies have provided insight into the optimal amount of patching ('dose'), leading to the adoption of standardized dosing strategies, which, though an advance on previous ad-hoc regimens, take little account of individual patient characteristics. This trial compares the effectiveness of a standardized dosing strategy (that is, a fixed daily occlusion dose based on disease severity) with a personalized dosing strategy (derived from known treatment dose-response functions), in which an initially prescribed occlusion dose is modulated, in a systematic manner, dependent on treatment compliance. A total of 120 children aged between 3 and 8 years of age diagnosed with amblyopia in association with either anisometropia or strabismus, or both, will be randomized to receive either a standardized or a personalized occlusion dose regimen. To avoid confounding by the known benefits of refractive correction, participants will not be randomized until they have completed an optical treatment phase. The primary study objective is to determine whether, at trial endpoint, participants receiving a personalized dosing strategy require fewer hours of occlusion than those in receipt of a standardized dosing strategy. Secondary objectives are to quantify the relationship between observed changes in visual acuity (logMAR, logarithm of the Minimum Angle of Resolution) with age, amblyopia type, and severity of amblyopic visual acuity deficit. This is the first randomized controlled trial of occlusion therapy for amblyopia to compare a treatment arm representative of current best practice with an arm representative of an entirely novel treatment regimen based on statistical

  18. An optimized voxel-based morphometry study in the evaluation of brain structural abnormalities in anisometropic amblyopia patients

    International Nuclear Information System (INIS)

    Liu Shengyuan; Zhang Jing; Zhang Quan; Yin Huiming; Zhang Lihong; Li Wei; Zhang Yunting

    2012-01-01

    Objective: To investigate possible neural mechanism of anisometropic amblyopia by analysing the whole brain volume changes both in grey matter and white matter using optimized voxel-based morphometry (VBM). Methods: Twelve anisometropic amblyopia patients and 12 age,gender and handedness matched healthy volunteers underwent 3-dimensional (3D) fast spoiled gradient echo (FSPGR) sequence scanning on 1.5 Tesla MR system. Raw data was processed and analyzed using statistical parametric mapping (SPM) 5. Results: Compared to healthy controls,the grey matter exhibiting significantly decreased volume in patients included right cuneus, bilateral occipital gyrus, right middle frontal gyrus, left middle temporal gyrus, right superior temporal gyrus, right precuneus,and middle part of right cingulate gyrus (clusters > 10). The grey matter showing increased volume in patients included right cerebellum,right parahippocampal gyrus, left precentral gyrus,and left superior frontal gyrus (clusters > 10). The white matter volume in bilateral optic radiation and internal capsule, especially right optic radiation, decreased significantly in patient group (clusters > 10 ). No white matter showed significantly increased volume in patient group. Conclusion: VBM can be used to investigate the changes of grey matter volume and white matter volume in the whole brain of anisometropic amblyopia children, it provides a method to illustrate the presumed neuro-mechanism from a morphologic point of view. (authors)

  19. [Amblyopia: reading speed in comparison with visual acuity for gratings, single Landolt Cs and series Landolt Cs].

    Science.gov (United States)

    Bach, M; Strahl, P; Waltenspiel, S; Kommerell, G

    1990-01-01

    In the treatment of amblyopia in preschool children, a means of predicting later reading ability would be helpful. This prediction might be possible using a test for visual acuity where the results correlate with reading ability in adult patients with amblyopia. We measured the following four parameters in 18 experienced readers with strabismic amblyopia: (1) time spent reading ten lines of a standard text in one of three magnifications, (2) visual acuity for gratings, (3) visual acuity for single Landolt Cs, and (4) visual acuity for crowded Landolt Cs (one Landolt C flanked by two full rings on each side each at a distance of 2.6 min of arc). The reading text was presented on paper at a distance of 40 cm; the subject had a choice of three magnifications. The acuity tests were generated by a computer on a VDU at 4.6 m. The relative impairment of the amblyopic eye was defined as the quotient between the performance of the amblyopic and the good eye. In addition, the difference between the times spent reading the ten lines with the amblyopic and with the good eye was calculated.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. A Comparison between Anxiety and Self-esteem amongst High School Freshman Students(Male and Female with Amblyopia in Gachsaran in 2015

    Directory of Open Access Journals (Sweden)

    Seyed Mohammad Karim Afzali

    2016-05-01

    Full Text Available The present research intends to investigate and compare the relationship between anxiety and self-esteem amongst high school freshman students (male and female with Amblyopia in Gachsaran city. To this end, all the male and female freshman students (1st Grade in high school suffering from Amblyopia in Gachsaran participated in the study as the research statistical population among which 80 students, including 40 girls and 40 boys, were selected based on Simple Random Sampling Method. Materials and tools used in this research included Beck Anxiety Inventory (BAI, Cooper-smith Self-esteem Inventory (CSEI and Snellen chart. In order to analyze results obtained from the present research, t-student test and correlation coefficient were used to investigate the relationship between the variables. Accordingly, the results indicated that: there is a statistically significant relationship between anxiety and self-esteem in students with Amblyopia (P˂0.000. Statistically significant difference in anxiety between male and female students with Amblyopia (P˂0.05 was observed. The results also showed that there is no any statistically significant difference in self-esteem between male and female students with Amblyopia (P˂0.66.

  1. Binocular iPad Game vs Patching for Treatment of Amblyopia in Children: A Randomized Clinical Trial.

    Science.gov (United States)

    Kelly, Krista R; Jost, Reed M; Dao, Lori; Beauchamp, Cynthia L; Leffler, Joel N; Birch, Eileen E

    2016-12-01

    Fellow eye patching has long been the standard treatment for amblyopia, but it does not always restore 20/20 vision or teach the eyes to work together. Amblyopia can be treated with binocular games that rebalance contrast between the eyes so that a child may overcome suppression. However, it is unclear whether binocular treatment is comparable to patching in treating amblyopia. To assess the effectiveness of a binocular iPad (Apple Inc) adventure game as amblyopia treatment and compare this binocular treatment with patching, the current standard of care. This investigation was a randomized clinical trial with a crossover design at a nonprofit eye research institute. Between February 20, 2015, and January 4, 2016, a total of 28 patients were enrolled in the study, with 14 randomized to binocular game treatment and 14 to patching treatment. Binocular game and patching as amblyopia treatments. The primary outcome was change in amblyopic eye best-corrected visual acuity (BCVA) at the 2-week visit. Secondary outcomes were change in stereoacuity and suppression at the 2-week visit and change in BCVA at the 4-week visit. Among 28 children, the mean (SD) age at baseline was 6.7 (1.4) years (age range, 4.6-9.5 years), and 7 (25%) were female. At baseline, the mean (SD) amblyopic eye BCVA was 0.48 (0.14) logMAR (approximately 20/63; range, 0.3-0.8 logMAR [20/40 to 20/125]), with 14 children randomized to the binocular game and 14 to patching for 2 weeks. At the 2-week visit, improvement in amblyopic eye BCVA was greater with the binocular game compared with patching, with a mean (SD) improvement of 0.15 (0.08) logMAR (mean [SD], 1.5 [0.8] lines) vs 0.07 (0.08) logMAR (mean [SD], 0.7 [0.8] line; P = .02) after 2 weeks of treatment. These improvements from baseline were significant for the binocular game (mean [SD] improvement, 1.5 [0.8] lines; P suppression improved from baseline at the 2-week visit for the binocular game (mean [SD], 4.82 [2.82] vs 3.24 [2.87]; P

  2. Femtosecond laser corneal refractive surgery for the correction of high myopic anisometropic amblyopia in juveniles

    Directory of Open Access Journals (Sweden)

    Jing Zhang

    2017-11-01

    Full Text Available AIM: To evaluate the effects of femtosecond laser-assisted in situ keratomileusis (FS-LASIK and small-incision lenticule extraction (SMILE to correct high myopic anisometropic amblyopia in juvenile patients. METHODS: From November 2013 to January 2015, 33 amblyopic patients with high myopic anisometropic amblyopia were studied. FS-LASIK (30 eyes or SMILE (3 eyes was performed in the amblyopic eyes. Visual acuity, refraction, contrast sensitivity, stereoacuity and complications were evaluated. Patients completed follow-up examinations at 3d, 1mo, 3mo and the last follow-up time (mean 8.17±3.23mo after surgery. RESULTS: The mean age at surgery was 9.04±3.04y (range 6-16y. The mean spherical equivalent in the amblyopic eyes was significantly decreased from -10.00±2.39 D preoperatively to -0.06±1.06 D at 1mo, -0.19±1.33 D at 3mo and -0.60±1.43 D at approximately 8mo postoperatively (P<0.05 for all. The mean myopic anisometropia was significantly decreased from -9.45±2.33 D preoperatively to +0.37±1.48 D at 1mo, -0.46±1.47 D at 3mo and -0.09±1.83 D at approximately 8mo (P<0.05 for all. The logarithm of the minimum angle of resolution (logMAR for uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively of the amblyopic eye improved from 1.74±0.35 and 0.98±0.63 preoperatively to 0.45±0.31 and 0.41±0.33 at approximately 8mo after surgery, respectively. The logMAR CDVA at 3d, 1, 3 and 8mo postoperatively improved by means of 1.42, 2.22, 2.96, and 4.39 lines, and a gain of more than two lines accounted for 45%, 50%, 74% and 86% of all patients, respectively. The contrast sensitivity of both amblyopic eyes and dominant eyes at 0.5, 2, 8 cycles per degree was significantly improved postoperatively (P<0.05 for all. Of the 33 pediatric patients, no patients had near stereopsis preoperatively and seven patients (21.2% recovered near stereopsis (400″ to 60″ at approximately 8mo after surgery. No intraoperative or

  3. Television Video Games in the Treatment of Amblyopia in Children Aged 4-7 Years.

    Science.gov (United States)

    Dadeya, Subhash; Dangda, Sonal

    2016-12-01

    To investigate the role of television video games in childhood amblyopia treatment. This prospective, randomized, interventional study included 40 patients between 4-7 years of age, with unilateral amblyopia (visual acuity in amblyopic eye between 1-0.6 LogMAR equivalents) attending the squint clinic at a tertiary eye hospital. All patients were prescribed optimal spectacle correction and occlusion therapy, i.e. full time patching according to patient's age, was initiated after six weeks.; full-time patching according to patient's age was initiated after 6 weeks. Subjects were randomly divided into two groups of 20 each. Patients in the first group, Group A (control), were prescribed patching alone. Patients in the second group, Group B (study), were made to play action video games, with the help of a commercial television set, along with patching. They attended 12 half-hour sessions each, at weekly intervals. Follow-up assessments included best corrected visual acuity (BCVA) (both distance and near) and stereoacuity measurements at 3, 6, 9, and 12 weeks. The mean age of patients was 6.03 ± 1.14 years. The distance BCVA in the amblyopic eye showed a significant improvement at final follow-up (12 weeks) in both groups: from 0.84 ± 0.19 to 0.55 ± 0.21 LogMAReq in Group A and 0.89 ± 0.16 to 0.46 ± 0.22 LogMAReq in Group B. However, improvement in BCVA was significantly better in group B at all visits (P=0.002, 12 weeks). The study group also had a significantly better outcome in terms near visual acuity improvement (P = 0.006, 12 weeks). There was also greater stereoacuity improvement in group B, with 7 patients improving to 100 secs of arc or better. Video games supplemental to occlusion may be considered favorable for visual development in amblyopic children, and the study encourages further research on this subject.

  4. [Evaluation of visual acuity in a historical cohort of 137 patients treated for amblyopia by occlusion 30-35 years ago].

    Science.gov (United States)

    Simonsz-Tóth, B; Loudon, S E; van Kempen-du Saar, H; van de Graaf, E S; Groenewoud, J H; Simonsz, H J

    2007-01-01

    Opinions differ on the course of the visual acuity in the amblyopic eye after cessation of occlusion therapy. This study evaluated visual acuity in a historical cohort treated for amblyopia with occlusion therapy 30-35 years ago. Between 1968 and 1975, 1250 patients had been treated by the orthoptist in the Waterland Hospital in Purmerend, The Netherlands. Of these, 471 received occlusion treatment for amblyopia (prevalence 5.0%, after comparison with the local birth rate). We were able to contact 203 of these patients, 137 were orthoptically re-examined in 2003. We correlated the current visual acuity with the cause of amblyopia, the age at start and end of treatment, the visual acuity at start and end of treatment, fixation, binocular vision and refractive errors. Mean age at the start of treatment was 5.4 +/- 1.9 years, 7.4 +/- 1.7 years at the end and 37 +/- 2.7 years at follow-up. Current visual acuity in the amblyopic eye was correlated with a low visual acuity at the start (p occlusion therapy, an eccentric fixation (p amblyopia (p = 0.005). At the end of the treatment, patients with a strabismic amblyopia (n = 98) had a visual acuity in the amblyopic eye of 0.29 logMAR +/- 0.3, and in 2003 0.27 +/- 0.3 logMAR. In patients with an anisometropic amblyopia (> 1 D, n = 16) visual acuity had decreased from 0.17 +/- 0.23 logMAR to 0.21 logMAR +/- 0.23. In patients with both strabismic and anisometropic amblyopia (n = 23), visual acuity had decreased from 0.52 logMAR +/- 0.54 to 0.65 logMAR +/- 0.54. Overall, acuity had decreased in 54 patients (39%) after cessation of treatment. Of these, 18 patients had an acuity decrease to less than 50% of their acuity at the end of treatment. In 15 of these 18 patients anisohypermetropia had increased. A decrease in visual acuity after cessation of occlusion therapy occurred in patients with a combined cause of amblyopia or with an increase in anisohypermetropia.

  5. Distinct Circuits for Recovery of Eye Dominance and Acuity in Murine Amblyopia.

    Science.gov (United States)

    Stephany, Céleste-Élise; Ma, Xiaokuang; Dorton, Hilary M; Wu, Jie; Solomon, Alexander M; Frantz, Michael G; Qiu, Shenfeng; McGee, Aaron W

    2018-05-24

    Degrading vision by one eye during a developmental critical period yields enduring deficits in both eye dominance and visual acuity. A predominant model is that "reactivating" ocular dominance (OD) plasticity after the critical period is required to improve acuity in amblyopic adults. However, here we demonstrate that plasticity of eye dominance and acuity are independent and restricted by the nogo-66 receptor (ngr1) in distinct neuronal populations. Ngr1 mutant mice display greater excitatory synaptic input onto both inhibitory and excitatory neurons with restoration of normal vision. Deleting ngr1 in excitatory cortical neurons permits recovery of eye dominance but not acuity. Reciprocally, deleting ngr1 in thalamus is insufficient to rectify eye dominance but yields improvement of acuity to normal. Abolishing ngr1 expression in adult mice also promotes recovery of acuity. Together, these findings challenge the notion that mechanisms for OD plasticity contribute to the alterations in circuitry that restore acuity in amblyopia. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Psychological causes of non-compliance with electronically monitored occlusion therapy for amblyopia.

    Science.gov (United States)

    Loudon, S E; Passchier, J; Chaker, L; de Vos, S; Fronius, M; Harrad, R A; Looman, C W N; Simonsz, B; Simonsz, H J

    2009-11-01

    To analyse psychological causes for low compliance with occlusion therapy for amblyopia. In a randomised trial, the effect of an educational programme on electronically measured compliance had been assessed. 149 families who participated in this trial completed a questionnaire based on the Protection Motivation Theory after 8 months of treatment. Families with compliance less than 20% of prescribed occlusion hours were interviewed to better understand their cause for non-compliance. Poor compliance was most strongly associated with a high degree of distress (p<0.001), followed by low perception of vulnerability (p = 0.014), increased stigma (p = 0.017) and logistical problems with treatment (p = 0.044). Of 44 families with electronically measured compliance less than 20%, 28 could be interviewed. The interviews confirmed that lack of knowledge, distress and logistical problems resulted in non-compliance. Poor parental knowledge, distress and difficulties implementing treatment seemed to be associated with non-compliance. For the same domains, the scores were more favourable for families who had received the educational programme than for those who had not.

  7. Visual Acuity Improvement of Amblyopia in an Adult With Levodopa/Carbidopa Treatment.

    Science.gov (United States)

    Orge, Faruk H; Dar, Suhail A

    2015-09-09

    Amblyopia is the leading cause of visual loss in children, affecting 2% to 3% of the population. Occlusion of the dominant eye is the primary and best treatment, although efficacy decreases after 6 years of age. As a result, levodopa/carbidopa has been explored as an adjunct to conventional therapy and has been shown to have an immediate impact on visual acuity. Several studies to date have shown mixed results on the benefit of supplementing occlusion therapy with levodopa/carbidopa, although they have primarily studied children. The authors describe the oldest patient (46 years old) documented in the literature to have shown improvement in visual acuity using levodopa/carbidopa. He was given a 16-week course at a dose in line with previous studies while being effectively occluded full time due to a glaucomatous right eye with no light perception. On 3-month follow-up, his left eye improved two lines and stabilized at 6 months. Copyright 2015, SLACK Incorporated.

  8. Unilateral phthiriasis palpebrarum infestation in a child during occlusion therapy for amblyopia: Case report.

    Science.gov (United States)

    Biler, Elif Demirkilinc; Selver, Ozlem Barut; Palamar, Melis; Uner, Ahmet; Uretmen, Onder

    2016-01-01

    An 8-year-old mentally retarded boy is brought to the hospital because of itching and burning at his right eye for 10 days. He was on full time right eye occlusion therapy for left amblyopia. Slit lamp examination revealed nits and adult lice anchored to the eyelashes in his occluded eye. Eyelashes and all detected lice and nits were mechanically trimmed, and sent for parasitological examination, which confirmed the diagnosis. Upon familial evaluation for additional infestation, the father was also found to have genital phthiriasis pubis and received appropriate treatment. While phthiriasis palpebrarum in children may signify sexual abuse, a detailed investigation by a child psychiatrist was performed and revealed no sign of abuse. Since the infestation was at only on occluded eye, the most possible explanation for the transmission was evaluated as the misusage of the adhesive patch in our case. In conclusion, sexual abuse should be excluded in children with phthiriasis palpebrarum and parents of amblyopic children on occlusion therapy should be warned about the importance of the hygiene of the patching in order to avoid any kind of infection and infestation.

  9. Binocular versus standard occlusion or blurring treatment for unilateral amblyopia in children aged three to eight years.

    Science.gov (United States)

    Tailor, Vijay; Bossi, Manuela; Bunce, Catey; Greenwood, John A; Dahlmann-Noor, Annegret

    2015-08-11

    Current treatments for amblyopia in children, occlusion and pharmacological blurring, have had limited success, with less than two-thirds of children achieving good visual acuity of at least 0.20 logMAR in the amblyopic eye, limited improvement of stereopsis, and poor compliance. A new treatment approach, based on the dichoptic presentation of movies or computer games (images presented separately to each eye), may yield better results, as it aims to balance the input of visual information from each eye to the brain. Compliance may also improve with these more child-friendly treatment procedures. To determine whether binocular treatments in children aged three to eight years with unilateral amblyopia result in better visual outcomes than conventional occlusion or pharmacological blurring treatment. We searched the Cochrane Eyes and Vision Group Trials Register (last date of searches: 14 April 2015), the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 3), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to April 2015), EMBASE (January 1980 to April 2015), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. Two review authors independently screened the results of the search in order to identify studies that met the inclusion criteria of the review: randomised controlled trials (RCTs) that enrolled participants between the ages of three and eight years old with unilateral amblyopia, defined as best-corrected visual acuity (BCVA) worse than 0.200 logMAR in the amblyopic eye, and BCVA 0.200 logMAR or better in the fellow eye, in the presence of an amblyogenic risk factor such as anisometropia, strabismus, or both. Prior

  10. Amblyopia treatment of adults with dichoptic training using the virtual reality oculus rift head mounted display: preliminary results.

    Science.gov (United States)

    Žiak, Peter; Holm, Anders; Halička, Juraj; Mojžiš, Peter; Piñero, David P

    2017-06-28

    The gold standard treatments in amblyopia are penalizing therapies, such as patching or blurring vision with atropine that are aimed at forcing the use of the amblyopic eye. However, in the last years, new therapies are being developed and validated, such as dichoptic visual training, aimed at stimulating the amblyopic eye and eliminating the interocular supression. To evaluate the effect of dichoptic visual training using a virtual reality head mounted display in a sample of anisometropic amblyopic adults and to evaluate the potential usefulness of this option of treatment. A total of 17 subjects (10 men, 7 women) with a mean age of 31.2 years (range, 17-69 year) and anisometropic amblyopia were enrolled. Best corrected visual acuity (BCVA) and stereoacuity (Stereo Randot graded circle test) changes were evaluated after 8 sessions (40 min per session) of dichoptic training with the computer game Diplopia Game (Vivid Vision) run in the Oculus Rift OC DK2 virtual reality head mounted display (Oculus VR). Mean BCVA in amblyopic eye improved significantly from a logMAR value of 0.58 ± 0.35 before training to a post-training value of 0.43 ± 0.38 (p virtual reality head mounted display seems to be an effective option of treatment in adults with anisometropic amblyopia. Future clinical trials are needed to confirm this preliminary evidence. Trial ID: ISRCTN62086471 . Date registered: 13/06/2017. Retrospectively registered.

  11. Suppression of metabolic activity caused by infantile strabismus and strabismic amblyopia in striate visual cortex of macaque monkeys.

