Adult Amblyopia Treatment
Treatment options for adults with amblyopia isn’t magic. It is real and based on science. For decades there has been a belief among eye doctors that if a patient had amblyopia (AKA “lazy eye”), it was untreatable after childhood. Whether the cut-off age was 6 years old, 8 years old, or 10 years old, it was assumed that after that age, it was pointless to try to improve the vision in the “lazy” eye. It was thought that even if the vision did improve, it would just worsen again after treatment stopped.
Amblyopia is a condition in which vision is reduced in one or both eyes even with glasses on. By definition, it is not caused by disease or injury, but instead develops when the brain does not get enough visual stimulation to use both eyes together. This could be due to blurry vision for a number of reasons or misaligned eyes. Catching amblyopia early is helpful and that is one of the reason that InfantSEE exists.
For many years, the only treatment for amblyopia was occlusion therapy, where a patch is worn over the eye with better vision to force the eye with poorer vision to work. Even if you don’t have a family member who needed to wear an eye patch, you probably are familiar with the concept in popular culture. Patching can be effective if done correctly. But it is hard work and takes motivation. (See the post on #IPatch the social media support of amblyopia patients who are patching right now.)
As I have been posting over the years, there has been significant scientific evidence that shows that despite what was once thought, it isn’t just young children that can be treated but also older children and adults. At the bottom of this post is a quick summary of some of the research on improvement of vision in adults with amblyopia:
And it is not just in the vision science laboratory that we notice improvement in adults with amblyopia. One recent patient of ours is a 35 year old woman with refractive amblyopia due to her farsightedness in her left eye. The best she was able to see was about 20/70 in that eye. Following a few months of treatment, she was able to see about 20/30, a significant improvement. She was so happy with her rapid progress, she said. “At my age, I thought all hopes of better vision were gone but after my vision therapy treatment I have seen a significant improvement in my vision!”
One adult patient with amblyopia said, “At my age, I thought all hopes of better vision were gone but after my vision therapy treatment I have seen a significant improvement in my vision!”
Why, despite the research and success in the therapy room, does the belief that “nothing can be done” after a certain age persist? Susan Barry, PhD (AKA Stereo Sue) does a great job of answering that here, but the simple answer is that change takes time and doctors are very slow to change such a prominent belief as this.
Treatment for adult amblyopia is complicated and does take effort on the part of the doctor and patient. Treatment may involve traditional occlusion (patching) with visually stimulating activities, but could also include the use of special glasses or contact lenses and more modern techniques that involve the use of both eyes together (known as MFBF) and also the Virtual Reality based Vivid Vision system.
That being said, treatment for amblyopia is difficult and there may be significant reasons to NOT attempt treatment. It may take longer than in young children and the overall goals might be different. A thorough evaluation by a doctor with experience with adult amblyopia patients is critical. You can search for a doctor in your area with both COVD and OEPF websites.
If you have questions about adult amblyopia treatment, you can call us at (813) 792-0637, or enter a message at the bottom of the page.
Bright Eyes Family Vision Care in Westchase and Bright Eyes Kids in New Tampa
Vision scientists don’t always write in terms that patients can understand. But I thought it was interesting to see what researchers say in their own words when they publish scientific papers on treatment of adult amblyopia. Enjoy.
- “Two adult patients are presented whose childhood amblyopia improved markedly.” (Willson, 1992)
- “perceptual learning can improve basic representations within an adult visual system that did not develop during the critical period” (Polat, 2003)
- “adult amblyopic visual system retains a substantial degree of plasticity: repetitive practice can substantially improve position discrimination acuity.” (Li, 2004)
- “adults with amblyopia can improve their perceptual performance…” (Levi, 2005) ” clearly show the success of the structured method, targeted at the specific deficiencies in amblyopia, to improve vision in children and adults.” (Polat, 2008)
- “These results show that the mature amblyopic brain is surprisingly malleable, and point to more intensive treatment methods for amblyopia.” (Li, 2008)
- “that this approach puts in place the necessary neural precursors required to fully recover stereo acuity in adult amblyopic subjects.” (Astle, 2011) “This provides a basis for the treatment of amblyopia in adults who currently have no treatment options.” (Jinrong, 2013)
- “The home-based dichoptic iPod approach represents a viable treatment for adults with amblyopia. (Hess, 2014)
- “perceptual learning of various visual discrimination tasks in adults with amblyopia can transfer completely...” (Zhang, 2014)
- “new treatments are emerging that directly target suppressive interactions within the visual cortex and, on the basis of initial data, appear to improve both binocular and monocular visual function, even in adults with amblyopia” (Hess, 2014)