An Exploratory Study: Prolonged Periods of Binocular Stimulation Can Provide an Effective Treatment for Childhood Amblyopia

Abstract

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.

A binocular iPad treatment for amblyopic children

“…Using the same method to assess severity of suppression, several laboratory studies reported a significant reduction in suppression in adults after repeated binocular game play and that the change in severity was correlated with the change in visual acuity. [6][7][8][9][10][11] On the other hand, Knox et al 12 reported results similar to the present study; there was no significant reduction in suppression with binocular treatment of amblyopic schoolchildren, and, although 50% of children had some reduction in severity of suppression, there was no significant correlation with visual acuity improvement. The discrepancies between adults and children may reflect the difficulty that children encounter in making global motion coherence judgments used to quantify severity of suppression, which may have introduced more variability for children than adults.…”

“…The laboratory-based studies have reported that 50-60% achieved improved stereoacuity. [6][7][8][9][10][11][12] This difference may, in part, be due to the different stereoacuity tests employed, including some with monocular cues. [17][18][19] That monocular cues may underlie artifactual stereoacuity results is underscored by reports in some of the papers in which patients with tropias of 4-20 deg (8-40 pd) achieved stereoacuity of 20-500 arcsec.…”

“…For binocular games, fellow-eye contrast was set to 15-20% with amblyopic eye contrast 100% to allow the child to experience binocular vision. 8,9,11,12 For the sham games, anaglyphic glasses were reversed so that amblyopic eye contrast was reduced, making it impossible for the child to experience binocular vision during game play. As the child demonstrated that they did experience binocular vision (by achieving a criterion game score), the lower contrast was gradually (5-10%) incremented day by day.…”

“…As the child demonstrated that they did experience binocular vision (by achieving a criterion game score), the lower contrast was gradually (5-10%) incremented day by day. The Tetris game, which was used in four previous amblyopic treatment pilot studies, 8,9,11,12 had highcontrast falling blocks and low-contrast stationary base blocks that had to be fit together to form continuous rows of blocks. In the Balloon game, a balloon launcher was aimed to place at least three balloons of identical shape adjacent to each other, so that they 'pop' and disappear.…”

“…Under investigator supervision, a total of 37 adults and 14 school-age amblyopic participants in six studies practised binocular tasks for 1-4 weeks using a haploscope, video goggles, or an iPod with a lenticular overlay to separate the monocular images. [6][7][8][9][10][11][12] As binocular function improved with training, visual acuity also improved, usually by an average of 0.2 logMAR but ranging from 0.0 to 0.9 logMAR improvement. The preliminary studies support the hypothesis that a binocular approach to treatment of amblyopia can be efficacious.…”