    Science.gov (United States)

    Wong, Agnes M F; Burkhalter, Andreas; Tychsen, Lawrence

    2005-02-01

    Suppression is a major sensorial abnormality in humans and monkeys with infantile strabismus. We previously reported evidence of metabolic suppression in the visual cortex of strabismic macaques, using the mitochondrial enzyme cytochrome oxidase as an anatomic label. The purpose of this study was to further elucidate alterations in cortical metabolic activity, with or without amblyopia. Six macaque monkeys were used in the experiments (four strabismic and two control). Three of the strabismic monkeys had naturally occurring, infantile strabismus (two esotropic, one exotropic). The fourth strabismic monkey had infantile microesotropia induced by alternating monocular occlusion in the first months of life. Ocular motor behaviors and visual acuity were tested after infancy in each animal, and development of stereopsis was recorded during infancy in one strabismic and one control monkey. Ocular dominance columns (ODCs) of the striate visual cortex (area V1) were labeled using cytochrome oxidase (CO) histochemistry alone, or CO in conjunction with an anterograde tracer ([H 3 ]proline or WGA-HRP) injected into one eye. Each of the strabismic monkeys showed inequalities of metabolic activity in ODCs of opposite ocularity, visible as rows of lighter CO staining, corresponding to ODCs of lower metabolic activity, alternating with rows of darker CO staining, corresponding to ODCs of higher metabolic activity. In monkeys who had infantile strabismus and unilateral amblyopia, lower metabolic activity was found in (suppressed) ODCs driven by the nondominant eye in each hemisphere. In monkeys who had infantile esotropia and alternating fixation (no amblyopia), metabolic activity was lower in ODCs driven by the ipsilateral eye in each hemisphere. The suppression included a monocular core zone at the center of ODCs and binocular border zones at the boundaries of ODCs. This suppression was not evident in the monocular lamina of the LGN, indicating an intracortical rather than

  12. [Supportive amblyopia treatment by means of computer games with background stimulation; a placebo controlled pilot study of 10 days].

    Science.gov (United States)

    Kämpf, U; Muchamedjarow, F; Seiler, T

    2001-04-01

    Computer programmes for visual stimulation may give new impulses to the field of amblyopia treatment by offering an option to shift the apparative visual training into the domestic sphere. Regarding this aspect we report on a placebo controlled study on a newly developed vision training consisting of a background stimulation by a drifting sinusoidal grating combined with a foreground game aimed to maintain the attention. Fourteen amblyopia patients aged from 6 to 13 years participated in the study. Seven were allocated to a placebo and seven to a treatment group. Both groups had to train at the computer for a period of 10 working days by two sessions of about 20 minutes daily. Whilst the placebo group played in front of a neutral background, the treatment group did this with a drifting sinusoidal grating in the background. The treatment condition resulted in a greater increase of visual acuity than the placebo condition. Near vision improved in the treatment group from 0.20 (SD +/- 4.51 steps) to 0.39 (SD +/- 3.06 steps), i.e. by 3.0 steps of visual acuity (SD +/- 1.8 steps), in the placebo group from 0.14 (SD +/- 6.02 steps) to 0.17 (SD +/- 5.85 steps), i.e. by 0.8 steps of visual acuity (SD +/- 1.6 steps). Far vision improved in the treatment group from 0.29 (SD +/- 2.57 steps) to 0.44 (SD +/- 3.16 steps), i.e. by 1.9 steps of visual acuity (SD +/- 1.3 steps), in the placebo group from 0.24 (SD +/- 5.20 steps) to 0.28 (SD +/- 5.51 steps), i.e. by 0.7 steps of visual acuity (SD +/- 1.1 steps). Stimulation with drifting sinusoidal gratings improves the visual acuity of amblyopic eyes in a specific way. The effect might be accounted for by a synergy of spatial and temporal frequency in form vs. motion channels. A preliminary hypothesis is discussed and will be the subject of ongoing research. The presented method has been developed for the treatment of "delayed" amblyopia in the elder child. It is aimed to support and complement occlusion therapy. However, the

  13. Comparison of the Thickness and Volume of the Macula and Fovea in Patients with Anisometropic Amblyopia Prior to and after Occlusion Therapy.

    Science.gov (United States)

    Yoon, Dong Hee; Chun, Bo Young

    2018-02-01

    To compare the thickness of superior, temporal, inferior, and nasal macula and foveal thickness and volume in patients with anisometropic amblyopia prior to and after successful occlusion therapy using optical coherence tomography (OCT) measurement. Data were collected prospectively on 30 patients with unilateral anisometropic amblyopia from December 2006 to August 2007. All patients had anisometropia of 2.0 diopters or more. OCT scans were obtained for all patients at diagnosis. Occlusion therapy was then prescribed and OCT scans were obtained again at the time of successful occlusion therapy (defined as interocular difference of amblyopia. The mean duration of occlusion was 11.24 months and mean best-corrected visual acuity at diagnosis was 0.35 ± 0.12 logarithm of the minimum angle of resolution. The mean thicknesses of the superior, temporal, inferior, and nasal macula prior to and after occlusion were not significantly different (p > 0.05). However, mean foveal volume prior to occlusion therapy (0.15 ± 0.02 mm³) decreased after occlusion (0.14 ± 0.01 mm³) with statistical significance (Wilcoxon signed rank test, p = 0.025). There was a meaningful decrease in foveal volume in patients with anisometropic amblyopia after successful occlusion therapy. Whether this decrease relates to visual improvement of the amblyopic eye remains to be determined. © 2018 The Korean Ophthalmological Society

  14. Home use of binocular dichoptic video content device for treatment of amblyopia: a pilot study.

    Science.gov (United States)

    Mezad-Koursh, Daphna; Rosenblatt, Amir; Newman, Hadas; Stolovitch, Chaim

    2018-04-01

    To evaluate the efficacy of the BinoVision home system as measured by improvement of visual acuity in the patient's amblyopic eye. An open-label prospective pilot-trial of the system was conducted with amblyopic children aged 4-8 years at the pediatric ophthalmology unit, Tel-Aviv Medical Center, January 2014 to October 2015. Participants were assigned to the study or sham group for treatment with BinoVision for 8 or 12 weeks. Patients were instructed to watch animated television shows and videos at home using the BinoVision device for 60 minutes, 6 days a week. The BinoVision program incorporates elements at different contrast and brightness levels for both eyes, weak eye tracking training by superimposed screen images, and weak eye flicker stimuli with alerting sound manipulations. Patients were examined at 4, 8, 12, 24, and 36 weeks. A total of 27 children were recruited (14 boys), with 19 in the treatment group. Median age was 5 years (range, 4-8 years). Mean visual acuity improved by 0.26 logMAR lines in the treatment group from baseline to 12 weeks. Visual acuity was improved compared to baseline during all study and follow-up appointments (P amblyopia treatment with the BinoVision home system demonstrated significant improvement in patients' visual acuity. Copyright © 2018 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  15. Optical treatment of amblyopia in astigmatic children: the sensitive period for successful treatment.

    Science.gov (United States)

    Harvey, Erin M; Dobson, Velma; Clifford-Donaldson, Candice E; Miller, Joseph M

    2007-12-01

    To compare the effectiveness of eyeglass treatment of astigmatism-related amblyopia in children younger than 8 years (range, 4.75-7.99 years) versus children 8 years of age and older (range, 8.00-13.53 years) over short (6-week) and long (1-year) treatment intervals. Prospective, interventional, comparative case-control study. Four hundred forty-six nonastigmatic (right and left eye, or =1.00 D) Native American (Tohono O'odham) children in kindergarten or grades 1 through 6. Eyeglass correction of refractive error, prescribed for full-time wear, in astigmatic children. Amount of change in mean right-eye best-corrected letter visual acuity for treated astigmatic children versus untreated, age-matched nonastigmatic children after short (6-week) and long (1-year) treatment intervals. Astigmatic children had significantly reduced mean best-corrected visual acuity at baseline compared to nonastigmatic children. Astigmats showed significantly greater improvement in mean best-corrected visual acuity (0.08 logarithm of the minimum angle of resolution [logMAR] unit; approximately 1 line), than the nonastigmatic children (0.01 logMAR unit) over the 6-week treatment interval. No additional treatment effect was observed between 6 weeks and 1 year. Treatment effectiveness was not dependent on age group ( or =8 years) and was not influenced by previous eyeglass treatment. Despite significant improvement, mean best-corrected visual acuity in astigmatic children remained significantly poorer than in nonastigmatic children after 1 year of eyeglass treatment, even when analyses were limited to results from highly compliant children. Sustained eyeglass correction results in significant improvement in best-corrected visual acuity in astigmatic children, including those previously believed to be beyond the sensitive period for successful treatment.

  16. Local and non-local deficits in amblyopia: acuity and spatial interactions.

    Science.gov (United States)

    Bonneh, Yoram S; Sagi, Dov; Polat, Uri

    2004-12-01

    Amblyopic vision is thought to be limited by abnormal long-range spatial interactions, but their exact mode of action and relationship to the main amblyopic deficit in visual acuity is largely unknown. We studied this relationship in a group (N=59) of anisometropic (N=21) and strabismic (or combined, N=38) subjects, using (1) a single and multi-pattern (crowded) computerized static Tumbling-E test with scaled spacing of two pattern widths (TeVA), in addition to an optotype (ETDRS chart) acuity test (VA) and (2) contrast detection of Gabor patches with lateral flankers (lateral masking) along the horizontal and vertical axes as well as in collinear and parallel configurations. By correlating the different measures of visual acuity and contrast suppression, we found that (1) the VA of the strabismic subjects could be decomposed into two uncorrelated components measured in TeVA: acuity for isolated patterns and acuity reduction due to flanking patterns. The latter comprised over 60% of the VA magnitude, on the average and accounted for over 50% of its variance. In contrast, a slight reduction in acuity was found in the anisometropic subjects, and the acuity for a single pattern could account for 70% of the VA variance. (2) The lateral suppression (contrast threshold elevation) in a parallel configuration along the horizontal axis was correlated with the VA (R2=0.7), as well as with the crowding effect (TeVA elevation, R2=0.5) for the strabismic group. Some correlation with the VA was also found for the collinear configuration in the anisometropic group, but less suppression and no correlation were found for all the vertical configurations in all the groups. The results indicate the existence of a specific non-local component of the strabismic deficit, in addition to the local acuity deficit in all amblyopia types. This deficit might reflect long-range lateral inhibition, or alternatively, an inaccurate and scattered top-down attentional selection mechanism.

  17. Effectiveness of the GoCheck Kids Vision Screener in Detecting Amblyopia Risk Factors.

    Science.gov (United States)

    Peterseim, M Millicent W; Rhodes, Ryan S; Patel, Rupa N; Wilson, M Edward; Edmondson, Luke E; Logan, Sarah A; Cheeseman, Edward W; Shortridge, Emily; Trivedi, Rupal H

    2018-03-01

    The GoCheck Kids smartphone photoscreening app (Gobiquity Mobile Health, Scottsdale, Arizona, USA), introduced in 2014, is marketed to pediatricians with little published validation. We wished to evaluate the GoCheck Kids Screener for accuracy in detecting amblyopia risk factors (ARF) using 2013 American Association for Pediatric Ophthalmology and Strabismus guidelines. Validity assessment. Children 6 months to 6 years of age presenting from October 2016 to August 2017 were included. Children were screened with the GoCheck preloaded Nokia Lumia 1020, software version 4.6 with image processing version R4d, prior to undergoing a comprehensive eye examination by a pediatric ophthalmologist masked to the screener results. Determination of the presence of age-specific ARF was made based upon the examination and compared with the GoCheck recommendation. A total of 206 children were included (average age 43 months). When compared to examination, GoCheck had a sensitivity of 76.0% and specificity of 67.2% in detecting ARF. Positive predictive value was 57.0% and negative predictive value 83.0%. The screener results of 13 children were changed from "no risk factors" to "risk factors identified" based on the GoCheck remote review process. Four images remained "not gradable" and screening was unsuccessful in 3 children. In our high-risk population, this version of the Gocheck Kids smartphone app was useful in identifying ARF in children who are often not able to cooperate with visual acuity testing. This study informs pediatricians about the efficacy of this new screener as they make decisions about how to best detect vision problems in young children. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. Sociocultural and psychological determinants in migrants for noncompliance with occlusion therapy for amblyopia.

    Science.gov (United States)

    Tjiam, Angela M; Akcan, Hilal; Ziylan, Fatma; Vukovic, Elizabet; Loudon, Sjoukje E; Looman, Caspar W N; Passchier, Jan; Simonsz, Huibert J

    2011-12-01

    Compliance with occlusion therapy for amblyopia in children is low when their parents have a low level of education, speak Dutch poorly, or originate from another country. We determined how sociocultural and psychological determinants affect compliance. Included were amblyopic children between the ages of 3 and 6, living in low socio-economic status (SES) areas. Compliance with occlusion therapy was measured electronically. Their parents completed an oral questionnaire, based on the "Social Position & Use of Social Services by Migrants and Natives" questionnaire that included demographics and questions on issues like education, employment, religion and social contacts. Parental fluency in Dutch was rated on a five-point scale. Regression analysis was used to describe the relationship between the level of compliance and sociocultural and psychological determinants. Data from 45 children and their parents were analyzed. Mean electronically measured compliance was 56 ± 44 percent. Children whose parents had close contact with their neighbors or who were highly dependent on their family demonstrated low levels of compliance. Children of parents who were members of a club and who had positive conceptualizations of Dutch society showed high levels of compliance. Poor compliance was also associated with low income, depression, and when patching interfered with the child's outdoor activity. Religion was not associated with compliance. Poor compliance with occlusion therapy seems correlated with indicators of social cohesion. High social cohesion at micro level, i.e., family, neighbors and friends, and low social cohesion on macro level, i.e., Dutch society, are associated with noncompliance. However, such parents tend to speak Dutch poorly, so it is difficult to determine its actual cause.

  19. Optimal compliance for amblyopia therapy: occlusion with a translucent tape on the lens.

    Science.gov (United States)

    Beneish, Raquel G; Polomeno, Robert C; Flanders, Michael E; Koenekoop, Robert K

    2009-10-01

    To demonstrate that optimal compliance to amblyopia therapy and a better visual outcome can be achieved by occluding the lens over the preferred eye with a translucent tape. Prospective study of amblyopic children. Eighty-four amblyopic children recruited from 2000 to 2006 at the Montreal Children's Vision Centre. A group of bilateral ametropes (mean age 3.8 years) were treated with glasses and occlusion of the sound eye with a translucent tape on the lens over the preferred eye, or an adhesive patch. The translucent tape reduced vision to hand motion at 0.3 m in the sound eye. Patients were divided into 2 groups depending on the treatment received. Group 1 (n = 36) was occluded with a translucent tape, and group 2 (n = 48) with a conventional adhesive patch, later replaced by the translucent tape. Twenty-five previously reported patients, treated with the conventional adhesive patch only, were used as controls (group 3). The mean amblyopic visual acuity was 20/100-2. Compliance was good in 36 patients (group 1), and was poor or deteriorated in 24/48 patients (group 2). Substituting the adhesive patch with a translucent tape permitted uninterrupted and prolonged occlusion, with a successful visual outcome. The amblyopic eye achieved a significantly better final vision (20/30+2; groups 1+2) than the controls (20/40+1; group 3) (p = 0.04). Sixty-four (76.19%) patients achieved >or=20/30. The translucent tape optimizes compliance and yields better vision by lengthening the duration of occlusion therapy and reducing the number of treatment failures due to noncompliance.

  20. Prevalence of Amblyopia and Strabismus in White and African-American Children Aged 6 through 71 Months: The Baltimore Pediatric Eye Disease Study

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    Friedman, David S.; Repka, Michael X.; Katz, Joanne; Giordano, Lydia; Ibironke, Josephine; Hawse, Patricia; Tielsch, James M.

    2009-01-01

    Objective To determine the age-specific prevalence of strabismus in White and African-American children aged 6 through 71 months and of amblyopia in White and African-American children aged 30 through 71 months. Design Cross-sectional population-based study. Participants White and African-American children aged 6 through 71 months in Baltimore, Maryland, United States. Among 4,132 children identified, 3,990 eligible children (97%) were enrolled and 2,546 children (62%) were examined. Methods Parents or guardians of eligible participants underwent an in-home interview and were scheduled for a detailed eye examination including optotype visual acuity and measurement of ocular deviations. Strabismus was defined as a heterotropia at near or distance fixation. Amblyopia was assessed in those children aged 30 through 71 months who were able to perform optotype testing at 3 meters. Main Outcome Measures The proportions of children aged 6 through 71 months with strabismus and of children aged 30 through 71 months with amblyopia. Results Manifest strabismus was found in 3.3% of White and 2.1% of African American children (relative prevalence (RP) 1.61, 95% confidence interval (CI): 0.97, 2.66). Esotropia and exotropia each accounted for close to half of all strabismus in both groups. Only one case of strabismus was found among 84 White children 6 through 11 months of age. Rates were higher in children 60 through 71 months of age (5.8% for Whites and 2.9% for African Americans (RP: 2.05, 95% CI: 0.79, 5.27). Amblyopia was present in 12 (1.8%) White and 7 (0.8%) African American children (RP: 2.23, 95% CI: 0.88, 5.62). Only one child had bilateral amblyopia. Conclusions Manifest strabismus affected 1 in 30 White and 1 in 47 African-American preschool aged children. The prevalence of amblyopia was under 2% in both Whites and African-Americans. National population projections suggest that there are approximately 677,000 cases of manifest strabismus among children 6–71 months

  1. A new binocular approach to the treatment of amblyopia in adults well beyond the critical period of visual development.

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    Hess, R F; Mansouri, B; Thompson, B

    2010-01-01

    The present treatments for amblyopia are predominantly monocular aiming to improve the vision in the amblyopic eye through either patching of the fellow fixing eye or visual training of the amblyopic eye. This approach is problematic, not least of which because it rarely results in establishment of binocular function. Recently it has shown that amblyopes possess binocular cortical mechanisms for both threshold and suprathreshold stimuli. We outline a novel procedure for measuring the extent to which the fixing eye suppresses the fellow amblyopic eye, rendering what is a structurally binocular system, functionally monocular. Here we show that prolonged periods of viewing (under the artificial conditions of stimuli of different contrast in each eye) during which information from the two eyes is combined 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). Concomitant improvement in monocular acuity of the amblyopic eye occurs with this reduction in suppression and strengthening of binocular fusion. Furthermore, in a majority of patients tested, stereoscopic function is established. This provides the basis for a new treatment of amblyopia, one that is purely binocular and aimed at reducing suppression as a first step.

  2. The Sensitivity, Specificity and Predictive Values of Snellen Chart Compared to the Diagnostic Test in Amblyopia Screening Program in Iran

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    Fatemeh Rivakani

    2015-12-01

    Full Text Available Introduction Amblyopia is a leading cause of visual impairment in both childhood and adult populations. Our aim in this study was to assess the epidemiological characteristics of the amblyopia screening program in Iran. Materials and Methods A cross-sectional study was done on a randomly selected sample of 4,636 Iranian children who were referred to screening program in 2013 were participated in validity study, too. From each provinces the major city were selected. Screening and diagnostic tests were done by instructors in first stage and optometrists in second stage, respectively. Finally data were analyzed by Stata version 13. Results The sensitivity was ranged from 74% to 100% among the various provinces such that Fars and Ardabil province had maximum and minimum values, respectively. The pattern of specificity was differ and ranged 44% to 84% among the provinces; Hormozgan and Fars had maximum and minimum values, respectively. The positive predictive value was also ranged from 35% to %81 which was assigned to Khuzestan and Ardabil provinces, respectively. The range of Negative Predictive value was 61% to 100% which was belonged to Ardabil and Fars provinces. Conclusion The total sensitivity (89% and negative predictive values (93% of screening test among children aged 3-6 years is acceptable, but only 51% of children refereed to second stage are true positive and this imposes considerable cost to health system.

  3. Terapia oclusiva em ambliopia: fatores prognósticos Occlusion therapy in amblyopia: factors that influence the outcome

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    Ana Carolina Fava Salata

    2001-04-01

    Full Text Available Objetivos: Ambliopia é o defeito visual mais comum em crianças e por mais de 250 anos a terapia oclusiva vem sendo o melhor tratamento. Sendo assim, propusemo-nos a determinar os fatores que influenciam no sucesso do tratamento da ambliopia por terapia oclusiva em nosso meio. Métodos: Foi realizado um estudo retrospectivo com 169 crianças amblíopes atendidas no Ambulatório de Ambliopia do Hospital de Clínicas da UNICAMP, Campinas (SP, entre janeiro de 1996 e maio de 1998. A população atendida foi classificada quanto ao sexo, idade de início do tratamento por faixa etária (3 grupos, olho afetado, tipo de ambliopia (estrabísmica, anisometrópica, por deprivação, associação de dois tipos, tempo de seguimento, gravidade da ambliopia (leve, moderada, grave, adesão ao tratamento (regular, irregular e resposta obtida (cura, melhora, sem cura. Resultados: A adesão ao tratamento não diferiu entre as faixas etárias (p=0,68 e não foi influenciada pela gravidade da ambliopia (p=0,82. Dos pacientes estudados 52,67% curaram-se, 19,52% melhoraram e 27,81% não obtiveram cura. Os pacientes com adesão regular tiveram índice de cura significativamente maior do que os pacientes com adesão irregular (p=0,0009. O resultado do tratamento não dependeu da idade de início do mesmo (p=0,39 e da gravidade da ambliopia (p=0,30. Conclusão: Concluímos, assim, que, no nosso grupo de estudo, a adesão é o principal fator prognóstico no sucesso da terapia oclusiva.Purpose: Amblyopia is the most common form of visual problem in children and for more than 250 years occlusion therapy is the standard treatment. Thus our purpose is to identify the factors that influence the outcome of amblyopia treatment with occlusion therapy. Methods: We reviewed 169 amblyopic children seen in the outpatient clinic of amblyopia of the Campinas State University, between January 1996 and May 1998. Patients were analyzed regar-ding sex, age at start of treatment (3

  4. PREVALENCE OF REFRACTIVE ERROR, STRABISMUS AND AMBLYOPIA AMONG CHILDREN WITH NORMAL DEVELOPMENT OR GLOBAL DEVELOPMENTAL DELAY/INTELLECTUAL DISABILITY ATTENDING OPHTHALMOLOGY OPD AT KLES HOSPITAL, BELAGAVI- A RETROSPECTIVE STUDY

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    Smitha K. S

    2017-04-01

    Full Text Available BACKGROUND Global developmental delay/intellectual disability are on a rise in children in the present time. Ocular and visual anomalies are frequently associated with it of which refractive errors are the most frequent. This if goes unnoticed leads to strabismus and amblyopia. MATERIALS AND METHODS This study aims to assess the prevalence of refractive error, strabismus and amblyopia among children with normal development or global developmental delay/intellectual disability attending ophthalmology OPD at KLES Hospital, Belagavi. Case records of all 200 new patients less than or equal to 12 years of age group who attended KLES, Dr. Prabhakar Kore Hospital between January 2015 and December 2015 were retrospectively reviewed. RESULTS The male:female ratio was 1.22:1. Out of the total evaluated 200 cases, 130 cases were with normal development and 70 with GDD/ID. Refractive errors were 85%, whereas the cases of amblyopia was 45.50% and strabismus 39.50%. Amblyopia with refractive error having GDD/ID was stastically significant as compared to amblyopia with refractive error having normal development (p=0.001. CONCLUSION Refractive error was the most common ocular disorder seen. Refractive error with amblyopia is more in children with GDD/ID as compared to normal children. Owing to the high percentage of visual anomalies, ophthalmological referral becomes essential in children with developmental anomalies.

