Looking beyond occlusion: A novel perspective for amblyopia treatment

Gopal, KS Santhan; Jayadev, Chaitra; Thomas, Sumi; Gopal, Sugandhi

doi:10.4103/ijo.ijo_741_20

Cited by 5 publications

(8 citation statements)

References 17 publications

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“…One of the most common causes is compliance but multiple reasons have been suggested in the literature. [ 2 3 4 5 6 ] We selected all the children who had already tried occlusion and either did not have any improvement or had only a single line improvement over a period of 6 months despite regularly patching for 6 h per day. [ 12 ]…”

Section: Discussionmentioning

confidence: 99%

“…Although occlusion has been the gold standard of treating amblyopia, various options are now tried in children apart from occlusion. [ 1 3 9 13 ] The occlu-tab uses white-screen technology to present the target images selectively to the amblyopic eye under binocular conditions through polarizing glasses. [ 9 ] It has been successfully used in the treatment of amblyopia and has shown better adherence time than patching.…”

Section: Discussionmentioning

confidence: 99%

“…suggested that covert and overt attention increases the lateral occipital activity. [ 3 14 ] When the child plays the games using the amblyopic eye, the overt attention mechanism is stimulated, and on doing the requisite task, the alternate covert mechanism is initiated. [ 3 13 14 ] This would increase the top to down impulses from the posterior parietal cortex to the V1 area in the occipital cortex.…”

Section: Discussionmentioning

confidence: 99%

“…[ 3 14 ] When the child plays the games using the amblyopic eye, the overt attention mechanism is stimulated, and on doing the requisite task, the alternate covert mechanism is initiated. [ 3 13 14 ] This would increase the top to down impulses from the posterior parietal cortex to the V1 area in the occipital cortex. [ 3 13 ] Using this device as a supplemental measure ensures better outcomes even in cases which are not responding to occlusion therapy in anisometropic amblyopia.…”

Section: Discussionmentioning

confidence: 99%

“…Most of the visual loss due to amblyopia is reversible if is timely detected and appropriately managed. [ 1 2 3 4 5 6 ]…”

mentioning

confidence: 99%

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Efficacy of supplemental Occlu-pad therapy with partial occlusion in children with refractive anisometropic amblyopia

Jethani

Kamat²,

Shah³

et al. 2022

Indian Journal of Ophthalmology

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Purpose: To study the efficacy of supplemental occlu-pad therapy with partial occlusion in children with refractive anisometropic amblyopia. Methods: Thirty-one children who did not improve after partial occlusion of 6 h for 6 months were supplemented with the use of occlu-pad for 1 h per day and three such sessions in a week. Results: The mean age was 6.8+/-1.4 years (range 5–9 years). A significant improvement of 3.2+/-1.3 lines in visual acuity was noticed at the end of 3 months of starting this supplemental therapy in children. Out of 31 children, 26 children improved at least 2 lines or more at the end of 3 months. All children ( n = 9) having anisohyperopic amblyopia improved at the end of 3 months Conclusion: Occlu-pad is useful in supplementing occlusion therapy in cases of refractive amblyopia and is more effective in anisohyperopic amblyopia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Most of the visual loss due to amblyopia is reversible if is timely detected and appropriately managed. [ 1 2 3 4 5 6 ]…”

mentioning

confidence: 99%

See 3 more Smart Citations

Efficacy of supplemental Occlu-pad therapy with partial occlusion in children with refractive anisometropic amblyopia

Jethani

Kamat²,

Shah³

et al. 2022

Indian Journal of Ophthalmology

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Comitant strabismus etiology: extraocular muscle integrity and central nervous system involvement—a narrative review

Sunyer-Grau

Quevedo

Rodríguez‐Vallejo³

et al. 2023

Graefes Arch Clin Exp Ophthalmol

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Strabismus is not a condition in itself but the consequence of an underlying problem. Eye misalignment can be caused by disease, injury, and/or abnormalities in any of the structures and processes involved in visual perception and oculomotor control, from the extraocular muscles and their innervations to the oculomotor and visual processing areas in the brain. A small percentage of all strabismus cases are the consequence of well-described genetic syndromes, acquired insult, or disease affecting the extraocular muscles (EOMs) or their innervations. We will refer to them as strabismus of peripheral origin since their etiology lies in the peripheral nervous system. However, in most strabismus cases, that is comitant, non-restrictive, non-paralytic strabismus, the EOMs and their innervations function properly. These cases are not related to specific syndromes and their precise causes remain poorly understood. They are generally believed to be caused by deficits in the central neural pathways involved in visual perception and oculomotor control. Therefore, we will refer to them as central strabismus. The goal of this narrative review is to discuss the possible causes behind this particular type of eye misalignment and to raise awareness among eyecare professionals about the important role the central nervous system plays in strabismus etiology, and the subsequent implications regarding its treatment. A non-systematic search was conducted using PubMed, Medline, Cochrane, and Google Scholar databases with the keywords “origins,” “causes,” and “etiology” combined with “strabismus.” A snowball approach was also used to find relevant references. In the following article, we will first describe EOM integrity in central strabismus; next, we will address numerous reasons that support the idea of central nervous system (CNS) involvement in the origin of the deviation, followed by listing several possible central causes of the ocular misalignment. Finally, we will discuss the implications CNS etiology has on strabismus treatment.

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Effects of anisometropic amblyopia on visual cognitive functions in children

Mao,

Liu,

Yin

et al. 2024

Clinical Exper Ophthalmology

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BackgroundTo investigate visual cognitive functions, including visual attention, executive function, and visual working memory, in children with anisometropic amblyopia versus those with normal vision.MethodsThirty‐five children with anisometropic amblyopia and 34 with normal vision participated. Visual acuity, stereoacuity, and contrast sensitivity were measured, followed by the Cambridge Neuropsychological Test Automated Battery's six subtests for cognitive evaluation. Visual attention was assessed using reaction time (RTI) and rapid visual information processing (RVP). Executive function was evaluated through the multitasking test (MTT). Visual working memory was assessed with spatial working memory (SWM), delayed matching to sample (DMS), and paired association learning (PAL), all under binocular conditions.ResultsThe amblyopia group exhibited longer reaction and movement times in the RTI than the control group (p < 0.01). A trend towards lower RVP A' scores, reflecting reduced ability to detect target sequences, appeared in the amblyopia group (p = 0.056). Amblyopic children demonstrated a lower multitasking cost in the MTT compared with the control group (p = 0.04). As difficulty increased in the SWM (from four to six boxes), amblyopic children revisited more (p = 0.01). In the DMS task, while no differences were observed across all delay times (p = 0.55), amblyopic children performed significantly worse than the control group under the 12‐second delay (p = 0.04). In the eight‐pattern PAL condition, the amblyopia group made more errors (p = 0.01).ConclusionsChildren with anisometropic amblyopia performed poorly on neuropsychological tests, particularly visual attention and working memory, but outperformed the control group in multitasking. These findings highlight the broader cognitive impacts of anisometropic amblyopia beyond vision.

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Looking beyond occlusion: A novel perspective for amblyopia treatment

Cited by 5 publications

References 17 publications

Efficacy of supplemental Occlu-pad therapy with partial occlusion in children with refractive anisometropic amblyopia

Efficacy of supplemental Occlu-pad therapy with partial occlusion in children with refractive anisometropic amblyopia

Comitant strabismus etiology: extraocular muscle integrity and central nervous system involvement—a narrative review

Effects of anisometropic amblyopia on visual cognitive functions in children

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