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Is Amblyopia Treatment Even Possible In Adult Patients?

We take inquiries from across the nation and even around the globe about adults getting amblyopia treatment. We always hear the same question: Have I gotten too old for lazy eye treatment? We always answer the same way every time: Individuals of any age can get treatment for their amblyopia.

Why does so much confusion revolve around this issue? Two reasons are actually in play here:

First is it possible for lazy eye, formally known as amblyopia, to be treated in the first place? Second, does treatment have an age cut-off? In order to provide answers to both questions, the condition of lazy eye or amblyopia must be defined.

Amblyopia is a situation in which one or even both eyes have a visual acuity that is less than would be expected when prescription lenses are used. The nickname of lazy eye comes from the thought that one eye with better vision would do the majority of the work of seeing things.

Lazy Eye: Two Eyes That Don’t Get Along

Many folks actually confuse lazy eye with the condition of strabismus, which is any kind of eye turn or ‘crossed eyes’. That’s not something they should do, because the conditions are distinct from one another and can exist either with or even without each other.

The primary issue here is that one simply isn’t seeing with clarity. Why is this? Given the high levels of astigmatism, constant eye turn, farsightedness, and nearsightedness, the human brain learns how to suppress or even turn off information from an impacted eye, and that suppression has a negative impact on developing clear vision.

Most of the time, the brain gets a pair of images from slightly varying angles which it combines into a three-dimensional image. This isn’t what happens in the event of amblyopia.

What Does Happen When Binocular Vision Isn’t Working Right?

In the case of amblyopia, the brain winds up suppressing one of the two images to the detriment of the binocular vision of a person. That individual could have numerous problems with their functional vision, like poor eye tracking or substandard depth perception.

Is It Possible To Treat Amblyopia At All?

Amblyopia is treatable given the plasticity of the brain. The brain’s circuitry is something that can change in any decade of life. We apply vision therapy in retraining the patient’s visual system. That includes not only their eyes, but even their brain and visual pathways.

The College of Optometrists in Vision Development has a website with a page covering the treatment of amblyopia, including the following:

-Contact lenses or eyeglasses, as the appropriate lenses can mean reducing stress so that an under-utilized eye might start working with increased efficiency

-Using eye drops, an eye patch, or special lenses to fog or block the favored eye, making the weaker eye work better or harder

-The restoration of single and clear vision, improvement of eye coordination, and visual equilibrium in both eyes through a program of specific vision therapy

Brain Plasticity Does Decrease And That Has Impact

It’s well-established that vision therapy is more effective when it gets administered in the earlier stages of life. As a patient ages, the plasticity of their brain generally starts to decline.

The visual system of a person adapts so they’re able to function, despite any present visual limitations. Dr. Susan Barry certain is one notable instance of this. A neurobiologist, she found ways to succeed in her own life, even in spite of her own vision issues.

Many adult patients have been able to adapt and then even persevere, despite having vision complications. That’s not to say it’s easy. For example, some students might make it to college with good grades but need twice as many study hours.

Adult Treatment For Amblyopia

The confusion over amblyopia treatment in adults might be relative to Harvard Medical School research which oversaw amblyopia treatment in cats. Researchers held the belief that cats couldn’t recover their stereovision since they had lived past the age range of 2 to 8 years old, which is the critical period of their vision development. It’s now known that the critical period ending does mean that amblyopia treatment is more difficult, yet not impossible.

So, things circle back to the central question: Are adults able to get amblyopia treatment? Certainly. The upside is that adults diagnosed with amblyopia can possibly get enhanced vision. However, no guarantees exist. Each patient and case is distinct, and all patients need thorough evaluation using a Functional Vision Test.

On the other hand, we strongly advise you to consult a developmental optometrist in order to see if treatment is even possible for your situation. Consult The Vision Therapy Center if you are a resident of Wisconsin.

To learn more about amblyopia treatment, please call us today at (919) 977-7480. Dr. Bassiri and the Fusion Eye Care team look forward to ensuring you get help with your amblyopia.

Determining The Dominant Eye

Perhaps you recall hearing about “ocular dominance” or a person’s “dominant eye,” but remain uncertain about what these terms really mean. It could be that you are interested in performing a test to determine your own dominant eye. If so, the paragraphs that follow can fill in the gaps.

What Is The Dominant Eye?

The dominant eye is simply that which sends a slightly better quality of information to the visual processing portion of the brain and transmits details of the true location of discrete objects with greater accuracy.

Generally speaking, this terminology is employed when discussing the typical visual function in which both eyes function properly and in tandem, rendering essentially the same visual acuity, but where one of the eyes takes the role of “preferred” or “leading” eye.

In other instances, however, “dominant eye” is a term utilized in reference to the properly working eye of patients with strabismus and amblyopia.

Testing For The Dominant Eye

There is a straightforward test that can be used to ascertain which is the dominant eye:

  1. First, extend the arms outward, producing a triangular shape between the forefingers and thumbs. The hands simply need to be placed together at an angle of 45 degrees.
  1. Keeping both eyes in an open position, center the triangle on an object that is some distance away. This could be a door handle or perhaps a clock on the wall.
  1. Shut the left eye fully.
  1. If the chosen object remains centered, the open right eye can be declared the dominant eye. However, if the object no longer remains within the triangle created with the hands, the left eye is dominant.

An alternative test for the dominant eye is as follows:

  1. Extend one of the arms outward, keeping the thumb on the extended hand upright. It is also possible to use that hand’s index finger.
  1. With both eyes still open and intentionally focusing on an object in the distance, the thumb should be superimposed onto it. If the thumb seems to partially disappear, this is okay.
  1. Close only one of the eyes at a time.
  1. The dominant eye is the one in which the thumb appears to remain directly in front of the chosen object during the period the other eye stays closed.

Each of these testing procedures represents a “sighting” test, as they both require the subject to align a makeshift device with a visual target. This is akin to the sight of a rifle.

There has been research to suggest that these types of dominant eye tests are essentially accurate and simple to conduct, but can be impacted by non-visual circumstances and handedness.

In order to mitigate the effects of such factors, some believe that non-sighting tests are more effective in determining ocular dominance and are therefore preferable.

These tests require the subject to keep both right and left eyes open. Visual stimuli will then be put before each of the eyes in turn, utilizing specialized devices for that purpose. The use of such tools is indicative of the natural limitations of non-sighting types of tests. Equipment of this type tends to be available mainly in clinical or research settings.

Ultimately, however, simplified eye tests such as those initially described are sufficient to determine which is the dominant eye.