  5. How Dutch orthoptists deal with noncompliance with occlusion therapy for amblyopia.

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    Tjiam, A M; Vukovic, E; Asjes-Tydeman, W L; Holtslag, G; Loudon, S E; Sinoo, M M; Simonsz, H J

    2010-12-01

    We previously found that compliance with occlusion therapy for amblyopia is poor, especially among children of non-native parents who spoke Dutch poorly and who were low educated. We investigated conception, awareness, attitude, and actions to deal with noncompliance among Dutch orthoptists. Orthoptists working in non-native, low socioeconomic status (SES) areas and a selection of orthoptists working elsewhere in the Netherlands were studied. They were observed in their practice, received a structured questionnaire, and underwent a semi-structured interview. Finally, a short survey was sent to all working orthoptists in the Netherlands. Nine orthoptists working in non-native, low-SES areas and 23 working elsewhere in the Netherlands participated. One hundred and fifty-one orthoptists returned the short survey. Major discrepancies existed in conception, awareness, and attitude. Opinions differed on what should be defined as noncompliance and on what causes noncompliance. Some orthoptists found noncompliance annoying, unpleasant, and hard to imagine, others were more understanding. Many pitied the noncompliant child. Almost all thought that the success of occlusion therapy lies both with the parents and the orthoptist, but one third thought that noncompliance was not solely their responsibility. Patients' compliance was estimated at 69.3% in non-native, low-SES areas (electronically, 52% had been measured), at 74.1% by the other 23 orthoptists, and at 73.8% in the short survey. Actions to improve compliance were diverse; some increased occlusion hours whereas others decreased them. In non-native, low-SES areas, 22% spoke Dutch moderately to none; the allotted time for a patient's first visit was 21'; the time spent on explaining to the parents was 2'30" and to the child 10". In practices of the other 23 orthoptists, 6% spoke Dutch moderately to none (P<0.0001), the time for a patient's first visit was 27'24" (P=0.47), and the periods spent explaining were 2'51" (P=0

  6. Binocular summation and other forms of non-dominant eye contribution in individuals with strabismic amblyopia during habitual viewing.

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    Brendan T Barrett

    Full Text Available BACKGROUND: Adults with amblyopia ('lazy eye', long-standing strabismus (ocular misalignment or both typically do not experience visual symptoms because the signal from weaker eye is given less weight than the signal from its fellow. Here we examine the contribution of the weaker eye of individuals with strabismus and amblyopia with both eyes open and with the deviating eye in its anomalous motor position. METHODOLOGY/RESULTS: The task consisted of a blue-on-yellow detection task along a horizontal line across the central 50 degrees of the visual field. We compare the results obtained in ten individuals with strabismic amblyopia with ten visual normals. At each field location in each participant, we examined how the sensitivity exhibited under binocular conditions compared with sensitivity from four predictions, (i a model of binocular summation, (ii the average of the monocular sensitivities, (iii dominant-eye sensitivity or (iv non-dominant-eye sensitivity. The proportion of field locations for which the binocular summation model provided the best description of binocular sensitivity was similar in normals (50.6% and amblyopes (48.2%. Average monocular sensitivity matched binocular sensitivity in 14.1% of amblyopes' field locations compared to 8.8% of normals'. Dominant-eye sensitivity explained sensitivity at 27.1% of field locations in amblyopes but 21.2% in normals. Non-dominant-eye sensitivity explained sensitivity at 10.6% of field locations in amblyopes but 19.4% in normals. Binocular summation provided the best description of the sensitivity profile in 6/10 amblyopes compared to 7/10 of normals. In three amblyopes, dominant-eye sensitivity most closely reflected binocular sensitivity (compared to two normals and in the remaining amblyope, binocular sensitivity approximated to an average of the monocular sensitivities. CONCLUSIONS: Our results suggest a strong positive contribution in habitual viewing from the non-dominant eye in

  7. Pediatric PRK (PhotoRefractive Keratectomy) with Mitomycin C (MCC) for Persistent Anisometropic Amblyopia. A Case Report.

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    Crawford, Courtney M; Frazier, Travis C; Torres, Mark F; Arnold, Robert W; Mazzoli, Robert A; Raymond, William R

    2012-01-01

    To evaluate the safety and efficacy of photorefractive keratectomy (PRK) with Mitomycin C (MMC) for the treatment of severe pediatric anisometropia and amblyopia resistant to more conservative treatment modalities. A 3 year-old-child, who at 18 months old underwent unilateral diode laser treatment for threshold ROP, developed 11 diopters of anisometropic myopia and secondary dense amblyopia of the Right Eye. Only after all conservative treatment options failed was he treated with PRK and MMC. Principal outcome measures included cycloplegic refraction, the amount of refractive correction, degree of corneal haze and change in visual acuity. On presentation: BCVA: 20/CF OD; 20/30 OS. CRNS: -11.50 diopters sphere OD; -0.50 diopters sphere OS. Unilateral PRK followed by application of MMC (0.2 mg/ml) for 1 min was performed under general anesthesia. Three-month postoperative findings include: VA: 20/30 OD; 20/25 OS. CRNS: +0.25 diopters sphere OD. At one year, the BCVA remained equal at the 20/30 level despite mild myopic regression OD. CRNS OD at one year was -1.25 +050 x 116. No corneal haze was appreciated. In this child, treatment with PRK and MMC safely reduced the anisometropia thus facilitating his visual rehabilitation. While encouraging, further study is required to verify the longer term results of this single case. To evaluate the safety and efficacy of photorefractive keratectomy (PRK) with Mitomycin C (MMC) for the treatment of severe pediatric anisometropia and amblyopia resistant to more conservative treatment modalities. A 3 year-old-child, who at 18 months old underwent unilateral diode laser treatment for threshold ROP, developed 11 diopters of anisometropic myopia and secondary dense amblyopia of the Right Eye. Only after all conservative treatment options failed was he treated with PRK and MMC. Principal outcome measures included cycloplegic refraction, the amount of refractive correction, degree of corneal haze and change in visual acuity. On

  8. Part-time versus full-time occlusion therapy for treatment of amblyopia: A meta-analysis.

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    Yazdani, Negareh; Sadeghi, Ramin; Momeni-Moghaddam, Hamed; Zarifmahmoudi, Leili; Ehsaei, Asieh; Barrett, Brendan T

    2017-06-01

    To compare full-time occlusion (FTO) and part-time occlusion (PTO) therapy in the treatment of amblyopia, with the secondary aim of evaluating the minimum number of hours of part-time patching required for maximal effect from occlusion. A literature search was performed in PubMed, Scopus, Science Direct, Ovid, Web of Science and Cochrane library. Methodological quality of the literature was evaluated according to the Oxford Center for Evidence Based Medicine and modified Newcastle-Ottawa scale. Statistical analyses were performed using Comprehensive Meta-Analysis (version 2, Biostat Inc., USA). The present meta-analysis included six studies [three randomized controlled trials (RCTs) and three non-RCTs]. Pooled standardized difference in the mean changes in the visual acuity was 0.337 [lower and upper limits: -0.009, 0.683] higher in the FTO as compared to the PTO group; however, this difference was not statistically significant ( P  = 0.056, Cochrane Q value = 20.4 ( P  = 0.001), I 2  = 75.49%). Egger's regression intercept was 5.46 ( P  = 0.04). The pooled standardized difference in means of visual acuity changes was 1.097 [lower and upper limits: 0.68, 1.513] higher in the FTO arm ( P  < 0.001), and 0.7 [lower and upper limits: 0.315, 1.085] higher in the PTO arm ( P  < 0.001) compared to PTO less than two hours. This meta-analysis shows no statistically significant difference between PTO and FTO in treatment of amblyopia. However, our results suggest that the minimum effective PTO duration, to observe maximal improvement in visual acuity is six hours per day.

  9. Grey and white matter changes in children with monocular amblyopia: voxel-based morphometry and diffusion tensor imaging study.

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    Li, Qian; Jiang, Qinying; Guo, Mingxia; Li, Qingji; Cai, Chunquan; Yin, Xiaohui

    2013-04-01

    To investigate the potential morphological alterations of grey and white matter in monocular amblyopic children using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI). A total of 20 monocular amblyopic children and 20 age-matched controls were recruited. Whole-brain MRI scans were performed after a series of ophthalmologic exams. The imaging data were processed and two-sample t-tests were employed to identify group differences in grey matter volume (GMV), white matter volume (WMV) and fractional anisotropy (FA). After image screening, there were 12 amblyopic participants and 15 normal controls qualified for the VBM analyses. For DTI analysis, 14 amblyopes and 14 controls were included. Compared to the normal controls, reduced GMVs were observed in the left inferior occipital gyrus, the bilateral parahippocampal gyrus and the left supramarginal/postcentral gyrus in the monocular amblyopic group, with the lingual gyrus presenting augmented GMV. Meanwhile, WMVs reduced in the left calcarine, the bilateral inferior frontal and the right precuneus areas, and growth in the WMVs was seen in the right cuneus, right middle occipital and left orbital frontal areas. Diminished FA values in optic radiation and increased FA in the left middle occipital area and right precuneus were detected in amblyopic patients. In monocular amblyopia, cortices related to spatial vision underwent volume loss, which provided neuroanatomical evidence of stereoscopic defects. Additionally, white matter development was also hindered due to visual defects in amblyopes. Growth in the GMVs, WMVs and FA in the occipital lobe and precuneus may reflect a compensation effect by the unaffected eye in monocular amblyopia.

  10. Part-time occlusion therapy for anisometropic amblyopia detected in children eight years of age and older.

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    Lee, Young Rok; Lee, Ju Youn

    2006-09-01

    To determine the outcome of part-time occlusion therapy in children with anisometropic amblyopia detected after they were 8 years of age. We analyzed 29 eyes with anisometropic amblyopia in children 8 years of age and older. The mean age was 8.79 +/- 0.98 (range 8-12) years old. The subjects whose best-corrected visual acuity (BCVA) did not improve by two lines or better within 2 weeks of wearing glasses full-time were prescribed occlusion therapy for 6 hours a day outside of school hours, along with the instruction to wear glasses full-time. Subjects who complied with occlusion for more than 3 hours a day were considered to comply well. The major component of the anisometropia was hyperopia in 51.7% of the subjects, and hyperopia plus astigmatism was found in 24.1%. The mean pretreatment BCVA score was 0.51 0.23 (LogMAR). Compliance was 89.66%. The mean posttreatment BCVA was 0.03 +/- 0.01 (LogMAR), and the success rate, based on a posttreatment BCVA of 0.1 (LogMAR) and better, was 96.43%. It took an average of 4.79 +/- 3.35 months to reach the desired posttreatment BCVA. The mean posttreatment stereopsis was 79.78 +/- 37.61 seconds of arc. The recurrence rate was 8%. The visual improvement was related to the degree of compliance (p = 0.000). The time taken to reach the posttreatment BCVA was shorter in subjects with a better pretreatment BCVA (p = 0.019), but it did not relate to the compliance (p = 0.366). The most common component of anisometropia detected after 8 years of age was hyperopia. The part-time occlusion therapy, which had been carried out after school hours, was successful in most cases.

  11. [Effectivity of an occlusion-supporting PC-based visual training programme by horizontal drifting sinus gratings in children with amblyopia].

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    Bau, V; Rose, K; Pollack, K; Spoerl, E; Pillunat, L E

    2012-10-01

    The studies of Kämpf et al. suggested an efficiency of a computer-based stimulation therapy by drifting sinus gratings in patients with anisometropic and/or strabismic amblyopia but provided no clear evidence. This is the first trial with amblyopic patients without previous treatment at the beginning of amblyopia therapy. A prospective, randomised, single-blinded, placebo-controlled study of n = 15 patients with anisometropic and/or strabismic amblyopia without previous treatment was performed. Age of the patients was between 4 and 10 years, mean 6.3 years (± 2.0), all after full correction of refraction errors and refractive adaptation. Stimulation therapy was performed 5 times a week over 4 weeks, respectively 2 × 20 min, a drifting sinus grating of constant spatial and temporal frequency was combined with computer games (n = 8). Control group had only computer games with a neutral background (n = 7). In both groups patching was only done in stimulation times. Stimulation and control group did not differ due to age, gender, and cause of amblyopie, baseline visual acuity, and time of wearing glasses. There was no significant difference in the development of visual acuity over the stimulation period between stimulation and control groups. Stimulation therapy with drifting sinus gratings did not improve the development of visual acuity in the first phase of amblyopia treatment combined with minimal occlusion therapy. Accordingly, the stimulation therapy is not adequate to replace sufficient occlusion therapy. Whether this therapy could support patching therapy and improve acuity development in later therapy phases cannot be assumed from this trial. Georg Thieme Verlag KG Stuttgart · New York.

  12. Randomised controlled trial of video clips and interactive games to improve vision in children with amblyopia using the I-BiT system

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    Herbison, Nicola; MacKeith, Daisy; Vivian, Anthony; Purdy, Jon; Fakis, Apostolos; Ash, Isabel M; Cobb, Sue V; Eastgate, Richard M; Haworth, Stephen M; Gregson, Richard M; Foss, Alexander JE

    2016-01-01

    Background Traditional treatment of amblyopia involves either wearing a patch or atropine penalisation of the better eye. A new treatment is being developed on the basis of virtual reality technology allowing either DVD footage or computer games which present a common background to both eyes and the foreground, containing the imagery of interest, only to the amblyopic eye. Methods A randomised control trial was performed on patients with amblyopia aged 4–8 years with three arms. All three arms had dichoptic stimulation using shutter glass technology. One arm had DVD footage shown to the amblyopic eye and common background to both, the second used a modified shooter game, Nux, with sprite and targets presented to the amblyopic eye (and background to both) while the third arm had both background and foreground presented to both eyes (non-interactive binocular treatment (non-I-BiT) games). Results Seventy-five patients were randomised; 67 were residual amblyopes and 70 had an associated strabismus. The visual acuity improved in all three arms by approximately 0.07 logMAR in the amblyopic eye at 6 weeks. There was no difference between I-BiT DVD and non-I-BiT games compared with I-BiT games (stated primary outcome) in terms of gain in vision. Conclusions There was a modest vision improvement in all three arms. Treatment was well tolerated and safe. There was no difference between the three treatments in terms of primary stated outcomes but treatment duration was short and the high proportion of previously treated amblyopia and strabismic amblyopia disadvantaged dichoptic stimulation treatment. Trial registration number NCT01702727, results. PMID:26951772

  13. Randomised controlled trial of video clips and interactive games to improve vision in children with amblyopia using the I-BiT system.

    Science.gov (United States)

    Herbison, Nicola; MacKeith, Daisy; Vivian, Anthony; Purdy, Jon; Fakis, Apostolos; Ash, Isabel M; Cobb, Sue V; Eastgate, Richard M; Haworth, Stephen M; Gregson, Richard M; Foss, Alexander Je

    2016-11-01

    Traditional treatment of amblyopia involves either wearing a patch or atropine penalisation of the better eye. A new treatment is being developed on the basis of virtual reality technology allowing either DVD footage or computer games which present a common background to both eyes and the foreground, containing the imagery of interest, only to the amblyopic eye. A randomised control trial was performed on patients with amblyopia aged 4-8 years with three arms. All three arms had dichoptic stimulation using shutter glass technology. One arm had DVD footage shown to the amblyopic eye and common background to both, the second used a modified shooter game, Nux, with sprite and targets presented to the amblyopic eye (and background to both) while the third arm had both background and foreground presented to both eyes (non-interactive binocular treatment (non-I-BiT) games). Seventy-five patients were randomised; 67 were residual amblyopes and 70 had an associated strabismus. The visual acuity improved in all three arms by approximately 0.07 logMAR in the amblyopic eye at 6 weeks. There was no difference between I-BiT DVD and non-I-BiT games compared with I-BiT games (stated primary outcome) in terms of gain in vision. There was a modest vision improvement in all three arms. Treatment was well tolerated and safe. There was no difference between the three treatments in terms of primary stated outcomes but treatment duration was short and the high proportion of previously treated amblyopia and strabismic amblyopia disadvantaged dichoptic stimulation treatment. NCT01702727, results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. A pilot randomized clinical trial of intermittent occlusion therapy liquid crystal glasses versus traditional patching for treatment of moderate unilateral amblyopia.

    Science.gov (United States)

    Wang, Jingyun; Neely, Daniel E; Galli, Jay; Schliesser, Joshua; Graves, April; Damarjian, Tina G; Kovarik, Jessica; Bowsher, James; Smith, Heather A; Donaldson, Dana; Haider, Kathryn M; Roberts, Gavin J; Sprunger, Derek T; Plager, David A

    2016-08-01

    To compare the effectiveness of intermittent occlusion therapy (IO therapy) using liquid crystal glasses and continuous occlusion therapy using traditional adhesive patches for treating amblyopia. Children 3-8 years of age with previously untreated, moderate, unilateral amblyopia (visual acuity of 20/40 to 20/100 in the amblyopic eye) were enrolled in this randomized controlled trial. Amblyopia was associated with strabismus, anisometropia, or both. All subjects had worn any optimal refractive correction for at least 12 weeks without improvement. Subjects were randomized into two treatment groups: a 4-hour IO therapy group with liquid crystal glasses (Amblyz), set at 30-second opaque/transparent intervals (occluded 50% of wear time), and a 2-hour continuous patching group (occluded 100% of wear time). For each patient, visual acuity was measured using ATS-HOTV before and after 12 weeks of treatment. Data from 34 patients were available for analysis. Amblyopic eye visual acuity improvement from baseline was 0.15 ± 0.12 logMAR (95% CI, 0.09-0.15) in the IO therapy group (n = 19) and 0.15 ± 0.11 logMAR (95% CI, 0.1-0.15) in the patching group (n = 15). In both groups improvement was significant, but the difference between groups was not (P = 0.73). No adverse effects were reported. In this pilot study, IO therapy with liquid crystal glasses is not inferior to adhesive patching and is a promising alternative treatment for children 3-8 years of age with moderate amblyopia. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  15. Effect of Timing of Initial Cataract Surgery, Compliance to Amblyopia Therapy on Outcomes of Secondary Intraocular Lens Implantation in Chinese Children: A Retrospective Case Series

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    Liuyang Li

    2018-01-01

    Full Text Available Purpose. As a secondary analysis, we reassess the association of initial congenital cataract surgery times, compliance to amblyopia therapy, and visual outcomes for a long-term follow-up in a secondary IOL implantation. Methods. Retrospective review of records of all infants with congenital cataracts who underwent secondary IOL implantation in the Eye and ENT Hospital of Fudan University from January 1, 2001, to December 31, 2007, and the minimum follow-up period was 5 years. Multiple regression analysis was used and the possible confounding factors were also analyzed to assess the effect on visual outcome. Results. A total of 110 patients (male: 59.1% were included. The median (min–max age at cataract extraction and IOL implantation was 7.5 (3.0–15.0 and 35.0 (22.0–184.0 months, respectively, and the average follow-up period was 99.3 ± 23.6 months. The median (min–max BCVA at final follow-up was 0.20 (0.01–1.00. Compliance to amblyopia therapy was none, poor, and good in 21.8%, 24.5%, and 53.6%, respectively. Postoperative BCVA [logMAR, median (min–max 0.70 (0.00–2.00] linearly decreased with increasing cataract extraction time (per month (β=0.04, 95% CI: 0.03–0.06, p<0.0001 in multivariable models with laterality and compliance to amblyopia therapy adjusted. Good compliance to amblyopia therapy was associated with better BCVA (logMAR at last follow-up (β=−0.40, 95% CI = −0.53 to −0.27, p<0.0001 with laterality, opacity type, and extraction time adjusted. Conclusions. For Chinese infants with congenital cataract, an earlier primary congenital cataract surgery at an age of 3 to 15 months is associated with a better visual outcome. Good compliance to amblyopia therapy was also significant to visual outcome.

