Treating Lazy Eye in Adults

It was long thought that treating amblyopia, the medical term for lazy-eye, after the "critical age" of 8-12 years old was not possible. Unfortunately, many optometrists and ophthalmologists still believe, refer to, and share this outdated view. Research, clinical trials, and well-documented patient cases, now show that amblyopia can be treated well into adult hood.

Brain Plasticity

In an excerpt from Stereopsis and amblyopia: A mini-review. Levi et al explain, "Brain plasticity is known to peak during a critical period in early childhood and to decrease thereafter (Bavelier et al., 2010; Movshon & Van Sluyters, 1981; Wiesel, 1982)." They go on to explain that this highlights the effectiveness of early intervention but the assumption that plasticity ends after a critical period has been detrimental to patient care.

Levi et al lament, "Amblyopic patients over the age of seven are often told that they will never be able to recover visual acuity or stereovision because their visual system is beyond the critical period for binocular vision. Young brains are certainly much more plastic than older ones, yet the last 15 years have shown that significant plasticity can still be induced beyond the critical period if appropriate input is provided." They share multiple references supporting this claim: Baroncelli, Maffei, & Sale, 2011; Bavelier et al., 2010; Hess, Thompson, & Baker, 2014; Levi, 2012; Levi & Li, 2009; Levi & Polat, 1996; Morishita & Hensch, 2008; Wong, 2012.

Though it can be more difficult to treat adults, there is evidence that improvements in acuity, depth perception, and vergence ability are all possible through vision therapy, eye surgery, and visual perceptual training. Amblyopia is treated through a combination of lenses and active vision therapy including virtual reality programs.

Stereo Sue

Dubbed “Stereo Sue” by neurologist Oliver Sacks in a New Yorker article by that name, Dr. Susan Barry is the author of the book Fixing My Gaze which describes her astonishing experience of gaining 3D stereovision after a lifetime of seeing in only two dimensions.

Fixing My Gaze book by Susan Barry

Dr. Barry was cross-eyed from early infancy and had three surgeries as a child that, according to her, "made my eyes look more or less straight." Dr. Barry did not develop stereovision until age 48 when she underwent optometric vision therapy under the guidance of a developmental optometrist. As a neurobiologist, Dr. Barry is in a unique position to tell her life story because she can, and does, give scientific explanations for why her eyes and brain could not produce 3-D images, and how she fixed that problem.

Vision Therapy for Adults with Lazy Eye

Recent Research

Recent research (Ziak at al) has shown improved visual acuity as well as improved stereo acuity at statistically significant levels in amblyopic patients aged 17-69 using virtual reality vision therapy technology. Another recent study (Ho et al, 2019) also showed improved visual acuity and stereo acuity in amblyopic and strabismic patients aged 3-69 using virtual reality vision therapy technology who were previously unsuccessful in traditional patching or occlusion therapy.

These studies are supported by another study by Vedamurthy et al where adult patients aged 19-56 with stereo-impairments (such as refractive amblyopia, alternating exotropia, and esotropia) trained weekly in a dichoptic virtual reality environment and the participants made measurable improvements in areas like visual acuity, reduced suppression, and stereo acuity. These studies all featured success using vision therapy activities in adult patient populations with varying diagnoses.

References

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