New studies show that Amblyopia or Lazy Eye Can be Successfully Treated in Older Children and Adults

There is still a general belief amongst ophthalmic professionals that amblyopia or Lazy Eye can be treated only up to a certain age, usually below 10-12 years and works only when treated at such young ages.

New scientific research contradicts popular beliefs and typical medical practice regarding age limits for the successful treatment of lazy eye. These doctors and their staff continue to offer outdated treatment programs to patients, rather than providing the newly proven treatment programs which give the best outcomes.

Eye patching or atropine drops and/or corrective lenses continue to be the most popular cure, but supervised visual training activities, known as Vision Therapy are not widely available or frequently recommended.

Did You Know Most Vision Takes Place in the Brain?

The eye takes the picture of what we see. Our brain helps us decode what it is.Vison is a three-step process involving (1) the eye, which captures the image, (2) the visual pathway within the brain (which delivers the image from the eye to the brain) and (3) the visual cortex (which interprets or gives meaning to the images).

Children and adults with 20/20 vision can experience symptoms such as visual fatigue, headaches, or difficulty with visual tasks because of disturbances along the neuropathways of the vision system within the brain. These patients experience struggles in school or the inability to enjoy regular activities.

What is Lazy Eye?

As the name suggests, a “lazy eye” is one that does not take part fully in the seeing process, or sees ‘less’ than normal. Bodily, a person with a lazy eye, looks the same as anyone else, as in there is no physical deformity. The vision or sight in the affected eye is less than what a normal eye sees, but not due to any pathological cause, but is more functional. The images the lazy eye sends to the brain are ignored (suppressed). As a result, only the better eye is used for sight by the brain. If not treated, vision can stay impaired.

There are a number of reasons why an eye might shut down, all of which involve an imbalance in performance between the eyes. Here are some of the reasons:

• Constant eye turn (strabismus) in one eye
• High prescription (blurry vision) in one eye
• Reduced vision in one eye from trauma, lid droop or cataract

In all of these cases, the brain uses the two eyes very differently. Early in vision development, the brain compensates for the imbalance by shutting down the weaker eye, resulting in a single, clear image in the other eye.

The basic treatment of lazy eye is to encourage its use whenever possible. Corrective eyeglasses or contact lenses can stimulate or push the eye to see well. Occlusion of the better fellow eye with either patching or blurring eye drops (atropine) can also force the use of the lazy eye. In addition, doing near visual activities with the occlusion, such as reading, using a computer, and playing video games, will stimulate greater use of the lazy eye. All of these approaches are currently in practice.

Vision therapy or visual training exercises support the development of improved vision in patients with lazy eye. They stimulate the eye-brain connection and force the lazy eye to take a more active part in seeing.

Concept of Vision Rehabilitation

Neuroplasticity has been shown to be active in many regions of the brain. The brain is not static. It consists of a dynamic system of neural networks that have the capacity of significant growth following repeated stimulation. For example, it is possible that new synapses can be created to counter a deficit acquired within the visual field

Eye Patching or Atropine Drops Are Often Not Enough

While occlusion (eye patching) or atropine may enhance visual acuity in the amblyopic eye, these techniques do not enhance the patient’s ability to use the two eyes together (binocular vision). If the patient does not learn to combine input from the lazy eye and the fellow eye simultaneously, then the beneficial effects of eye patching may be lost. This may explain why 25% of patients, who are successfully treated with eye patching, experience a regression in vision after the patching treatment has ended.

Treatment with Eye Muscle Exercises or Orthoptics Are Not Enough

Eye muscle exercises called orthoptics are employed with or without eye patching to fix a lazy eye. Orthoptists practice eye muscle exercises (convergence, etc.) but this remains limited in its scope as it almost exclusively focuses on eye muscles only (convergence) and excludes the relation with the human brain (neuroplasticity). Lazy Eye or amblyopia is a neurological condition, so treatments that address the eye muscles only is not effective.

Vision Therapy Treats Both Eyes and the Entire Visual System

Vision therapy provides additional treatments for all aspects of vision impacted by amblyopia. With vision therapy, the patient engages in visual activities which require the simultaneous use of both the lazy eye and unaffected eye at all distances (near, middle and far range). Through a series of steps, vision therapy retrains the brain to use both eyes together, showing a way to allow the adult brain to rewire itself and form new connections.

Vision Therapy is Physiotherapy for the Lazy Eye

It has long been accepted that our ability to move and coordinate can be enhanced with training and practice. No one would question the benefits of physical therapy for a patient who has sustained a leg injury. However, for most of the last century, therapy for a lazy eye has been discouraged because it was thought that improvements in vision could not be made past the “critical period.” Recent studies show that we have the ability to change, enhance, and develop many perceptual and visual skills throughout life. Optometric vision therapy is effective in treating people with amblyopia AT ALL AGES.

No one should be denied treatment simply on the basis of age.

At Shroff Eye Vision Therapy Clinic

After regular use of the Vision Rehabilitation Program over a six month period, patients have reported an improvement in their sight

Vision Therapy sessions develop efficient visual-motor and visual perceptive-cognitive processing skills. Initial sessions focus on enhancing the brain’s ability to control many functions of the eye including eye alignment, eye teaming ability and coordination, focusing, movement accuracy as well as visual speed and integration. Then, the program develops visual-motor skills and endurance through the use of specialized computer and optical devices, including therapeutic lenses, prisms, and filters. During the final stages of therapy, patient’s newly acquired visual skills are reinforced and automated through repetition and integration with their motor and cognitive skills

References:

Neurobiologist Susan R. Barry, Ph.D. and Rachel Cooper, Adult Patient Who Overcame Lazy Eye with Therapy