  16. Efficacy of perceptual vision therapy in enhancing visual acuity and contrast sensitivity function in adult hypermetropic anisometropic amblyopia

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    Yalcin E

    2013-12-01

    Full Text Available Elvan Yalcin, Ozlem BalciWorld Eye Hospital, Department of Pediatric Ophthalmology, Istanbul, TurkeyBackground: The purpose of this study was to evaluate the efficacy of neural vision therapy, also termed perceptual vision therapy, in enhancing best corrected visual acuity (BCVA and contrast sensitivity function in amblyopic patients.Methods: This prospective study enrolled 99 subjects previously diagnosed with unilateral hypermetropic amblyopia aged 9–50 years. The subjects were divided into two groups, with 53 subjects (53 eyes in the perceptual vision therapy group and 46 subjects (46 eyes in the control group. Because the nature of the treatment demands hard work and strict compliance, we enrolled the minimal number of subjects required to achieve statistically significant results. Informed consent was obtained from all subjects. Study phases included a baseline screening, a series of 45 training sessions with perceptual vision therapy, and an end-of-treatment examination. BCVA and contrast sensitivity function at 1.5, 3, 6, 12, and 18 cycles per degree spatial frequencies were obtained for statistical analysis in both groups. All subjects had follow-up examinations within 4–8 months. With the exception of one subject from the study group and two subjects from the control group, all subjects had occlusion during childhood. The study was not masked.Results: The results for the study group demonstrated a mean improvement of 2.6 logarithm of the minimum angle of resolution (logMAR lines in visual acuity (from 0.42 to 0.16 logMAR. Contrast sensitivity function improved at 1.5, 3, 6, 12, and 18 cycles per degree spatial frequencies. The control group did not show any significant change in visual acuity or contrast sensitivity function. None of the treated eyes showed a drop in visual acuity. Manifest refractions remained unchanged during the study.Conclusion: The results of our study demonstrate the efficacy of perceptual vision therapy in

  17. Effect and sustainability of part-time occlusion therapy for patients with anisometropic amblyopia aged > or =8 years.

    Science.gov (United States)

    Hwang, D J; Kim, Y J; Lee, J Y

    2010-09-01

    To study the effect and long-term sustainability of part-time occlusion therapy for anisometropic amblyopia after 8 years of age. A total of 41 anisometropic amblyopes aged > or =8 years were analysed. In six patients, best-corrected visual acuity (BCVA) of amblyopic eye improved more than two lines within 2 weeks of full-time spectacle wear. The remaining patients were assigned to perform part-time patching during out-of-school hours. Long-term results were assessed in patients who were observed over 1 year after the end of the treatment. Among 35 patients, four dropped out, refusing further treatment, and one changed to atropine penalisation. The part-time patching schedule was completed in 30 patients. 90% of patients (27/30) complied well. Mean BCVA in the amblyopic eye improved significantly (ppart-time occlusion treatment in school-aged amblyopes, which had been carried out after school hours, was successful and the effect was sustained in most cases.

  18. Interocular suppression in strabismic amblyopia results in an attenuated and delayed hemodynamic response function in early visual cortex.

    Science.gov (United States)

    Farivar, Reza; Thompson, Benjamin; Mansouri, Behzad; Hess, Robert F

    2011-12-20

    Factors such as strabismus or anisometropia during infancy can disrupt normal visual development and result in amblyopia, characterized by reduced visual function in an otherwise healthy eye and often associated with persistent suppression of inputs from the amblyopic eye by those from the dominant eye. It has become evident from fMRI studies that the cortical response to stimulation of the amblyopic eye is also affected. We were interested to compare the hemodynamic response function (HRF) of early visual cortex to amblyopic vs. dominant eye stimulation. In the first experiment, we found that stimulation of the amblyopic eye resulted in a signal that was both attenuated and delayed in its time to peak. We postulated that this delay may be due to suppressive effects of the dominant eye and, in our second experiment, measured the cortical response of amblyopic eye stimulation under two conditions--where the dominant eye was open and seeing a static pattern (high suppression) or where the dominant eye was patched and closed (low suppression). We found that the HRF in response to amblyopic eye stimulation depended on whether the dominant eye was open. This effect was manifested as both a delayed HRF under the suppressed condition and an amplitude reduction.

  19. Ambliopia por estrabismo: estudo retrospectivo de pacientes em hospital universitário Strabismic amblyopia: a retrospective study on patients from a university hospital

    Directory of Open Access Journals (Sweden)

    Deborah Salerno Costa

    2006-04-01

    Full Text Available OBJETIVO: Avaliar a influência da adesão ao tratamento, da gravidade da ambliopia e da idade de início do tratamento em pacientes com ambliopia por estrabismo submetidos à terapia oclusiva. MÉTODOS: Analisaram-se 569 prontuários de pacientes com ambliopia por estrabismo atendidos no Hospital das Clínicas da Faculdade de Medicina da USP no período de 1983 a 2000. Os critérios de exclusão foram: perda de seguimento, idade maior que 12 anos, presença de nistagmo e outras doenças oculares. Todos foram submetidos a exame oftalmológico completo com avaliação da motilidade ocular, divididos por faixas etárias e classificados quanto ao tipo de estrabismo, gravidade da ambliopia e adesão ao tratamento. Os dados foram analisados estatisticamente pelo método de Fisher. RESULTADOS: Foram incluídos 198 pacientes (34,8%. Não houve diferença de adesão nos diversos grupos etários. A taxa de sucesso foi maior nos pacientes com boa adesão independente da gravidade da ambliopia. Porém a adesão ao tratamento foi menor no grupo com ambliopia grave, que foi o mais freqüente e obteve menor taxa de sucesso em nossa amostra. Não houve relação entre idade e sucesso terapêutico. CONCLUSÕES: O estudo demonstrou que a adesão ao tratamento oclusivo desempenha papel fundamental na eficácia terapêutica. Com isto, idade de início do tratamento isoladamente não teve influência no sucesso terapêutico, uma vez que foi possível obter boa adesão a despeito da idade. Além disto, os resultados foram piores nos casos de ambliopia grave, nos quais a adesão foi menor.PURPOSE: To evaluate the influence of compliance with treatment, severity of amblyopia and age at the beginning of treatment in patients with strabismic amblyopia submitted to patching. METHODS: The data were selected from medical records of 569 patients seen at the Department of Ophthalmology, University of São Paulo during the period of 1983 to 2000. Exclusion criteria: loss of

  20. Evaluation of the Role of Monocular Video Game Play as an Adjuvant to Occlusion Therapy in the Management of Anisometropic Amblyopia.

    Science.gov (United States)

    Singh, Archita; Sharma, Pradeep; Saxena, Rohit

    2017-07-01

    To evaluate the role of monocular video game play as an adjuvant to occlusion therapy in the treatment of anisometropic amblyopia. In a prospective randomized study design, 68 children with ages ranging from 6 to 14 years who had anisometropic amblyopia with a best corrected visual acuity (BCVA) in the amblyopic eye of better than 6/36 and worse than 6/12 and no manifest strabismus were recruited. They were randomly allocated into two groups: 34 children received 1 hour per day of video game play for the first month plus 6 hours per day of occlusion therapy (video game and occlusion group) and 34 children received 6 hours per day of occlusion therapy alone (occlusion only group). Patients were then evaluated at baseline and 1 and 3 months after treatment for BCVA, stereoacuity, and contrast sensitivity. In the video game and occlusion group, BCVA improved from 0.61 ± 0.12 logarithm of the minimum angle of resolution (logMAR) at baseline to 0.51 ± 0.14 logMAR (P = .001) at 1 month and 0.40 ± 0.15 logMAR (P = .001) at 3 months. In the occlusion only group, BCVA improved from 0.65 ± 0.09 logMAR at baseline to 0.60 ± 0.10 logMAR (P = .001) at 1 month and 0.48 ± 0.10 logMAR (P = .001) at 3 months. There was significantly more improvement in the video game and occlusion group compared to the occlusion only group (P = .003 at 1 month and P = .027 at 3 months). Video game play plus occlusion therapy enhances the visual recovery in anisometropic amblyopia. [J Pediatr Ophthalmol Strabismus. 2017;54(4):244-249.]. Copyright 2017, SLACK Incorporated.

  1. Efficacy of split hours part-time patching versus continuous hours part-time patching for treatment of anisometropic amblyopia in children: a pilot study.

    Science.gov (United States)

    Sachdeva, Virender; Mittal, Vaibhev; Kekunnaya, Ramesh; Gupta, Amit; Rao, Harsha L; Mollah, Joseph; Sontha, Anand; Gunturu, Rekha; Rao, B Venkateshwar

    2013-07-01

    To compare efficacy of 'split hours part-time patching' and 'continuous hours part-time patching' for the treatment of anisometropic amblyopia. We designed a prospective, interventional, non-randomised, comparative pilot study involving children between 4 and 11 years of age with anisometropic amblyopia who were treated with either continuous wear (Group A) or split hours part-time patching (Group B) as per parents wish, after appropriate discussion with the parents. Children were followed-up for the improvement in visual acuity and the compliance at each follow-up visit. 44 and 24 children were recruited in Group A and Group B, respectively (mean ± SD baseline BCVA of the amblyopic eye: 0.99 ± 0.32 and 0.95 ± 0.23 logMAR, respectively). BCVA (adjusted for baseline BCVA and age) at 3 months in Group A (0.59 ± 0.24) was comparable (p=0.08) with that in Group B (0.71 ± 0.24). This was same even at 6 months (0.51 ± 0.25 in Group A and 0.59 ± 0.25 in Group B, p=0.25). The improvement in BCVA at 3 months was also comparable (p=0.06) in Group A (0.39 ± 0.23) and Group B (0.26 ± 0.23). The improvement in BCVA at 6 months was also comparable (p=0.14) in Group A (0.47 ± 0.26) and Group B (0.37 ± 0.26). Both patching regimens lead to significant and comparable improvement in BCVA in anisometropic amblyopia up to 6 months of follow-up.

  2. A new model of strabismic amblyopia: Loss of spatial acuity due to increased temporal dispersion of geniculate X-cell afferents on to cortical neurons.

    Science.gov (United States)

    Crewther, D P; Crewther, S G

    2015-09-01

    Although the neural locus of strabismic amblyopia has been shown to lie at the first site of binocular integration, first in cat and then in primate, an adequate mechanism is still lacking. Here we hypothesise that increased temporal dispersion of LGN X-cell afferents driven by the deviating eye onto single cortical neurons may provide a neural mechanism for strabismic amblyopia. This idea was investigated via single cell extracellular recordings of 93 X and 50 Y type LGN neurons from strabismic and normal cats. Both X and Y neurons driven by the non-deviating eye showed shorter latencies than those driven by either the strabismic or normal eyes. Also the mean latency difference between X and Y neurons was much greater for the strabismic cells compared with the other two groups. The incidence of lagged X-cells driven by the deviating eye of the strabismic cats was higher than that of LGN X-cells from normal animals. Remarkably, none of the cells recorded from the laminae driven by the non-deviating eye were of the lagged class. A simple computational model was constructed in which a mixture of lagged and non-lagged afferents converge on to single cortical neurons. Model cut-off spatial frequencies to a moving grating stimulus were sensitive to the temporal dispersion of the geniculate afferents. Thus strabismic amblyopia could be viewed as a lack of developmental tuning of geniculate lags for neurons driven by the amblyopic eye. Monocular control of fixation by the non-deviating eye is associated with reduced incidence of lagged neurons, suggesting that in normal vision, lagged neurons might play a role in maintaining binocular connections for cortical neurons. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. A Randomized Trial of a Binocular iPad Game Versus Part-Time Patching in Children Aged 13 to 16 Years With Amblyopia.

    Science.gov (United States)

    Manh, Vivian M; Holmes, Jonathan M; Lazar, Elizabeth L; Kraker, Raymond T; Wallace, David K; Kulp, Marjean T; Galvin, Jennifer A; Shah, Birva K; Davis, Patricia L

    2018-02-01

    To compare visual acuity (VA) improvement in teenagers with amblyopia treated with a binocular iPad game vs part-time patching. One hundred participants aged 13 to 75% of prescribed treatment. In teenagers aged 13 to <17 years, improvement in amblyopic eye VA with the binocular iPad game used in this study was not found to be better than patching, and was possibly worse. Nevertheless, it remains unclear whether the minimal treatment response to binocular treatment was owing to poor treatment adherence or lack of treatment effect. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Performance of Spot Photoscreener in Detecting Amblyopia Risk Factors in Chinese Pre-school and School Age Children Attending an Eye Clinic.

    Directory of Open Access Journals (Sweden)

    Yajun Mu

    Full Text Available To evaluate the effectiveness of Spot photoscreener in detecting amblyopia risk factors meeting 2013 the American Association of Pediatric Ophthalmology and Strabismus (AAPOS criteria in Chinese preschool and school-age children.One hundred and fifty-five children (310 eyes, aged between 4 to 7 years (5.74 ± 1.2 years underwent complete ophthalmologic examination, photoscreening, and cycloplegic retinoscopy refraction. The agreement of the results obtained with the photoscreening and retinoscopy was evaluated by linear regression and Bland-Altman plots. The sensitivity and specificity of detecting amblyopia risk factors were calculated based on the AAPOS 2013 guidelines. The overall effectiveness of detecting amblyopia risk factors was analyzed with Receiver Operating Characteristic (ROC curves.The mean refractive errors measured with the Spot were: spherical equivalent (SE = 0.70 ± 1.99 D, J0 = 0.87 ± 1.01 D, J45 = 0.09 ± 0.60 D. The mean results from retinoscopy were: SE = 1.19 ± 2.22 D, J0 = 0.77 ± 1.00 D, J45 = -0.02 ± 0.45 D. There was a strong linear agreement between results obtained from those two methods (R2 = 0.88, P<0.01. Bland-Altman plot indicated a moderate agreement of cylinder values between the two methods. Based on the criteria specified by the AAPOS 2013 guidelines, the sensitivity and specificity (in respective order for detecting hyperopia were 98.31% and 97.14%; for detecting myopia were 78.50% and 88.64%; for detecting astigmatism were 90.91% and 80.37%; for detecting anisometropia were 93.10% and 85.25%; and for detection of strabismus was 77.55% and 88.18%.The refractive values measured from Spot photoscreener showed a moderate agreement with the results from cycloplegic retinoscopy refraction, however there was an overall myopic shift of -0.49D. The performance in detecting individual amblyopia risk factors was satisfactory, but could be further improved by optimizing criteria based on ROC curves.

  5. Effect of a Binocular iPad Game vs Part-time Patching in Children Aged 5 to 12 Years With Amblyopia: A Randomized Clinical Trial.

    Science.gov (United States)

    Holmes, Jonathan M; Manh, Vivian M; Lazar, Elizabeth L; Beck, Roy W; Birch, Eileen E; Kraker, Raymond T; Crouch, Eric R; Erzurum, S Ayse; Khuddus, Nausheen; Summers, Allison I; Wallace, David K

    2016-12-01

    A binocular approach to treating anisometropic and strabismic amblyopia has recently been advocated. Initial studies have yielded promising results, suggesting that a larger randomized clinical trial is warranted. To compare visual acuity (VA) improvement in children with amblyopia treated with a binocular iPad game vs part-time patching. A multicenter, noninferiority randomized clinical trial was conducted in community and institutional practices from September 16, 2014, to August 28, 2015. Participants included 385 children aged 5 years to younger than 13 years with amblyopia (20/40 to 20/200, mean 20/63) resulting from strabismus, anisometropia, or both. Participants were randomly assigned to either 16 weeks of a binocular iPad game prescribed for 1 hour a day (190 participants; binocular group) or patching of the fellow eye prescribed for 2 hours a day (195 participants; patching group). Study follow-up visits were scheduled at 4, 8, 12, and 16 weeks. A modified intent-to-treat analysis was performed on participants who completed the 16-week trial. Binocular iPad game or patching of the fellow eye. Change in amblyopic-eye VA from baseline to 16 weeks. Of the 385 participants, 187 were female (48.6%); mean (SD) age was 8.5 (1.9) years. At 16 weeks, mean amblyopic-eye VA improved 1.05 lines (2-sided 95% CI, 0.85-1.24 lines) in the binocular group and 1.35 lines (2-sided 95% CI, 1.17-1.54 lines) in the patching group, with an adjusted treatment group difference of 0.31 lines favoring patching (upper limit of the 1-sided 95% CI, 0.53 lines). This upper limit exceeded the prespecified noninferiority limit of 0.5 lines. Only 39 of the 176 participants (22.2%) randomized to the binocular game and with log file data available performed more than 75% of the prescribed treatment (median, 46%; interquartile range, 20%-72%). In younger participants (aged 5 to effects (including diplopia) were uncommon and of similar frequency between groups. In children aged 5 to younger

  6. Implementation of an Educational Cartoon ("the Patchbook") and Other Compliance-Enhancing Measures by Orthoptists in Occlusion Treatment of Amblyopia.

    Science.gov (United States)

    Tjiam, A M; Asjes-Tydeman, W L; Holtslag, G; Vukovic, E; Sinoo, M M; Loudon, S E; Passchier, J; de Koning, H J; Simonsz, H J

    2016-09-01

    This implementation study evaluated orthoptists' use of an educational cartoon ("the Patchbook") and other measures to improve compliance with occlusion therapy for amblyopia. Participating orthoptists provided standard orthoptic care for one year, adding the Patchbook in the second year. They attended courses on compliance and intercultural communication by communication skills training. Many other compliance-enhancing measures were initiated. Orthoptists' awareness, attitude, and activities regarding noncompliance were assessed through interviews, questionnaires, and observations. Their use of the Patchbook was measured. The study was performed in low socio-economic status (SES) areas and in other areas in the Netherlands. It was attempted to integrate education on compliance into basic and continuing orthoptic training. The Patchbook was used by all 9 orthoptists who participated in low-SES areas and 17 of 23 orthoptists in other areas. Courses changed awareness and attitude about compliance, but this was not sustained. Although orthoptists estimated compliance during patching at 70%, three-quarters never suspected noncompliance during a full day of observation in any of their patients. Explanations to parents who spoke Dutch poorly were short. In the second year, explanations to children were longer. Implementation of all 7 additional compliance-enhancing measures failed. Education on compliance was not integrated into orthoptists' training. Almost all orthoptists used the Patchbook and, as another study demonstrated, it proved to be very effective, especially in low-SES areas. Duration of explanation was inversely proportional to parents' fluency in Dutch. Noncompliance was rarely suspected by orthoptists. Although 7 additional compliance-enhancing measures had been conceived and planned with the best intentions, they were not realized. These required extra, unpaid time from the orthoptists, which is especially scarce in hospitals in low-SES areas where the

  7. Preliminary results from the use of the novel Interactive binocular treatment (I-BiT) system, in the treatment of strabismic and anisometropic amblyopia.

    Science.gov (United States)

    Waddingham, P E; Butler, T K H; Cobb, S V; Moody, A D R; Comaish, I F; Haworth, S M; Gregson, R M; Ash, I M; Brown, S M; Eastgate, R M; Griffiths, G D

    2006-03-01

    We have developed a novel application of adapted virtual reality (VR) technology, for the binocular treatment of amblyopia. We describe the use of the system in six children. Subjects consisted of three conventional treatment 'failures' and three conventional treatment 'refusers', with a mean age of 6.25 years (5.42-7.75 years). Treatment consisted of watching video clips and playing interactive games with specifically designed software to allow streamed binocular image presentation. Initial vision in the amblyopic eye ranged from 6/12 to 6/120 and post-treatment 6/7.5 to 6/24-1. Total treatment time was a mean of 4.4 h. Five out of six children have shown an improvement in their vision (average increase of 10 letters), including those who had previously failed to comply with conventional occlusion. Improvements in vision were demonstrable within a short period of time, in some children after 1 h of treatment. This system is an exciting and promising application of VR technology as a new treatment for amblyopia.

  8. "Combined Occlusion and Atropine Therapy" Versus "Augmented Part-Time Patching" in Children with Refractory/Residual Amblyopia: A Pilot Study.

    Science.gov (United States)

    Sachdeva, Virender; Mittal, Vaibhev; Gupta, Varun; Gunturu, Rekha; Kekunnaya, Ramesh; Chandrasekharan, Anjali; Chabblani, Preeti Patil; Rao, Harsha L

    2016-01-01

    To compare the efficacy of combined occlusion and atropine therapy (COAT) and augmented part-time patching for the treatment of unilateral refractory/residual amblyopia. This retrospective study evaluated children between 4 and 11 years with refractory/residual amblyopia who were treated with either additional atropine (COAT group) or increased hours of patching (augmented group). Data were collected on improvement in best-corrected visual acuity (BCVA; logarithm of the minimum angle of resolution [logMAR] units) at each follow-up visit. There were 19 children in the COAT group and 17 children in the augmented group. The baseline BCVA of the amblyopic eye was 0.79 ± 0.36 logMAR in the COAT group and 0.72 ± 0.26 logMAR in augmented group. Children were statistically significantly younger in the COAT group (6.4 ± 2.2 years) compared to the augmented group (8.6 ± 3.3 years, P = 0.02). The mean duration of follow-up was statistically significantly longer in the augmented group (20.2 COAT group; 13.9 months augmented group) (P = 0.03). Compliance was similar in both groups. LogMAR BCVA (adjusted for difference in age and baseline BCVA) was statistically significantly better in the COAT group (0.56 ± 0.04) compared to the augmented group (0.80 ± 0.04) at 3 months (P = 0.000); 6 months (COAT group, 0.50 ± 0.04 vs. augmented group, 0.74 ± 0.04; P = 0.04) and at 1 year (COAT group, 0.42 ± 0.04 vs. augmented group, 0.67 ± 0.04, P = 0.000). There was statistically significantly greater improvement in logMAR BCVA at 6 months in COAT group (0.26 ± 0.15) compared to the augmented group (0.02 ± 0.14), (P = 0.0002). Age, gender, pretreatment BCVA, duration of follow-up, or compliance to patching did not affect improvement in BCVA. COAT may result in greater improvement in BCVA than augmented part-time patching in children with unilateral residual/refractory amblyopia.

  9. “Combined Occlusion and Atropine Therapy” Versus “Augmented Part-Time Patching” in Children with Refractory/Residual Amblyopia: A Pilot Study

    Science.gov (United States)

    Sachdeva, Virender; Mittal, Vaibhev; Gupta, Varun; Gunturu, Rekha; Kekunnaya, Ramesh; Chandrasekharan, Anjali; Chabblani, Preeti Patil; Rao, Harsha L.

    2016-01-01

    Purpose: To compare the efficacy of combined occlusion and atropine therapy (COAT) and augmented part-time patching for the treatment of unilateral refractory/residual amblyopia. Methodology: This retrospective study evaluated children between 4 and 11 years with refractory/residual amblyopia who were treated with either additional atropine (COAT group) or increased hours of patching (augmented group). Data were collected on improvement in best-corrected visual acuity (BCVA; logarithm of the minimum angle of resolution [logMAR] units) at each follow-up visit. Results: There were 19 children in the COAT group and 17 children in the augmented group. The baseline BCVA of the amblyopic eye was 0.79 ± 0.36 logMAR in the COAT group and 0.72 ± 0.26 logMAR in augmented group. Children were statistically significantly younger in the COAT group (6.4 ± 2.2 years) compared to the augmented group (8.6 ± 3.3 years, P = 0.02). The mean duration of follow-up was statistically significantly longer in the augmented group (20.2 COAT group; 13.9 months augmented group) (P = 0.03). Compliance was similar in both groups. LogMAR BCVA (adjusted for difference in age and baseline BCVA) was statistically significantly better in the COAT group (0.56 ± 0.04) compared to the augmented group (0.80 ± 0.04) at 3 months (P = 0.000); 6 months (COAT group, 0.50 ± 0.04 vs. augmented group, 0.74 ± 0.04; P = 0.04) and at 1 year (COAT group, 0.42 ± 0.04 vs. augmented group, 0.67 ± 0.04, P = 0.000). There was statistically significantly greater improvement in logMAR BCVA at 6 months in COAT group (0.26 ± 0.15) compared to the augmented group (0.02 ± 0.14), (P = 0.0002). Age, gender, pretreatment BCVA, duration of follow-up, or compliance to patching did not affect improvement in BCVA. Conclusions: COAT may result in greater improvement in BCVA than augmented part-time patching in children with unilateral residual/refractory amblyopia. PMID:27162453

  10. Bold-functional MRI study of the abnormal cortex and the relationship between the inpairment of vision and the decreased activation of the visual cortex in anisometropic amblyopia

    International Nuclear Information System (INIS)

    Wang Jian; Li Chuanming; Zhou Yang; Xie Bing; Yu Qiongwu; Wang Hui; Qiu Mingguo; Weng Xuchu

    2006-01-01

    Objective: To assess the activation changes on Brodmann areas 17, 18 and 19 in anisometropic amblyopia and compare the features of the cortex activations before and after refractive correction on amblyopic eyes. Methods: Bold-fMRI technique on 1.5 T Simens Sonata MRI and the blocks designation mode was used. The visual stimulation task was a black and white checkerboard with frequencies of 1 cycle/degree and 8 Hz. The baseline stimulus is a white cross-line at the center of the screen with black background. No other light or influence was allowed in the scanning room. The distance between the eyes and screen was 0.6 m. The experimental group included 10 anisometropic amblyopes. TSE and EPI sequence were used for the anatomical and functional data acquisitions. For experimental group, the activation areas of the visual cortex on both eyes were consequently measured before and after refractive correction. All data were analyzed online with t-test and offline with AFNI software. The threshold value was set to 0.001. During data processing, motion correction and three-dimensional smooth were used in all data. The time-signal intensity curves and the functional images were obtained. After Talairach coordinated the function images of every one, the activation areas were measured in Brodmann areas 17, 18 and 19. The SPSS 12.0 software was used for statistic analysis. The difference of the cortical activations of amblyopic eyes before and after refractive correction was analyzed. The cortical activations of amblyopic eyes and the fellow eyes after refractive correction were compared. The visual acuity of the amblyopia eyes was measured. And the correlation between the lesion of cortical activation and visual acuity was analyzed. Results: It was found that the cortex was activated obviously in the calcarine cortex around, occipital lobe, LGN and temporal lobe. The activation areas of amblyopic eyes was (3.7±0.4) x 10 4 voxels, and (4.1±0.5 ) x 10 4 voxets after corrected

  11. Development of motor fusion in patients with a history of strabismic amblyopia who are treated part-time with Bangerter foils.

    Science.gov (United States)

    Abrams, Michael S; Duncan, Candace L; McMurtrey, Ryan

    2011-04-01

    To document the development of motor fusion when patients with a history of strabismic amblyopia are treated part-time with Bangerter foils. This was a prospective interventional outcome study of consecutive patients with a history of strabismic amblyopia, horizontal strabismus (only) ≤20(∆), visual acuity of 20/60 or better in the nonfixating eye, and no motor fusion (as indicated by the absence of prism vergence) for 1 year before entry into the study. Subjects wore a 0.1 density Bangerter foil for 3-4 hours daily. Data on visual acuity, alignment, and motor fusion status were collected for a minimum of 2 years. Patients with motor fusion were then followed for a minimum of 18 months to assess the stability of their motor fusion status after the Bangerter foil was discontinued. Of the 46 patients meeting entry criteria (mean age, 5.3 ± 1.7 years) who completed follow-up, 28 (61%) developed motor fusion. Motor fusion was retained in all 17 patients who were followed after their foils were discontinued for a mean of 13.3 months. A child's motor fusion status is generally believed to be established during an early formative period of visual development. The development of motor fusion in many of our patients during the course of part-time Bangerter foil treatment suggests that improvements in motor fusion status can occur at a later age than previously believed. Copyright © 2011 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  12. Amblyopia: Lazy Eye Treatment

    Science.gov (United States)

    ... with Myopia Aug 31, 2017 Eye Injuries from Laundry Packets On the Rise Jun 30, 2017 Combating ... with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology Job Center © American ...

  13. Amblyopia: Lazy Eye Diagnosis

    Science.gov (United States)

    ... with Myopia Aug 31, 2017 Eye Injuries from Laundry Packets On the Rise Jun 30, 2017 Combating ... with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology Job Center © American ...

  14. Amblyopia (For Parents)

    Science.gov (United States)

    [Skip to Content] for Parents Parents site Sitio para padres General Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family ...

  15. Análise do custo do tratamento da ambliopia para o paciente em hospital universitário A cost analysis of therapy for amblyopia for an outpatient at a university hospital

    Directory of Open Access Journals (Sweden)

    Luciana Ottaiano Cerântola de Almeida

    2005-08-01

    Full Text Available OBJETIVO: Avaliar os custos do tratamento da ambliopia para o paciente pela oclusão do olho dominante, assim como seu resultado visual. MÉTODOS: Realizou-se estudo prospectivo para avaliar o custo do tratamento de ambliopia por oclusão no Setor de Estrabismo do Hospital São Paulo - Universidade Federal de São Paulo/Escola Paulista de Medicina. Crianças portadoras de ambliopia entre 3 e 7 anos de idade foram incluídas no estudo. Os pacientes foram acompanhados a partir do diagnóstico até três retornos consecutivos. Ao diagnóstico prescreveram-se óculos se necessário e oclusão total, direta e contínua do olho dominante. Nos retornos coletaram-se dados referentes ao tratamento e ao custo do tratamento da ambliopia. Para análise dos resultados os custos foram divididos em diretos (óculos e oclusor e indiretos (transporte e desconto do dia de trabalho do acompanhante. RESULTADOS: Foram analisados 14 pacientes com idade média de 5,21 anos, sendo 7 (50% do sexo masculino e 7 (50% do sexo feminino. Observou-se melhora da acuidade visual em 71,43% dos pacientes. O custo médio mensal do tratamento da ambliopia foi de R$ 59,49 e o custo médio anual de R$ 714,47. O custo médio mensal do tratamento da ambliopia equivale a 12,20% da renda familiar mensal média dos pacientes neste estudo. CONCLUSÃO: O tratamento de oclusão da ambliopia é eficiente e melhorou a acuidade visual do olho amblíope em 71,43% dos casos. O custo mensal deste tratamento é de R$ 59,49 e representa 12,20% da renda familiar mensal dos pacientes avaliados.PURPOSE: To analyze the costs of therapy for amblyopia for an outpatient using occlusion of the normal sighted eye and its visual results. METHODS: A prospective study was performed to evaluate the costs of therapy for amblyopia at the Strabismus Sector of the Hospital São Paulo - Universidade Federal de São Paulo/Escola Paulista de Medicina. Children with amblyopia ranging in age from 3 to 7 years were

  16. Effectiveness of a Binocular Video Game vs Placebo Video Game for Improving Visual Functions in Older Children, Teenagers, and Adults With Amblyopia: A Randomized Clinical Trial.

    Science.gov (United States)

    Gao, Tina Y; Guo, Cindy X; Babu, Raiju J; Black, Joanna M; Bobier, William R; Chakraborty, Arijit; Dai, Shuan; Hess, Robert F; Jenkins, Michelle; Jiang, Yannan; Kearns, Lisa S; Kowal, Lionel; Lam, Carly S Y; Pang, Peter C K; Parag, Varsha; Pieri, Roberto; Raveendren, Rajkumar Nallour; South, Jayshree; Staffieri, Sandra Elfride; Wadham, Angela; Walker, Natalie; Thompson, Benjamin

    2018-02-01

    Binocular amblyopia treatment using contrast-rebalanced stimuli showed promise in laboratory studies and requires clinical trial investigation in a home-based setting. To compare the effectiveness of a binocular video game with a placebo video game for improving visual functions in older children and adults. The Binocular Treatment of Amblyopia Using Videogames clinical trial was a multicenter, double-masked, randomized clinical trial. Between March 2014 and June 2016, 115 participants 7 years and older with unilateral amblyopia (amblyopic eye visual acuity, 0.30-1.00 logMAR; Snellen equivalent, 20/40-20/200) due to anisometropia, strabismus, or both were recruited. Eligible participants were allocated with equal chance to receive either the active or the placebo video game, with minimization stratified by age group (child, age 7 to 12 years; teenager, age 13 to 17 years; and adult, 18 years and older). Falling-blocks video games played at home on an iPod Touch for 1 hour per day for 6 weeks. The active video game had game elements split between eyes with a dichoptic contrast offset (mean [SD] initial fellow eye contrast, 0.23 [0.14]). The placebo video game presented identical images to both eyes. Change in amblyopic eye visual acuity at 6 weeks. Secondary outcomes included compliance, stereoacuity, and interocular suppression. Participants and clinicians who measured outcomes were masked to treatment allocation. Of the 115 included participants, 65 (56.5%) were male and 83 (72.2%) were white, and the mean (SD) age at randomization was 21.5 (13.6) years. There were 89 participants (77.4%) who had prior occlusion. The mean (SD) amblyopic eye visual acuity improved 0.06 (0.12) logMAR from baseline in the active group (n = 56) and 0.07 (0.10) logMAR in the placebo group (n = 59). The mean treatment difference between groups, adjusted for baseline visual acuity and age group, was -0.02 logMAR (95% CI, -0.06 to 0.02; P = .25). Compliance with more than 25

  17. Resultados do tratamento da ambliopia com levodopa combinada à oclusão Results of amblyopia treatment with levodopa associated with occlusion therapy

    Directory of Open Access Journals (Sweden)

    Edson Procianoy

    2004-10-01

    Full Text Available OBJETIVO: Verificar a melhora da acuidade visual com levodopa/benzerazida combinada à oclusão parcial e seguida por oclusão total, em pacientes com ambliopia considerada irreversível. MÉTODOS: Realizou-se estudo experimental aberto, envolvendo 37 pacientes entre 7 e 40 anos de idade, com ambliopia por estrabismo ou anisometropia, durante 9 semanas. Todos os pacientes foram tratados com levodopa (0,70 mg/kg/dia e benzerazida 25% associada à oclusão de 4 horas/dia do olho dominante por 5 semanas e, nas 4 semanas seguintes foi realizada somente a oclusão total (24 h do olho dominante. A acuidade visual foi medida na tabela do ETDR (Early Treatment Diabetic Retinopathy com escala logMAR (logaritmo do mínimo ângulo de resolução antes de iniciar o tratamento e após 1, 3, 5 e 9 semanas de tratamento. As adesões ao tratamento de oclusão e a ingesta do me-dicamento foram verificadas por meio de questionário e pela contagem das cápsulas. Os efeitos adversos foram avaliados por exame clínico e questionário. RESULTADOS: Após 9 semanas de tratamento, a acuidade visual média melhorou em logMAR de 0,58 ± 0,16 para 0,23 ± 0,16 (melhora de 4 linhas na tabela ETDR. CONCLUSÃO: Levodopa, na dose de 0,70 mg/kg/dia, é bem tolerada e associada à oclusão produz melhora significativa na acuidade visual de pacientes com ambliopia considerada irreversível.PURPOSE: To evaluate visual acuity improvement with levodopa/benzerazide associated with partial occlusion and followed by total occlusion therapy in patients with amblyopia considered irreversible. METHODS: A 9-week experimental open study was performed involving 37 patients, between 7 and 40 years old, with strabismic and/or anisometropic amblyopia. All patients were treated with levodopa (0.70 mg/kg/day and 25% benzerazide associated with 4-hour/day occlusion of the dominant eye for 5 weeks. In the last 4 weeks, only the total occlusion (24 h of the dominant eye was performed. Visual acuity

  18. Analysis of Macular and Retinal Nerve Fiber Layer Thickness in Children with Refractory Amblyopia after Femtosecond Laser-assisted Laser In situ Keratomileusis: A Retrospective Study.

    Science.gov (United States)

    Zhao, Peng-Fei; Zhou, Yue-Hua; Zhang, Jing; Wei, Wen-Bin

    2017-09-20

    Localized macular edema and retinal nerve fiber layer (RNFL) thinning have been reported shortly after laser in situ keratomileusis (LASIK) in adults. However, it is still unclear how LASIK affects the retina of children. This study aimed to investigate the macular retina and RNFL thickness in children with refractive amblyopia who underwent femtosecond laser-assisted LASIK (FS-LASIK). In this study, we included 56 eyes of 32 patients with refractive amblyopia who underwent FS-LASIK in our hospital from January 2012 to December 2016. Foveal (foveal center retinal, parafoveal retinal, and perifoveal), macular inner retinal (superior and inferior), and peripapillary RNFL thicknesses (superior, inferior, temporal, and nasal) were measured using Fourier-domain optical coherence tomography before surgery and 1 day, 3 days, and 1 week after surgery. We divided these patients into three groups based on their refractive error: High myopic group with 22 eyes (equivalent sphere, >6.00 D), mild myopic group with 19 eyes (equivalent sphere, 0-6.00 D), and hyperopic group with 15 eyes (equivalent sphere, >+0.50 D). We compared the macular retina and RNFL thickness before and after LASIK. A paired simple t-test was used for data analysis. One week after surgery, the visual acuity for all 56 eyes of the 32 patients reached their preoperative best-corrected vision. Visual acuity improved two lines or better for 31% of the patients. The residual refractive errors in 89% of the patients were within ±0.5 D. In the high myopic group, the foveal center retinal and parafoveal retinal thicknesses were thicker 1 day and 3 days after surgery than before surgery (t = 2.689, P = 0.012; t = 2.383, P = 0.018, respectively); no significant difference was found 1 week after surgery (P > 0.05). The foveal center retinal and parafoveal retinal thicknesses were greater 1 day after surgery than they were before surgery (P = 0.000 and P = 0.005, respectively) in the mild myopic and hyperopic groups

  19. Performance of Photoscreener in Detection of Refractive Error in All Age Groups and Amblyopia Risk Factors in Children in a Tribal District of Odisha: The Tribal Odisha Eye Disease Study (TOES) # 3

    Science.gov (United States)

    Panda, Lapam; Barik, Umasankar; Nayak, Suryasmita; Barik, Biswajit; Behera, Gyanaranjan; Kekunnaya, Ramesh

    2018-01-01

    Purpose To evaluate effectiveness of Welch Allyn Spot Vision Screener in detecting refractive error in all age groups and amblyopia risk factors in children in a tribal district of India. Methods All participants received dry retinoscopy and photorefraction; children also received cycloplegic retinoscopy. Statistical analysis included Bland-Altman and coefficient of determination (R2). Results Photoscreener could not elicit a response in 113 adults and 5 children of 580 recruited participants. In Bland-Altman analysis mean difference of Spot screener spherical equivalent (SSSE) and dry retinoscopy spherical equivalent (DRSE) was 0.32 diopters (D) in adults and 0.18 D in children; this was an overestimation of hyperopia and underestimation of myopia. In Bland-Altman analysis of SSSE and cycloplegic retinoscopy spherical equivalent (CRSE) the mean difference was −0.30 D in children; this was an overestimation of myopia and underestimation of hyperopia. In regression analysis the relationship between SSSE and DRSE was poor in adults (R2 = 0.50) and good in children (R2 = 0.92). Cubic regression model for Spot versus cycloretinoscopy in children was: CRSE = 0.34 + 0.85 SSSE − 0.01 SSSE2 + 0.006 SSSE3. It was 87% accurate. Sensitivity and specificity of Spot in detecting amblyopia risk factors (2013 American Association for Pediatric Ophthalmology and Strabismus [AAPOS] criteria) was 93.3% and 96.9% respectively. Sensitivity of Spot screener in detection of amblyopia was 72%. Conclusions Photoscreener has 87% accuracy in refraction in children. Its value could be used for subjective correction tests. Translational Relevance Photoscreening could complement traditional retinoscopy to address refractive error in children in a resource-limited facility region. PMID:29881649

  20. Evaluation and development of a novel binocular treatment (I-BiT™) system using video clips and interactive games to improve vision in children with amblyopia ('lazy eye'): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Foss, Alexander J; Gregson, Richard M; MacKeith, Daisy; Herbison, Nicola; Ash, Isabel M; Cobb, Sue V; Eastgate, Richard M; Hepburn, Trish; Vivian, Anthony; Moore, Diane; Haworth, Stephen M

    2013-05-20

    Amblyopia (lazy eye) affects the vision of approximately 2% of all children. Traditional treatment consists of wearing a patch over their 'good' eye for a number of hours daily, over several months. This treatment is unpopular and compliance is often low. Therefore results can be poor. A novel binocular treatment which uses 3D technology to present specially developed computer games and video footage (I-BiT™) has been studied in a small group of patients and has shown positive results over a short period of time. The system is therefore now being examined in a randomised clinical trial. Seventy-five patients aged between 4 and 8 years with a diagnosis of amblyopia will be randomised to one of three treatments with a ratio of 1:1:1 - I-BiT™ game, non-I-BiT™ game, and I-BiT™ DVD. They will be treated for 30 minutes once weekly for 6 weeks. Their visual acuity will be assessed independently at baseline, mid-treatment (week 3), at the end of treatment (week 6) and 4 weeks after completing treatment (week 10). The primary endpoint will be the change in visual acuity from baseline to the end of treatment. Secondary endpoints will be additional visual acuity measures, patient acceptability, compliance and the incidence of adverse events. This is the first randomised controlled trial using the I-BiT™ system. The results will determine if the I-BiT™ system is effective in the treatment of amblyopia and will also determine the optimal treatment for future development. ClinicalTrials.gov identifier: NCT01702727.

  1. Avaliação da espessura da camada de fibras nervosas da retina e mácula em pacientes com ambliopia Thickness of the retinal nerve fiber layer, macular thickness, in patients with amblyopia

    Directory of Open Access Journals (Sweden)

    Juliana Mitre

    2010-02-01

    Full Text Available OBJETIVO: Avaliar a espessura da camada de fibras nervosas da retina em olhos amblíopes e comparar com olhos normais e certificar se há correlação com a redução da acuidade visual. Além disso, este estudo se propõe avaliar a eficácia e eficiência em uma série de casos do protótipo de um equipamento nacional de magnificação para leitura. MÉTODOS: Participaram deste estudo 30 pacientes na faixa etária entre 9 e 80 anos (17 do sexo masculino. Foi desenvolvido um aparelho portátil, patenteado pela Unifesp (PI#020050145260, com um sistema de captura de imagens acoplado a um monitor de 5,6 polegadas proporcionando um aumento de 15 x. Foram analisadas a eficácia da acuidade visual e a eficiência de leitura após a utilização do protótipo proposto. RESULTADOS: Seis pacientes (20% apresentaram AV 8M, 12 pacientes (40% apresentaram AV 6M, 7 pacientes (23,3% apresentaram 5 M, 5 pacientes (16,7% apresentaram 4M. A média de acuidade visual antes da utilização do SLP medida pela tabela LHNV-1 logMAR foi de 5,75M e após a utilização 100% dos pacientes atingiram a eficácia de AV J1. CONCLUSÃO: O protótipo do SLP mostrou-se um recurso alternativo no processo de inclusão social das pessoas com baixa visão com diferentes níveis de resíduo visual. Também pode proporcionar incentivo psicológico, permitir conforto, mobilidade e independência àqueles que necessitam de uma leitura mais prolongada e maior distância de trabalho.OBJECTIVE: To compare the thickness of the retinal nerve fiber layer (RNFLand the macular thickness of the amblyopic eye with those of the non-amblyopic eye in patients with unilateral amblyopia using optical coherence tomography (OCT. METHODS: OCT was performed for13 patients with unilateral amblyopia who had no neurologic disease. Nine male andfour female patients, whose ages ranged from 23 to 63 years, were enrolled in the study. The RNFL thickness average analysis program was used to evaluate mean

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  4. Amblyopia after unilateral infantile cataract extraction after six weeks of age Ambliopia no pós-operatório de catarata congênita unilateral operada após seis semanas de vida

    Directory of Open Access Journals (Sweden)

    Fábio Ejzenbaum

    2009-10-01

    Full Text Available PURPOSE: To determine interocular grating acuity difference in children treated for unilateral infantile cataract. METHODS: A group of 27 children previously treated for unilateral infantile cataract, had their monocular visual acuity measured by sweep visual evoked potentials. Interocular grating acuity difference was calculated as the absolute subtraction of monocular acuity scores. Lens status, opacity severity and eye alignment were considered for analysis. RESULTS: Mean interocular grating acuity difference obtained from unilateral cataract patients was 0.58 ± 0.20 logMAR. This result was significantly larger than 0.10 logMAR used as normative data. Children with severe opacities had a more pronounced amblyopia than the moderate ones. No significant correlation between amblyopia and strabismus or aphakia was found. CONCLUSIONS: Interocular acuity difference in this group of unilateral congenital cataract was more pronounced than previous reports, mainly because of delay in diagnosis, surgery and optical correction.OBJETIVOS: Determinar a diferença interocular da acuidade visual de resolução de grades em crianças operadas de catarata congênita unilateral. MÉTODOS: Um grupo de 27 pacientes operados de catarata congênita unilateral tiveram mensurada sua acuidade visual monocular pelo potencial visual evocado de varredura. A diferença interocular foi calculada pela subtração absoluta das acuidades monoculares. A intensidade da opacificação, implante ou não de lente intraocular e presença de estrabismo foram consideradas para análise. RESULTADOS: A média da diferença interocular foi de 0,58 ± 0,20 logMAR. Esse resultado foi significantemente maior que 0,10 logMAR, valor considerado como média normal nos estudos normativos. Crianças com opacidades intensas tiveram ambliopia mais pronunciada que os casos moderados. Não houve correlação significante entre a intensidade da ambliopia com estrabismo e afacia. CONCLUSÕES: A

  5. Tratamento do coloboma de pálpebra superior pela técnica de Cutler-Beard e sua associação com ambliopia: relato de caso Upper eyelid coloboma treatment with the Cutler-Beard technique and its association with amblyopia: case report

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    André Bezerra de Menezes Reiff

    2002-09-01

    Full Text Available Neste relato é apresentado um caso de coloboma congênito de pálpebra superior reconstruído por meio de retalho de transposição de pálpebra inferior (retalho de Cutler-Beard, com bom resultado estético e funcional. A paciente apresentou como complicação o desenvolvimento de ambliopia por privação de imagem (em função do período de oclusão visual, entre a primeira e a segunda intervenção cirúrgica, que respondeu adequadamente à terapêutica instituída. Realizou-se revisão bibliográfica, comentando-se os princípios que regem a reconstrução de defeitos da pálpebra superior, mostrando vantagens e desvantagens de cada técnica e levantou-se discussão quanto ao melhor método de reconstrução nos recém-nascidos, em função dos riscos da ocorrência de ambliopia.The authors present a case of a large congenital coloboma of the upper eyelid which was reconstructed through a transposition flap from the lower eyelid (Cutler-Beard technique, with good esthetic and functional result. The patient presented as a complication, development of deprivation amblyopia, (as a result of the time of visual axis occlusion between the first and second operation, which was solved utilizing appropriate therapy. A bibliographic review was made and the principles that rule the treatment of upper eyelid defects were commented, showing the advantages and disadvantages of each technique. Discussion was raised about the best method of reconstruction in newborns, facing the risks of occurrence of amblyopia.

  6. Diagnóstico de la coordinación visomotora en escolares con estrabismo y ambliopía / Visualmotor coordination diagnose for students with strabismus and amblyopia

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    Yaimara Peña-Peña,

    2017-02-01

    Full Text Available La atención a las particularidades de los escolares con estrabismo y ambliopía exige como un elemento a contemplar la estimulación de la coordinación visomotora. En la constante búsqueda de las mejores opciones que garanticen la atención individualizada de estos escolares se consideró oportuno diagnosticar el comportamiento de este factor coordinativo. La investigación tomó como grupo de estudio a 21 escolares que cursaron el primer grado en la escuela especial Antonio Suárez Domínguez, en la provincia de Camagüey, durante los cursos comprendidos entre los años 2012 a 2015. Se propusieron diversas pruebas para medir la coordinación visomotora con el objetivo de ofrecer a los profesores de Educación Física Adaptada un instrumento para su diagnóstico en el primer ciclo de la enseñanza primaria porque ni el Programa de Educación Física, ni las pruebas de eficiencia física contemplan cómo evaluarla. La propuesta se valoró teóricamente por medio del criterio de experto (Delphy y en la práctica con un experimento de diseño pre-experimental. La consideración de los expertos acerca de la prueba adaptada y su factibilidad se corrobora en la práctica al develarse la incidencia positiva en los resultados obtenidos, de acuerdo con las particularidades de estos escolares. Abstract A key element when attending the special needs of students with strabismus and amblyopia is the stimulation of visualmotor coordination. From the standpoint of the constant research for better options that guarantee individual attention to these students it was considered appropriate to diagnose the coordinative factor behavior. Researchers took a sample of 21 first grade students of the special needs school Antonio Suárez Domínguez, Camagüey province, during the school years 2012-2015. Since neither the Physical Education Syllabus nor the Physical efficiency test had the necessary tools, various tests were taken to measure visualmotor coordination

  7. Detecção de ambliopia, ametropias e fatores ambliogênicos em comunidade assistida por Programa da Saúde da Família no Rio de Janeiro, Brasil Amblyopia, ametropia and amblyogenic factors detection in a community assisted by Health Family Program in Rio de Janeiro, Brazil

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    Arlette Machado Oliveira

    2010-10-01

    visão das crianças brasileiras e seria útil que essa avaliação fosse um marcador estatístico do SUS.OBJECTIVE: To determine amblyogenic factors and amblyopia prevalence in a Health Family assisted community área of Lapa (RJ and to estimate in the same area the sensiblity and specificity among visual acuity methods (ETDRS versus LEA optotypes in pre-school children. METHODS: Cross section study of 93 children from three to six years old. All the children were submitted to complete ophthalmological evaluation which included: anamnesis, ectoscopy, double blind visual acuity measurements with LEA and ETDRS optotypes, red reflex, Titmus Test, objective cycloplegic refraction, subjective refraction, ocular motility evaluation, anterior segment biomicroscopy, fundoscopy. The data were collected in Ronaldo Gazolla Policlinic of Estacio de Sá University. RESULTS: The amblyogenic factors prevalence were : 8,4% of strabismus, 11,86% of anisometropia and 15,2% of ametropia. The ETDRS visual acuity test had 100% of sensibility and 18% of specificity for amblyopia detection. Lea visual acuity test had 100% sensibility and 30,9% specificity for amblyopia detection. CONCLUSION: Both optotype tests ETDRS and LEA can be used for amblyopia screening because they had 100% sensibility. The specificity was higher for LEA optotypes. However, the specificity still remained in a low level. Therefore, it is necessary to complement the visual acuity screening with a complete ophthalmological exam in the individuals screened to have amblyopia. Visual screening performed by Health Community Agents could identify children with visual acuity problems, and they could be referred to an ophthalmological complete exam, in an age group that visual acuity problems resolution is a priority. Helth Family Program can be used to evaluate visual acuity children status and it would be useful that this evaluation could be a statiscal SUS mark.

  8. Detecção de ambliopia, ametropias e fatores ambliogênicos em comunidade assistida por Programa da Saúde da Família no Rio de Janeiro, Brasil Amblyopia, ametropia and amblyogenic factors detection in a community assisted by Health Family Program in Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Arlette Machado Oliveira

    2010-04-01

    utilizado para avaliar o estado de visão das crianças brasileiras e seria útil que essa avaliação fosse um marcador estatístico do SUS.OBJECTIVES: To determine amblyogenic factors and amblyopia prevalence in a Health Family assisted community área of Lapa (RJ; and to estimate in the same area the sensiblity and specificity among visual acuity methods ( ETDRS versus LEA optotypes in pre-school children. METHODS: Cross section study of 93 children from three to six years old. All the children were submitted to complete ophthalmological evaluation which included: anamnesis, ectoscopy, double blind visual acuity measurements with LEA and ETDRS optotypes, red reflex, Titmus Test, objective cycloplegic refraction, subjective refraction, ocular motility evaluation, anterior segment biomicroscopy, fundoscopy. The data were collected in Ronaldo Gazolla Policlinic of Estacio de Sá University. RESULTS: The amblyogenic factors prevalence were : 8,4% of strabismus, 11,86% of anisometropia and 15,2% of ametropia. The ETDRS visual acuity test had 100% of sensibility and 18% of specificity for amblyopia detection. Lea visual acuity test had 100% sensibility and 30,9% specificity for amblyopia detection. CONCLUSION: Both optotype tests ETDRS and LEA can be used for amblyopia screening because they had 100% sensibility. The specificity was higher for LEA optotypes. However, the specificity still remained in a low level. Therefore, it is necessary to complement the visual acuity screening with a complete ophthalmological exam in the individuals screened to have amblyopia. Visual screening performed by Health Community Agents could identify children with visual acuity problems, and they could be referred to an ophthalmological complete exam, in an age group that visual acuity problems resolution is a priority. Helth Family Program can be used to evaluate visual acuity children status and it would be useful that this evaluation could be a statiscal SUS mark.

  9. Amblyopia: What Is the Cause of Lazy Eye?

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  10. The perceptual consequences of interocular suppression in amblyopia.

    Science.gov (United States)

    Maehara, Goro; Thompson, Benjamin; Mansouri, Behzad; Farivar, Reza; Hess, Robert F

    2011-11-21

    It is known that information from an amblyopic eye can be strongly suppressed when both eyes are open. The authors investigated the way in which suppression influences the relative perception of suprathreshold contrast and luminance between a person's eyes under dichoptic viewing conditions. Stimuli consisted of four patches of luminance or four patches containing gratings. Two patches were presented to each eye. Ten amblyopes with mild suppression (six strabismic, three anisometropic and strabismic, and one deprivation; mean age, 34.5 years) and three control observers with normal vision (mean age, 33.0 years) matched the appearance of the stimuli presented to each eye. The match involved manipulation of either luminance or contrast. Amblyopes with mild suppression decreased stimulus luminance in the fellow fixing eye or increased luminance in the amblyopic eye to achieve a match (mean matching luminance, 21.1 and 39.6 cd/m(2) for the fellow fixing eye and the amblyopic eye, respectively; standard luminance, 30 cd/m(2)). This interocular mismatch was also observed when luminance was variable and contrast was kept constant (mean matching luminance, 22.8 cd/m(2) for the fellow fixing eye). On the other hand, the amblyopic eye showed no loss of perceived contrast. There was little or no mismatch between the two eyes of control participants with normal binocular vision. Amblyopes have monocular deficits in contrast perception but dichoptic deficits in luminance perception, suggesting that suppression in its mild form involves luminance processing.

  11. Methanol Induced Toxic Amblyopia--A Case Report.

    Science.gov (United States)

    Khan, A H; Rahaman, M F; Mollah, R I; Alam, A; Hassan, S N; Chowdhury, M A

    2016-01-01

    A 28-year-old man, smoker having history of occasional alcohol intake--was admitted in the Department of Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU) with gradual diminution of vision in both eyes 10 days after consumption of homemade alcoholic beverage in a wedding ceremony. His initial acuity of vision was limited to no perception of light in right eye and hand movement in left eye. Fundus examination revealed pale optic discs in both eyes. The patient was treated with Injection Methylprednisolone 1000 mg intravenous slowly over 1 hour for 3 consecutive days. This was followed by oral prednisolone 60 mg daily for 14 days and then gradually tapered over 4 weeks. The patient also received Injection Hydroxycobalamine and Injection Folinic Acid for 2 weeks. On the 3rd day of treatment there was perception of light in the right eye and on the 10th day the visual acuity improved to hand movement. In the left eye, the visual acuity gradually improved to 6/60 on 3rd day and on 10th day improved to 6/24. Four weeks later, the visual acuity had recovered in both eyes to 6/18. Combination of intravenous and oral steroid along with vitamin B1 and folinic acid has been found effective in treating severe methanol induced optic neuropathy.

  12. Perceptual learning improves contrast sensitivity, visual acuity, and foveal crowding in amblyopia.

    Science.gov (United States)

    Barollo, Michele; Contemori, Giulio; Battaglini, Luca; Pavan, Andrea; Casco, Clara

    2017-01-01

    Amblyopic observers present abnormal spatial interactions between a low-contrast sinusoidal target and high-contrast collinear flankers. It has been demonstrated that perceptual learning (PL) can modulate these low-level lateral interactions, resulting in improved visual acuity and contrast sensitivity. We measured the extent and duration of generalization effects to various spatial tasks (i.e., visual acuity, Vernier acuity, and foveal crowding) through PL on the target's contrast detection. Amblyopic observers were trained on a contrast-detection task for a central target (i.e., a Gabor patch) flanked above and below by two high-contrast Gabor patches. The pre- and post-learning tasks included lateral interactions at different target-to-flankers separations (i.e., 2, 3, 4, 8λ) and included a range of spatial frequencies and stimulus durations as well as visual acuity, Vernier acuity, contrast-sensitivity function, and foveal crowding. The results showed that perceptual training reduced the target's contrast-detection thresholds more for the longest target-to-flanker separation (i.e., 8λ). We also found generalization of PL to different stimuli and tasks: contrast sensitivity for both trained and untrained spatial frequencies, visual acuity for Sloan letters, and foveal crowding, and partially for Vernier acuity. Follow-ups after 5-7 months showed not only complete maintenance of PL effects on visual acuity and contrast sensitivity function but also further improvement in these tasks. These results suggest that PL improves facilitatory lateral interactions in amblyopic observers, which usually extend over larger separations than in typical foveal vision. The improvement in these basic visual spatial operations leads to a more efficient capability of performing spatial tasks involving high levels of visual processing, possibly due to the refinement of bottom-up and top-down networks of visual areas.

  13. Is hemiplegic cerebral palsy equivalent to amblyopia of the corticospinal system?

    Science.gov (United States)

    Eyre, Janet A; Smith, Martin; Dabydeen, Lyvia; Clowry, Gavin J; Petacchi, Eliza; Battini, Roberta; Guzzetta, Andrea; Cioni, Giovanni

    2007-11-01

    Subjects with severe hemiplegic cerebral palsy have increased ipsilateral corticospinal projections from their noninfarcted cortex. We investigated whether their severe impairment might, in part, be caused by activity-dependent, competitive displacement of surviving contralateral corticospinal projections from the affected cortex by more active ipsilateral corticospinal projections from the nonaffected cortex, thereby compounding the impairment. Transcranial magnetic stimulation (TMS) characterized corticospinal tract development from each hemisphere over the first 2 years in 32 healthy children, 14 children with unilateral stroke, and 25 with bilateral lesions. Magnetic resonance imaging and anatomic studies compared corticospinal tract growth in 13 patients with perinatal stroke with 46 healthy subjects. Infants with unilateral lesions initially had responses after TMS of the affected cortex, which became progressively more abnormal, and seven were eventually lost. There was associated hypertrophy of the ipsilateral corticospinal axons projecting from the noninfarcted cortex. Magnetic resonance imaging and anatomic studies demonstrated hypertrophy of the corticospinal tract from the noninfarcted hemisphere. TMS findings soon after the stroke did not predict impairment; subsequent loss of responses and hypertrophy of ipsilateral corticospinal axons from the noninfarcted cortex predicted severe impairment at 2 years. Infants with bilateral lesions maintained responses to TMS from both hemispheres with a normal pattern of development. Rather than representing "reparative plasticity," increased ipsilateral projections from the noninfarcted cortex compound disability by competitively displacing surviving contralateral corticospinal projections from the infarcted cortex. This may provide a pathophysiological explanation for why signs of hemiplegic cerebral palsy appear late and progress over the first 2 years of life.

  14. Contrast masking in strabismic amblyopia: attenuation, noise, interocular suppression and binocular summation.

    Science.gov (United States)

    Baker, Daniel H; Meese, Tim S; Hess, Robert F

    2008-07-01

    To investigate amblyopic contrast vision at threshold and above we performed pedestal-masking (contrast discrimination) experiments with a group of eight strabismic amblyopes using horizontal sinusoidal gratings (mainly 3c/deg) in monocular, binocular and dichoptic configurations balanced across eye (i.e. five conditions). With some exceptions in some observers, the four main results were as follows. (1) For the monocular and dichoptic conditions, sensitivity was less in the amblyopic eye than in the good eye at all mask contrasts. (2) Binocular and monocular dipper functions superimposed in the good eye. (3) Monocular masking functions had a normal dipper shape in the good eye, but facilitation was diminished in the amblyopic eye. (4) A less consistent result was normal facilitation in dichoptic masking when testing the good eye, but a loss of this when testing the amblyopic eye. This pattern of amblyopic results was replicated in a normal observer by placing a neutral density filter in front of one eye. The two-stage model of binocular contrast gain control [Meese, T.S., Georgeson, M.A. & Baker, D.H. (2006). Binocular contrast vision at and above threshold. Journal of Vision 6, 1224-1243.] was 'lesioned' in several ways to assess the form of the amblyopic deficit. The most successful model involves attenuation of signal and an increase in noise in the amblyopic eye, and intact stages of interocular suppression and binocular summation. This implies a behavioural influence from monocular noise in the amblyopic visual system as well as in normal observers with an ND filter over one eye.

  15. Prevalence of strabismic binocular anomalies, amblyopia and anisometropia. Rehabilitation Faculty of Shahid Beheshti Medical University

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    Mohsen Akhgary

    2011-07-01

    Discussion: The results show that the prevalence of anisometropia was higher than shown in previous studies but prevalence of convergence insufficiency, esotropia and exotropia was lower than previous studies.

  16. An educational cartoon accelerates amblyopia therapy and improves compliance, especially among children of immigrants.

    Science.gov (United States)

    Tjiam, Angela M; Holtslag, Gerdien; Vukovic, Elizabet; Asjes-Tydeman, Wijnanda L; Loudon, Sjoukje E; Borsboom, Gerard J J M; de Koning, Harry J; Simonsz, Huibert J

    2012-11-01

    We showed previously that an educational cartoon that explains without words why amblyopic children should wear their eye patch improves compliance, especially in children of immigrant parents who speak Dutch poorly. We now implemented this cartoon in clinics in low socioeconomic status (SES) areas with a large proportion of immigrants and clinics elsewhere in the Netherlands. Clinical, prospective, nonrandomized, preimplementation, and postimplementation study. Amblyopic children aged 3 to 6 years who started occlusion therapy. Preimplementation, children received standard orthoptic care. Postimplementation, children starting occlusion therapy received the cartoon in addition. At implementation, treating orthoptists followed a course on compliance. In low SES areas, compliance was measured electronically during 1 week. The clinical effects of the cartoon-electronically measured compliance, outpatient attendance rate, and speed of reduction in interocular-acuity difference (SRIAD)-averaged over 15 months of observation. In low SES areas, 114 children were included preimplementation versus 65 children postimplementation; elsewhere in the Netherlands, 335 versus 249 children were included. In low SES areas, mean electronically measured compliance was 52.0% preimplementation versus 62.3% postimplementation (P=0.146); 41.8% versus 21.6% (P=0.043) of children occluded less than 30% of prescribed occlusion time. Attendance rates in low SES areas were 60.3% preimplementation versus 76.0% postimplementation (P=0.141), and 82.7% versus 84.5%, respectively, elsewhere in the Netherlands. In low SES areas, the SRIAD was 0.215 log/year preimplementation versus 0.316 log/year postimplementation (P=0.025), whereas elsewhere in the Netherlands, these were 0.244 versus 0.292 log/year, respectively (P=0.005; the SRIAD's improvement was significantly better in low SES areas than elsewhere, P=0.0203). This advantage remained after adjustment for confounding factors. Overall, 25.1% versus 30.1% (P=0.038) had completed occlusion therapy after 15 months. After implementation of the cartoon, electronically measured compliance improved, attendance improved, acuity increased more rapidly, and treatment was shorter. This may be due, in part, to additional measures such as the course on compliance. However, that these advantages were especially pronounced in children in low SES areas with a large proportion of immigrants who spoke Dutch poorly supports its use in such areas. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  17. Occlusion therapy improves phase-alignment of the cortical response in amblyopia.

    Science.gov (United States)

    Kelly, John P; Tarczy-Hornoch, Kristina; Herlihy, Erin; Weiss, Avery H

    2015-09-01

    The visual evoked potential (VEP) generated by the amblyopic visual system demonstrates reduced amplitude, prolonged latency, and increased variation in response timing (phase-misalignment). This study examined VEPs before and after occlusion therapy (OT) and whether phase-misalignment can account for the amblyopic VEP deficits. VEPs were recorded to 0.5-4cycles/degree gratings in 10 amblyopic children (2-6years age) before and after OT. Phase-misalignment was measured by Fourier analysis across a limited bandwidth. Signal-to-noise ratios (SNRs) were estimated from amplitude and phase synchrony in the Fourier domain. Responses were compared to VEPs corrected for phase-misalignment (individual epochs shifted in time to correct for the misalignment). Before OT, amblyopic eyes (AE) had significantly more phase-misalignment, latency prolongation, and lower SNR relative to the fellow eye. Phase-misalignment contributed significantly to low SNR but less so to latency delay in the AE. After OT, phase-alignment improved, SNR improved and latency shortened in the AE. Raw averaged waveforms from the AE improved after OT, primarily at higher spatial frequencies. Correcting for phase-misalignment in the AE sharpened VEP peak responses primarily at low spatial frequencies, but could not account for VEP waveform improvements in the AE after OT at higher spatial frequencies. In summary, VEP abnormalities from the AE are associated with phase-misalignment and reduced SNR possibly related to desynchronization of neuronal activity. The effect of OT on VEP responses is greater than that accounted for by phase-misalignment and SNR alone. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. The effect of prolonged monocular occlusion on latent nystagmus in the treatment of amblyopia

    NARCIS (Netherlands)

    H.J. Simonsz (Huib)

    1989-01-01

    textabstractWe recorded eye movements in 5 patients with latent nystagmus (LN) before and after 2 days of occlusion of the better eye. The slow-phase speed of the nystagmus (SPS) was in general, before occlusion, lower when the better eye fixated but, after occlusion, lower when the worse eye

  19. Torpedo maculopathy with an anisometropic amblyopia in a 5-year-old Caucasian girl: case report

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    Marco Dutra-Medeiros

    2013-08-01

    Full Text Available The aim of this study is to report a clinical case of asymptomatic female Caucasian children with torpedo maculopathy. A 5-year-old girl was referred to our clinic for routine evaluation. The ophthalmic examination revealed best-corrected visual acuity of 20/20 in both eyes, without any changes in the biomicroscopy. Fundus examination showed normal findings in one eye, whereas in the contralateral eye it disclosed, in the temporal sector of the macular region, a whitish, atrophic, oval chorioretinal lesion with clearly defined margins. Posterior evaluations documented the stability of the lesion. Torpedo maculopathy diagnosis is based on its characteristic shape and peculiar location. The differential diagnosis has to be estabilished versus choroidal lesions (melanoma and nevus, congenital or iatrogenic hyperplasia of the retinal pigment epithelium (RPE and particularly versus the congenital pigmented lesions associated with Gardner's syndrome.

  20. Prevalence of Refractive Error in Singaporean Chinese Children: The Strabismus, Amblyopia, and Refractive Error in Young Singaporean Children (STARS) Study

    OpenAIRE

    Dirani, Mohamed; Chan, Yiong-Huak; Gazzard, Gus; Hornbeak, Dana Marie; Leo, Seo-Wei; Selvaraj, Prabakaran; Zhou, Brendan; Young, Terri L.; Mitchell, Paul; Varma, Rohit; Wong, Tien Yin; Saw, Seang-Mei

    2010-01-01

    Using population-based data, the authors report, for the first time, the prevalence of refractive error in Singaporean Chinese children aged 6 to 72 months. In selected regions of Singapore, myopia has been shown to affect more than 80% of adults; therefore, this paper provides insights into the development of refractive error at a very young age.

  1. Blocking PirB up-regulates spines and functional synapses to unlock visual cortical plasticity and facilitate recovery from amblyopia

    Science.gov (United States)

    Bochner, David N.; Sapp, Richard W.; Adelson, Jaimie D.; Zhang, Siyu; Lee, Hanmi; Djurisic, Maja; Syken, Josh; Dan, Yang; Shatz, Carla J.

    2015-01-01

    During critical periods of development, the brain easily changes in response to environmental stimuli, but this neural plasticity declines by adulthood. By acutely disrupting paired immunoglobulin-like receptor B(PirB) function at specific ages, we show that PirB actively represses neural plasticity throughout life. We disrupted PirB function either by genetically introducing a conditional PirB allele into mice or by minipump infusion of a soluble PirB ectodomain (sPirB) into mouse visual cortex. We found that neural plasticity, as measured by depriving mice of vision in one eye and testing ocular dominance, was enhanced by this treatment both during the critical period and when PirB function was disrupted in adulthood. Acute blockade of PirB triggered the formation of new functional synapses, as indicated by increases in miniature excitatory postsynaptic current (mEPSC) frequency and spine density on dendrites of layer 5 pyramidal neurons. In addition, recovery from amblyopia— the decline in visual acuity and spine density resulting from long-term monocular deprivation— was possible after a 1-week infusion of sPirB after the deprivation period. Thus, neural plasticity in adult visual cortex is actively repressed and can be enhanced by blocking PirB function. PMID:25320232

  2. Nuevas tecnologías en el tratamiento de la ambliopía

    OpenAIRE

    Santiago Blanco, Alberto

    2015-01-01

    Amblyopia is a neurodevelopment disorder which affect the vision. The amblyopia is the principal cause of loss vision in pedriatic and it affect 3% people. The main treatments are a patch or a optic correction. Until now, it was believed that amblyopia can only treat during the critical period. But it has discovered there is plasticity in adult. Actually there are no invasive treatments that can induce plasticity in adult. These treatments are transcranial magnetic stimulation(TME), transcran...

  3. Psychophysical research progress of interocular suppression in amblyopic visual system

    OpenAIRE

    Jing-Jing Li; Yi Huang

    2016-01-01

    Some recent animal experiments and psychophysical studies indicate that patients with amblyopia have a structurally intact binocular visual system that is rendered functionally monocular due to suppression, and interocular suppression is a key mechanism in visual deficits experienced by patients with amblyopia. The aim of this review is to provide an overview of recent psychophysical findings that have investigated the important role of interocular suppression in amblyopia, the measurement an...

  4. Paediatric cataract: challenges and complications

    Directory of Open Access Journals (Sweden)

    Dr P Vijayalakshmi

    2016-10-01

    Full Text Available Amblyopia should always be anticipated in children with unilateral cataract, asymmetrical bilateral cataracts (or where there is a delay between the first and second eye operation, or a delay of more than a year between diagnosis/ detection and surgery, cataracts with anisometropia or traumatic cataracts with corneal scars. When amblyopia is detected, occlusion therapy (eye patching must be instituted at the earliest opportunity. The patching regimen is the same with any strabismic amblyopia and sometimes needs to be aggressive at the start. It is crucial to explain the need for patching to the parents, since compliance is the greatest obstacle to the success of amblyopia treatment.

  5. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 50 of 273 ... Vol 25, No 1 (2017), Amblyopia in rural Nigerian school children, Abstract ... Vol 11, No 2 (2003), Amblyopia: Types, Presentation And Treatment – A Review ... Vol 16, No 2 (2008), Causse of Adult Blindness at ECWA Eye ...

  6. The effect of omitting an early population-based vision screen in the Netherlands : A micro-simulation model approach

    NARCIS (Netherlands)

    F. Sloot; E. Heijnsdijk; F. Goudsmit; E.W. Steyerberg; H.J. de Koning; H.J. Simonsz; Dr. J.H. Groenewoud

    2016-01-01

    To estimate the effect of omitting an individual screen from a child vision screening programme on the detection of amblyopia in the Netherlands. A previous study (Rotterdam Amblyopia Screening Effectiveness Study) suggested that the three screens carried out between 6 and 24 months contributed

  7. Estrabismo y ambliopía, conceptos básicos para el médico de atención primaria. Estrabismo and amblyopia, basic concepts to the physician in primary attention.

    OpenAIRE

    Juan Carlos Serrano Camacho, MD*; Martha Lía Gaviria Bravo, MD**

    2011-01-01

    El estrabismo y la ambliopía son patologías relativamente frecuentes en la población general. La ambliopía constituye la causa principal de disminución de visión unilateral. Existen diferentes tipos de estrabismo mientras que la ambliopía se debe únicamente a tres mecanismos fisiopatológicos. El objetivo de este artículo es brindar al médico de atención primaria y al estudiante de medicina una revisión completa y actualizada sobre estos dos temas. Para esto revisa...

  8. REFRACTIVE ANOMALIES OF AMBLYOPIC CHILDREN WITH AND WITHOUT STRABISMUS

    Directory of Open Access Journals (Sweden)

    Ljiljana Otašević

    2003-04-01

    Full Text Available Refractive anomalies occur when the ratio of the refraction ability and the eye length is distrurbed. Amblyopia isunderstood as dimness of vision without detectable lesions of the eye.The aim of the paper is to analyze refractive anomalies occurring in amblyopic children without of with strabismus. The cards of the children suffering from amblyopia and of five of more years of age have been singled out. The number of children obtained in that way is 243. Under special observation were bilateral and unilateral amblyopias and refractive anomalies in children both with and without strabismus. Out of 243 children there are 153 without strabismus (the majority of them reported for examination at the age of seven and 90 with strabismus (the majority of them reported at the age of five. In both the groups bilateral and unilateral amblyopia was registered so that the overall number of the observed amblyopic eyes was 369. In the children without strabismus we mostly found light amblyopia while in the froup of children with strabismus we found, in a great number, medium serious amblyopia while the presence of serious amblypia was also detected. As for refractive anomalies in both the groups of amblyopic children the most freqent were hypermetropic astigmatism and hypermetropia. Because of refractive anomalies as well as with strabismus with small angle, amblyopias are often discovered only when sharpness if vision is being checked; therefore, of great importance are regular systematic examinations of vision sharpness of younger children.

  9. The prevalence of specific reading disability in an amblyopic population. A preliminary report.

    Science.gov (United States)

    Koklanis, Konstandina; Georgievski, Zoran; Brassington, Kate; Bretherton, Lesley

    2006-01-01

    To investigate the prevalence of specific reading disability in children with functional amblyopia and to explore the relationship between the two. In this prospective study, 20 consecutive children, aged 6 to 15 years (mean 8 +/-1.99 years), and diagnosed with amblyopia underwent a vision and reading assessment. The orthoptic examination included the assessment of participants' visual acuity, ocular motility and binocular functions. Specific reading disability was diagnosed using the Wide Range Achievement Test (WRAT III Reading Subtest). Intelligence, phonological awareness, rapid automatized naming (RAN), and the ability to read pseudo or nonsense words was also assessed using various psycho-linguistic reading tests. The prevalence of specific reading disability in this small series of amblyopic children was found to be 5% (n=1/20). This was even less than that reported in the local Victoria general population (16%). The type of amblyopia appeared related to phonological awareness (p=0.018) and decoding words (p=0.024), those with anisometropic amblyopia performing significantly better on these tasks than the strabismic amblyopes. The presence of binocular vision functions was also related to decoding words; those with binocular single vision performed better than those with suppression and lacking single binocular vision (p=0.007). Generally, amblyopic children also showed a lower RAN score when compared to phonological awareness score. There was no statistically significant difference for the severity of amblyopia (p=>0.05). In this very small pilot series, reading disorders were relatively rare in children with amblyopia. However, strabismic amblyopia and presence of suppression may have an adverse effect on phonological skills. In addition, amblyopia may be associated with a deficit in RAN. Further research is needed and planned to gain a better understanding about the relationship between amblyopia and reading ability.

  10. Psychophysical research progress of interocular suppression in amblyopic visual system

    Directory of Open Access Journals (Sweden)

    Jing-Jing Li

    2016-03-01

    Full Text Available Some recent animal experiments and psychophysical studies indicate that patients with amblyopia have a structurally intact binocular visual system that is rendered functionally monocular due to suppression, and interocular suppression is a key mechanism in visual deficits experienced by patients with amblyopia. The aim of this review is to provide an overview of recent psychophysical findings that have investigated the important role of interocular suppression in amblyopia, the measurement and modulation of suppression, and new dichoptic treatment intervention that directly target suppression.

  11. Glaucoma

    Medline Plus

    Full Text Available ... the special health problems and requirements of the blind.” News & Events Events Calendar NEI Press Releases News ... Videos Home Age-Related Macular Degeneration Amblyopia Animations Blindness Cataract Convergence Insufficiency Diabetic Eye Disease Dilated Eye ...

  12. Glaucoma

    Medline Plus

    Full Text Available ... Education Programs National Eye Health Education Program (NEHEP) Diabetic Eye Disease Education Program Glaucoma Education Program Low ... Macular Degeneration Amblyopia Animations Blindness Cataract Convergence Insufficiency Diabetic Eye Disease Dilated Eye Exam Dry Eye For ...

  13. 78 FR 46407 - Qualification of Drivers; Exemption Applications; Vision

    Science.gov (United States)

    2013-07-31

    ...'s disease, and refractive amblyopia. In most cases, their eye conditions were not recently developed...), Juan R. Cano (TX), John Cole (IL), Kenneth Crider (KY), Jon R. Grunschel (MA), Dean Hawley (NC...

  14. Nigerian Journal of Medicine - Vol 21, No 4 (2012)

    African Journals Online (AJOL)

    Malignant Renal Tumours in Adults in Nnamdi Azikiwe University Teaching Hospital, ... Prevalence of Amblyopia among Secondary School Students in Calabar, ... Feasibility of Early Diagnosis and Treatment of Acute Chest Syndrome in ...

  15. Outcome of strabismus surgery by nonadjustable suture among ...

    African Journals Online (AJOL)

    Outcome of strabismus surgery by nonadjustable suture among adults attending a ... postoperative residual deviation, 83 patients (86%) had defective vision with amblyopia. ... Conclusion: Surgical treatment of strabismus in Saudi adult with ...

  16. NJP VOLUME 41 NO 3

    African Journals Online (AJOL)

    PROF. EZECHUKWU

    2014-02-19

    Feb 19, 2014 ... sure, treatment given, post treat- ment visual acuities at ... adults and children resulting in ophthalmic morbidity ... Prompt diagnosis and treatment of ocular injuries ... improve in affected children because of amblyopia. This.

  17. A REVIEW OF CHALAZIA IN SAGAMU

    African Journals Online (AJOL)

    TAIBAT OTULANA

    presentation and type of treatment of chalazion in Sagamu,. Nigeria. ... findings. Surgery is the standard method of treatment. ... rigidity. Dense amblyopia and secondary exotropia have .... adults and multiple lesions are significant findings.

  18. Spectacles in Children‑ Do's and Don'ts

    African Journals Online (AJOL)

    Conclusions: Children have visual needs that differ from adults, and therefore, the prescription of glasses has to ... treatment of myopia, hypermetropia, astigmatism, and anisometropia. ... accommodative esotropia, strabismic amblyopia, and.

  19. Are 3-D Movies Bad for Your Eyes?

    Medline Plus

    Full Text Available ... normal 3-D vision in children is stimulated as they use their eyes in day-to-day ... years. However, children who have eye conditions such as amblyopia (an imbalance in visual strength between the ...

  20. Ptosis - infants and children

    Science.gov (United States)

    Blepharoptosis - children; Congenital ptosis; Eyelid drooping - children; Eyelid drooping - amblyopia; Eyelid drooping - astigmatism ... Ptosis in infants and children is often due to a problem with the muscle that raises the eyelid. A nerve problem in the eyelid can ...

  1. Are 3-D Movies Bad for Your Eyes?

    Medline Plus

    Full Text Available ... they use their eyes in day-to-day social and natural environments, and this development is largely complete by age three years. However, children who have eye conditions such as amblyopia (an ...

  2. Glaucoma

    Medline Plus

    Full Text Available ... Amblyopia Animations Blindness Cataract Convergence Insufficiency Diabetic Eye Disease Dilated Eye Exam Dry Eye For Kids Glaucoma Healthy Vision Tips Leber Congenital Amaurosis Low Vision Refractive Errors Retinopathy of Prematurity ...

  3. The Effect of Long Term Monocular Occlusion on Vernier Threshold: Elasticity in the Young Adult Visual System.

    Science.gov (United States)

    1986-06-01

    susceptible to an abnormal visual experience, is still not well defined but of importance in the treatment of amblyopia and other anomalies that cause...Toward a New Pupillary Aper- ture", Invest. Opthalmol. Vis. Sci., Dec. 1981, Vol.21, No. 6, pp 869-873. 3. Awaya, S., et. al., " Amblyopia in Man...be- lieve that the attrition of X-cells in the LGB provides a new demonstration of neural plasticity in the adult visual system. (13) Creutzfeldt and

  4. Assessment of the Density of Suppression to Identify Risk of Intractable Diplopia in the United Kingdom.

    Science.gov (United States)

    Newsham, David; O'Connor, Anna R

    2016-06-01

    Occlusion used to treat amblyopia towards the end of the developmental component of the critical period gives a risk of inducing intractable diplopia. In the United Kingdom, the density of suppression is assessed via the Sbisa/Bagolini filter bar, but there is very little research evidence to guide clinical practice or interpretation of the tests used. The aims of this study were to determine current practice and estimate the incidence of intractable diplopia following amblyopia treatment. Current practice and incidence of intractable diplopia following amblyopia were determined via a questionnaire distributed to head orthoptists in every eye department in the United Kingdom. The questionnaire explored testing and test conditions, interpretation of the test results, and cases of intractable diplopia over the last 5 years. There was considerable variation in clinical practice of the measurement of the density of suppression and interpretation of the results to guide the treatment of amblyopia. The minimum age of patients taking the test ranged from 2 to 8 years and the minimum filter considered still safe to continue treatment ranged from 4 to 17. It is estimated there were 24 cases of intractable diplopia over the last 5 years. The issue of intractable diplopia and amblyopia treatment is likely to become increasingly important as there appears to be greater plasticity and scope to treat amblyopia in teenagers and adults than was previously thought. Lack of knowledge of how to evaluate the risk may lead to more cases of intractable diplopia or alternatively treatment being withheld unnecessarily.

  5. Compliance of amblyopic patients with occlusion therapy: A pilot study

    Directory of Open Access Journals (Sweden)

    Sana Al-Zuhaibi

    2009-01-01

    Materials and Methods: A total of 31 families with a child (aged 2-12 years, undergoing unilateral amblyopia treatment at the pediatric ophthalmology clinic of Sultan Qaboos University Hospital, Oman, were recruited for this one month study. Parents were interviewed and completed a closed-ended questionnaire. Clinical data including, visual acuity, refraction, diagnosis and treatment, for each patient was collected from the hospital chart and was entered in a data collection sheet. Compliance with occlusion therapy was assessed by self-report accounts of parents and was graded into good, partial, or poor. Association between various factors and degree of compliance was studied using logistic regression modeling. Results: Only 14 (45% patients showed good compliance to occlusion therapy. 17 (55% patients were noncompliant. Improvement in visual acuity strongly correlated with compliance to patching (P = 0.008. Other variables that were studied included, age at onset of therapy; gender; degree of amblyopia; type of amblyopia; use of glasses; and compliance with glasses. These did not emerge as significant predictors of compliance. All but one family with poor compliance stated that the main challenge in following the recommendation to patch for requisite hours was in getting their child to cooperate. Only in one instance, the family cited nonavailability of patches as the main hindrance to compliance. 10/31 (32% families expressed a desire for more information and 18/31 (58% parents did not understand that amblyopia meant decreased vision. Conclusion: Poor compliance is a barrier to successful amblyopia therapy in our practice. Improvement in visual acuity is associated with better compliance with patching. Parents find it difficult to comprehend and retain verbal explanations of various components regarding occlusion therapy for amblyopia. Future study with a larger sample of patients is recommended to investigate the factors affecting compliance with amblyopia

  6. The regional extent of suppression: strabismics versus nonstrabismics.

    Science.gov (United States)

    Babu, Raiju Jacob; Clavagnier, Simon R; Bobier, William; Thompson, Benjamin; Hess, Robert F

    2013-10-09

    Evidence is accumulating that suppression may be the cause of amblyopia rather than a secondary consequence of mismatched retinal images. For example, treatment interventions that target suppression may lead to better binocular and monocular outcomes. Furthermore, it has recently been demonstrated that the measurement of suppression may have prognostic value for patching therapy. For these reasons, the measurement of suppression in the clinic needs to be improved beyond the methods that are currently available, which provide a binary outcome. We describe a novel quantitative method for measuring the regional extent of suppression that is suitable for clinical use. The method involves a dichoptic perceptual matching procedure at multiple visual field locations. We compare a group of normal controls (mean age: 28 ± 5 years); a group with strabismic amblyopia (four with microesotropia, five with esotropia, and one with exotropia; mean age: 35 ± 10 years); and a group with nonstrabismic anisometropic amblyopia (mean age: 33 ± 12 years). The extent and magnitude of suppression was similar for observers with strabismic and nonstrabismic amblyopia. Suppression was strongest within the central field and extended throughout the 20° field that we measured. Suppression extends throughout the central visual field in both strabismic and anisometropic forms of amblyopia. The strongest suppression occurs within the region of the visual field corresponding to the fovea of the fixing eye.

  7. Decreased cortical activation in response to a motion stimulus in anisometropic amblyopic eyes using functional magnetic resonance imaging.

    Science.gov (United States)

    Bonhomme, Gabrielle R; Liu, Grant T; Miki, Atsushi; Francis, Ellie; Dobre, M-C; Modestino, Edward J; Aleman, David O; Haselgrove, John C

    2006-12-01

    Motion perception abnormalities and extrastriate abnormalities have been suggested in amblyopia. Functional MRI (fMRI) and motion stimuli were used to study whether interocular differences in activation are detectable in motion-sensitive cortical areas in patients with anisometropic amblyopia. We performed fMRI at 1.5 T 4 control subjects (20/20 OU), 1 with monocular suppression (20/25), and 2 with anisometropic amblyopia (20/60, 20/800). Monocular suppression was thought to be form fruste of amblyopia. The experimental stimulus consisted of expanding and contracting concentric rings, whereas the control condition consisted of stationary concentric rings. Activation was determined by contrasting the 2 conditions for each eye. Significant fMRI activation and comparable right and left eye activation was found in V3a and V5 in all control subjects (Average z-values in L vs R contrast 0.42, 0.43) and in the subject with monocular suppression (z = 0.19). The anisometropes exhibited decreased extrastriate activation in their amblyopic eyes compared with the fellow eyes (zs = 2.12, 2.76). Our data suggest motion-sensitive cortical structures may be less active when anisometropic amblyopic eyes are stimulated with moving rings. These results support the hypothesis that extrastriate cortex is affected in anisometropic amblyopia. Although suggestive of a magnocellular defect, the exact mechanism is unclear.

  8. Unilateral Posterior Polymorphous Corneal Dystrophy Presented as Anisometropic Astigmatism: 3 Case Reports

    Directory of Open Access Journals (Sweden)

    Hyun Sun Jeon

    2017-04-01

    Full Text Available Background: Posterior polymorphous corneal dystrophy (PPCD is typically considered bilateral and asymptomatic. However, few case reports on patients with unilateral PPCD with asymmetric refractive error have mentioned anisometropic amblyopia development. In support of this, we report 3 cases of unilateral PPCD that presented as anisometropic astigmatism. Visual prognosis related to amblyopia development is discussed. Case Presentation: All 3 patients had a band lesion in the affected eye and a difference of at least 1.5 diopters in cylindrical refractive error between their eyes. The affected eye had a greater amount of astigmatism in all cases. Two patients (Cases 1 and 2 also had amblyopia in the affected eye. Case 1 was a 25-year-old male with a unilateral PPCD diagnosis and a band lesion involving the visual axis. Case 2 was an 11-year-old boy diagnosed with unilateral PPCD. The boy was treated with occlusion and atropine therapy over a 2-year period. Case 3 was a 4-year-old girl diagnosed with unilateral PPCD. The girl had a 30-month history of corrective spectacle use and had no amblyopia. In all cases, the corneal endothelial cell count was lower in the affected eye than in the unaffected contralateral eye. Conclusions: Practitioners should closely monitor patients with unilateral PPCD for astigmatic anisometropia and amblyopia development. Visual prognosis for patients with unilateral PPCD may be related to lesion position, age at diagnosis, astigmatism severity, and early-childhood corrective spectacle use.

  9. Deficient motion-defined and texture-defined figure-ground segregation in amblyopic children.

    Science.gov (United States)

    Wang, Jane; Ho, Cindy S; Giaschi, Deborah E

    2007-01-01

    Motion-defined form deficits in the fellow eye and the amblyopic eye of children with amblyopia implicate possible direction-selective motion processing or static figure-ground segregation deficits. Deficient motion-defined form perception in the fellow eye of amblyopic children may not be fully accounted for by a general motion processing deficit. This study investigates the contribution of figure-ground segregation deficits to the motion-defined form perception deficits in amblyopia. Performances of 6 amblyopic children (5 anisometropic, 1 anisostrabismic) and 32 control children with normal vision were assessed on motion-defined form, texture-defined form, and global motion tasks. Performance on motion-defined and texture-defined form tasks was significantly worse in amblyopic children than in control children. Performance on global motion tasks was not significantly different between the 2 groups. Faulty figure-ground segregation mechanisms are likely responsible for the observed motion-defined form perception deficits in amblyopia.

  10. The Indication of Surgical Treatment and Visual Rehabilitation in the Congenital Cataracts

    Directory of Open Access Journals (Sweden)

    Uğur Keklikçi

    2005-01-01

    Full Text Available Congenital cataracts constitute an important part of blindness in childhood. It’s a curable disease which is one of the most common causes of blindness in childhood. Main treatment is surgical operation. Timing of surgery, appropriate and rapid post sur- gery visual rehabilitation have a major effect on prognosis. Surgery should be perfor-med as soon as possible after the diagnosis in order to prevent amblyopia.Visual rehabi- litation of congenital cataract includes optical correction and amblyopia treatment. The most effective treatment of amblyopia is occlusion therapy. In this article congenital cataracts were evaluated in the light of recent literature and the importance of the timing of surgery and visual rehabilitation were attempted to be emphasized.

  11. Vision Screening in Children Aged 6 Months to 5 Years: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

    2017-09-05

    One of the most important causes of vision abnormalities in children is amblyopia (also known as "lazy eye"). Amblyopia is an alteration in the visual neural pathway in a child's developing brain that can lead to permanent vision loss in the affected eye. Among children younger than 6 years, 1% to 6% have amblyopia or its risk factors (strabismus, anisometropia, or both). Early identification of vision abnormalities could prevent the development of amblyopia. Studies show that screening rates among children vary by race/ethnicity and family income. Data based on parent reports from 2009-2010 indicated identical screening rates among black non-Hispanic children and white non-Hispanic children (80.7%); however, Hispanic children were less likely than non-Hispanic children to report vision screening (69.8%). Children whose families earned 200% or more above the federal poverty level were more likely to report vision screening than families with lower incomes. To update the 2011 US Preventive Services Task Force (USPSTF) recommendation on screening for amblyopia and its risk factors in children. The USPSTF reviewed the evidence on the accuracy of vision screening tests and the benefits and harms of vision screening and treatment. Surgical interventions were considered to be out of scope for this review. Treatment of amblyopia is associated with moderate improvements in visual acuity in children aged 3 to 5 years, which are likely to result in permanent improvements in vision throughout life. The USPSTF concluded that the benefits are moderate because untreated amblyopia results in permanent, uncorrectable vision loss, and the benefits of screening and treatment potentially can be experienced over a child's lifetime. The USPSTF found adequate evidence to bound the potential harms of treatment (ie, higher false-positive rates in low-prevalence populations) as small. Therefore, the USPSTF concluded with moderate certainty that the overall net benefit is moderate for

  12. Asymmetric Dichoptic Masking in Visual Cortex of Amblyopic Macaque Monkeys.

    Science.gov (United States)

    Shooner, Christopher; Hallum, Luke E; Kumbhani, Romesh D; García-Marín, Virginia; Kelly, Jenna G; Majaj, Najib J; Movshon, J Anthony; Kiorpes, Lynne

    2017-09-06

    In amblyopia, abnormal visual experience leads to an extreme form of eye dominance, in which vision through the nondominant eye is degraded. A key aspect of this disorder is perceptual suppression: the image seen by the stronger eye often dominates during binocular viewing, blocking the image of the weaker eye from reaching awareness. Interocular suppression is the focus of ongoing work aimed at understanding and treating amblyopia, yet its physiological basis remains unknown. We measured binocular interactions in visual cortex of anesthetized amblyopic monkeys (female Macaca nemestrina ), using 96-channel "Utah" arrays to record from populations of neurons in V1 and V2. In an experiment reported recently (Hallum et al., 2017), we found that reduced excitatory input from the amblyopic eye (AE) revealed a form of balanced binocular suppression that is unaltered in amblyopia. Here, we report on the modulation of the gain of excitatory signals from the AE by signals from its dominant fellow eye (FE). Using a dichoptic masking technique, we found that AE responses to grating stimuli were attenuated by the presentation of a noise mask to the FE, as in a normal control animal. Responses to FE stimuli, by contrast, could not be masked from the AE. We conclude that a weakened ability of the amblyopic eye to modulate cortical response gain creates an imbalance of suppression that favors the dominant eye. SIGNIFICANCE STATEMENT In amblyopia, vision in one eye is impaired as a result of abnormal early visual experience. Behavioral observations in humans with amblyopia suggest that much of their visual loss is due to active suppression of their amblyopic eye. Here we describe experiments in which we studied binocular interactions in macaques with experimentally induced amblyopia. In normal monkeys, the gain of neuronal response to stimulation of one eye is modulated by contrast in the other eye, but in monkeys with amblyopia the balance of gain modulation is altered so that

  13. Prevalence of strabismus among pre-school children community in ...

    African Journals Online (AJOL)

    Background: Though strabismus is a common presenting ocular problem at outpatient clinics of ophthalmology its magnitude in Ethiopia is not known. Objective: To determine the magnitude and type of manifest strabismus and strabismic amblyopia among pre-school children. Methods: A cros-sectional study was ...

  14. Brief communication : Unilateral blindness and low vision due to ...

    African Journals Online (AJOL)

    1995-11-15

    To assess the magnitude of unilateral blindness or low vision caused by strabismic amblyopia in astrabismic population, a prospective study was conducted between November 15, 1995 and March 20, 1997 at Menelik II Hospital. The visual acuity of 361 patients with strabismus was evaluated. The average age of ...

  15. [Therapeutic schedule in ambliopia--experience of Eye Clinic Cluj].

    Science.gov (United States)

    Vladuţiu, Cristina; Sevan, Simona; Popoviciu, Sarmisa

    2009-01-01

    To establlsh a protocol for the treatment of amblyopia and the methods used to maintain the results (visual acuity). Fifty children with amblyopia were treated in the Pediatric Ophthalmology Department of the Ophthalmological Cllnic in Cluj. Full time occlusion was used in all children. Pleoptic methods (Haidinger procedure, anti crowding fenomenon exercices and visual attention exercices) were done in the amblyopic children. The study analyzed the correlation of the visual acuity and the type of amblyopia (strabismic, anysometropic), the age of the patients and the age at the initiation of the treatment, the compliance. The visual acuity was followed up by check outs every 4-6 months. The study concluded that the treatment of choice in amblyopia is the full time occlusion. The partial occlusion and the optical penalization is reserved for the maintenance of the result (visual acuity) until the children reach the age of 7-8, when the sensitive period of visual development ends. The compliance of the children and parents is important. The hospitalization and the pleoptics used in a amlyopic children collectivity improve the children cooperation and the therapeutical results.

  16. Journal of Biosciences | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Biosciences; Volume 33; Issue 2. Issue front cover thumbnail. Volume 33, Issue 2. June 2008, pages 157-307. pp 157-158. Clipboard: Recovery from amblyopia in adults via decreased visual cortical inhibition caused by experience in an enriched environment · Liisa A Tremere Raphael Pinaud.

  17. The prevalence and causes of bilateral and unilateral blindness in an elderly urban Danish population. The Copenhagen City Eye Study

    DEFF Research Database (Denmark)

    Buch, Helena; Vinding, T; La Cour, M

    2001-01-01

    of bilateral blindness, accounting for 60% of all blind persons. Glaucoma, myopic macular degeneration, cataract and retinitis pigmentosa were jointly the second most common cause, each accounting for 10% of all bilaterally blind persons. Diabetic retinopathy was not a cause of bilateral blindness. Amblyopia...

  18. Uveitis in Children: Diagnosis and Management.

    Science.gov (United States)

    Gupta, Anju; Ramanan, A V

    2016-01-01

    Uveitis is a term used to describe inflammation of uvea, which is the middle layer of eye. It is an important cause of blindness in children in both developed and developing countries. Delayed diagnosis, inadequate treatment and risk of amblyopia are some of the factors that are unique to childhood uveitis and are responsible for significant morbidity seen with this disease.

  19. THE SURGICAL MANAGEMENT OF PARETIC SQUINT

    African Journals Online (AJOL)

    which has been acquired in adult life. ... The adult, on the other hand, will have great difficulty ... or amblyopia with a constant manifest squint, is likely to ... treatment. Another precipitating cause is parturition, and, particu- larly where there have ...

  20. 75 FR 77942 - Qualification of Drivers; Exemption Applications; Vision

    Science.gov (United States)

    2010-12-14

    ... INFORMATION CONTACT: Dr. Mary D. Gunnels, Director, Medical Programs, (202) 366-4001, [email protected] crash, for which he was not cited and no convictions for moving violations in a CMV. Marcus L. Conner Mr. Conner, 52, has had amblyopia in his right eye since childhood. The best corrected visual acuity in his...

  1. 76 FR 73769 - Qualification of Drivers; Exemption Applications; Vision

    Science.gov (United States)

    2011-11-29

    ... moving violations in a CMV. Mark A. Ferris Mr. Ferris, 55, has had amblyopia in his left eye since... an examination in 2011, his optometrist noted, ``In my professional opinion, Mr. Ferris has more than sufficient vision to perform the driving tasks required to operate any commercial motor vehicle.'' Mr. Ferris...

  2. Glaucoma

    Medline Plus

    Full Text Available ... search for current job openings visit HHS USAJobs Home >> NEI YouTube Videos >> NEI YouTube Videos: Glaucoma Listen NEI YouTube Videos YouTube Videos Home Age-Related Macular Degeneration Amblyopia Animations Blindness Cataract ...

  3. Research

    African Journals Online (AJOL)

    abp

    23 sept. 2015 ... PubMed | Google Scholar. 6. Lithander J. Prevalence of amblyopia with anisometropia or strabismus among schoolchildren in the Sultanate of Oman,. 2003. Google Scholar. 7. Garvey KA et al. Revalence of strabismus among preschool, kindergarten, and first-grade Tohono O'odham children. Optometry.

  4. Glaucoma

    Medline Plus

    Full Text Available ... Glaucoma Listen NEI YouTube Videos YouTube Videos Home Age-Related Macular Degeneration Amblyopia Animations Blindness Cataract Convergence ... is maintained by the NEI Office of Science Communications, Public Liaison, and Education. Technical questions about this ...

  5. Gold Standard Tests

    Science.gov (United States)

    2001-06-01

    a slow release caffeine . NATO - RTA - Electroencephal Clin Neurophysiol 1997;103:554- AMP Meeting, 29 Sep-3Oct 1997, Rotterdam. 62. 22. Pieron H...I1 yellow Miscellaneous Strychnine + Cannabis indica + Tobacco LI, LII + (amblyopia) Sildenafil citrate + LI, III blue, blue- flashing lights

  6. Estimated Prevalence of Monocular Blindness and Monocular ...

    African Journals Online (AJOL)

    with MB/MSVI; among the 109 (51%) children with MB/MSVI that had a known etiology, trauma. Table 1: Major anatomical site of monocular blindness and monocular severe visual impairment in children. Anatomical cause. Total (%). Corneal scar. 89 (42). Whole globe. 43 (20). Lens. 42 (19). Amblyopia. 16 (8). Retina. 9 (4).

  7. A System for Controlled Presentation of the Arden Contrast Sensitivity Test.

    Science.gov (United States)

    1985-12-01

    and Woo,1978); I.?glaucoma (Atkin, et al,1979); amblyopia (Hess,1979); retinal degeneration (Woo and Long,1979); multiple sclerosis (Regan, et al...decrease, contrast sensitivity diminishes, and imaging L shifts to an area covering 12 -15 of the peripheral macula . The theoretical threshold grid

  8. Researchers Find Essential Brain Circuit in Visual Development

    Science.gov (United States)

    ... 2013 Researchers find essential brain circuit in visual development NIH-funded study could lead to new treatments for amblyopia. The cartoon at left shows the connections from the eyes to the brain in a mouse. The right image shows the binocular zone of the mouse ...

  9. Screening for suppression in young children: the Polaroid Suppression test

    NARCIS (Netherlands)

    Pott, J.W.R.; Oosterveen, DK; Van Hof-van Duin, J

    1998-01-01

    Background: Assessment of monocular visual impairment during screening of young children is often hampered by lack of cooperation. Because strabismus, amblyopia, or anisometropia may lead to monocular suppression during binocular viewing conditions, a test was developed to screen far suppression in

  10. Assessing Suppression in Amblyopic Children With a Dichoptic Eye Chart.

    Science.gov (United States)

    Birch, Eileen E; Morale, Sarah E; Jost, Reed M; De La Cruz, Angie; Kelly, Krista R; Wang, Yi-Zhong; Bex, Peter J

    2016-10-01

    Suppression has a key role in the etiology of amblyopia, and contrast-balanced binocular treatment can overcome suppression and improve visual acuity. Quantitative assessment of suppression could have a role in managing amblyopia. We describe a novel eye chart to assess suppression in children. We enrolled 100 children (7-12 years; 63 amblyopic, 25 nonamblyopic with strabismus or anisometropia, 12 controls) in the primary cohort and 22 children (3-6 years; 13 amblyopic, 9 nonamblyopic) in a secondary cohort. Letters were presented on a dichoptic display (5 letters per line). Children wore polarized glasses so that each eye saw a different letter chart. At each position, the identity of the letter and its contrast on each eye's chart differed. Children read 8 lines of letters for each of 3 letter sizes. The contrast balance ratio was the ratio at which 50% of letters seen by the amblyopic eye were reported. Amblyopic children had significantly higher contrast balance ratios for all letter sizes compared to nonamblyopic children and controls, requiring 4.6 to 5.6 times more contrast in the amblyopic eye compared to the fellow eye (P amblyopia treatment was correlated with change in contrast balance ratio (r ranged from 0.43-0.62 for the 3 letter sizes). Severity of suppression can be monitored as part of a routine clinical exam in the management of amblyopia in children.

  11. Costs and methods of preventive visual screening and the relation between esotropia and increasing hypermetropia

    NARCIS (Netherlands)

    H.J. Simonsz (Huib); B. Grosklauser; B. Leuppi

    1992-01-01

    textabstractAtkinson has shown that early correction of hypermetropia reduces the incidence of esotropia. If esotropia is reduced by prescribing glasses early, the rate of esotropia-induced amblyopia can be similarly reduced; this would have important economic consequences. We have studied (1) how

  12. Glaucoma

    Medline Plus

    Full Text Available ... Macular Degeneration Amblyopia Animations Blindness Cataract Convergence Insufficiency Diabetic Eye Disease Dilated Eye Exam Dry Eye For Kids Glaucoma Healthy Vision Tips Leber Congenital Amaurosis Low Vision Refractive Errors Retinopathy of Prematurity Science Spanish Videos Webinars NEI YouTube ...

  13. Comparison of the Effect of Cycloplegia on Astigmatism Measurements in a Pediatric Amblyopic Population: A Prospective Study.

    Science.gov (United States)

    Goyal, Sunali; Phillips, Paul H; Rettiganti, Mallikarjuna; Gossett, Jeffrey M; Lowery, R Scott

    2018-06-18

    To study the effect of cycloplegia on astigmatism measurements in pediatric patients with amblyopia. This was a prospective comparative clinical study. Participants 4 to 17 years old were recruited from the patient population at the Arkansas Children's Hospital eye clinic after informed consent was obtained. Autorefractor measurements were used to obtain values of refractive error in amblyopic and non-amblyopic patients before and after cycloplegia. The groups were subdivided into myopia and hyperopia and with and without underlying amblyopia. The refractive error was expressed as sphere, cylinder, axis of astigmatism, and spherical equivalent. The treatment effect was summarized as the mean difference (95% confidence interval) for each outcome. No statistically significant difference was found on the axis and power of astigmatism before and after cycloplegia in the patients with amblyopia (P = .28 and .99, respectively). Non-cycloplegic autorefraction measurements may be considered safe for refining astigmatism power and axis in pediatric patients with amblyopia. [J Pediatr Ophthalmol Strabismus. 201X; XX(X):XXXX.]. Copyright 2018, SLACK Incorporated.

  14. Straatsma syndrome: two case reports

    Directory of Open Access Journals (Sweden)

    Gabriela Nogueira

    Full Text Available Abstract This article reports two cases of Straatsma Syndrome, a rare disease, emphasizing its clinical features that inclued myopia, strabismus and amblyopia associated with persistent myelinated fibers in the retina. Ophthalmic examination, color retinography and optical coherence tomography were performed.

  15. Glaucoma

    Medline Plus

    Full Text Available ... search for current job openings visit HHS USAJobs Home » NEI YouTube Videos » NEI YouTube Videos: Glaucoma Listen NEI YouTube Videos YouTube Videos Home Age-Related Macular Degeneration Amblyopia Animations Blindness Cataract ...

  16. Interocular Shift of Visual Attention Enhances Stereopsis and Visual Acuities of Anisometropic Amblyopes beyond the Critical Period of Visual Development: A Novel Approach

    Directory of Open Access Journals (Sweden)

    Liwen Huang

    2014-01-01

    Full Text Available Aims. Increasing evidence shows that imbalanced suppressive drive prior to binocular combination may be the key factor in amblyopia. We described a novel binocular approach, interocular shift of visual attention (ISVA, for treatment of amblyopia in adult patients. Methods. Visual stimuli were presented anaglyphically on a computer screen. A square target resembling Landolt C had 2 openings, one in red and one in cyan color. Through blue-red goggles, each eye could only see one of the two openings. The patient was required to report the location of the opening presented to the amblyopic eye. It started at an opening size of 800 sec of arc, went up and down in 160 sec of arc step, and stopped when reaching the 5th reversals. Ten patients with anisometropic amblyopia older than age 14 (average age: 26.7 were recruited and received ISVA treatment for 6 weeks, with 2 training sessions per day. Results. Both Titmus stereopsis (z=-2.809, P=0.005 and Random-dot stereopsis (z=-2.317, P=0.018 were significantly improved. Average improvement in best corrected visual acuity (BCVA was 0.74 line (t=5.842, P<0.001. Conclusions. The ISVA treatment may be effective in treating amblyopia and restoring stereoscopic function.

  17. Marfan Syndrome

    Science.gov (United States)

    ... can treat many of its symptoms. Thanks to new research and treatments, people with Marfan syndrome who are diagnosed early ... This helps doctors stay on top of any new problems. Doctors might also ... or kids with amblyopia or strabismus will probably need to wear glasses. ...

  18. Use of ultrasonic dissection in the early surgical management of periorbital haemangiomas.

    Science.gov (United States)

    Claude, O; Picard, A; O'Sullivan, N; Baccache, S; Momtchilova, M; Enjolras, O; Vazquez, M P; Diner, P A

    2008-12-01

    To evaluate the efficacy and safety of the early surgical excision of periorbital haemangiomas with an ultrasonic scalpel in infants at risk of visual impairment. A retrospective analysis of 67 infants diagnosed to be at risk of amblyopia from periorbital haemangiomas, treated consecutively with the Dissectron between 1994 and 2005. Ophthalmic outcome parameters included the pre- and postoperative measurement of visual axis occlusion, strabismus, astigmatism, and degree of amblyopia. Visual performance showed an overall improvement of 30% following treatment. Seventy-six patients were found to have abnormal ophthalmic examinations preoperatively, compared to 46 following surgery. After surgery, visual axis occlusion decreased from 73 to 6%; amblyopia decreased from 67 to 22%, strabismus decreased from 26 to 18% and astigmatism (>onedioptre) decreased from 66 to 31%. Mean astigmatism values decreased from 3.5 to 1.9 dioptres. No new cases of astigmatism, strabismus or amblyopia were diagnosed postoperatively. Three minor complications resolved with conservative treatment. All patients were satisfied with the outcome of their surgery. Early surgical excision of periorbital haemangiomas using the Dissectron in infants with an established risk of visual impairment is a safe and effective alternative to pharmacological therapy. The use of the Dissectron is associated with reduced operative times and a shorter hospital stay.

  19. An Unusual Case of Unilateral Multifocal Choroiditis in a Young Male

    African Journals Online (AJOL)

    systemic illness or of any drug intake. Clinical findings ... amblyopia due to extreme exotropia was the reason of low visual acuity in the left ... author is credited and the new creations are licensed under the identical terms. For reprints contact: ...

  20. Understanding Your Vision: The "Imperfect Eye"

    Science.gov (United States)

    ... eye," amblyopia is the most common cause of visual impairment among children. The condition affects about two-to-three out ... the most common cause of monocular (one-eye) visual impairment among children and young and middle-aged adults. Helping kids ...