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Active Vision therapy for Amblyopia

Dr. Arun Verma

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Active Vision Therapy

Introduction

In all branches of medical science, there is now great emphasis not only on early diagnosis and treatment of all disorders and diseases but also on measures that aim at their prevention.

However, squint in children with its associated loss of normal binocular vision, and frequently with the loss of useful vision in one eye due to amblyopia (lazy eye) if early treatment is not undertaken, has till now been much neglected mainly because of an inadequate appreciation of simple principles relating to its investigations and treatment.

Doctors in general and the lay public in particular have been ignorant about the various grades of vision, e.g. Simultaneous perception, fusion and stereopsis and not much interest has been shown to understand the importance of binocular vision and depth perception.

This paper is designed to present a simple approach to the subject of binocular vision, like 3-D perceptions, squint, amblyopia and their understanding by the patients, parents and the general doctors.

Binocular single vision (BSV) is one of the most important features of the human race that has bestowed upon it the supremacy over the rest of the animal kingdom.

It is not without reason that about 60% of the brain tissue and more than half of the twelve cranial nerves serve the eyes.

This binocular single vision is accomplished by a perfect coordination of the two eyes both at rest and movement. The two ?dimensional images of an object of interest formed at the fovea of each eye is processed and perceived in the brain as one three dimensional (3-D) image. This requires constant and controlled activity of the appropriate eye muscles to maintain fixation of the two eye-cameras on the concerned object, irrespective of the movement between it and the observer. It also requires the accommodational or focusing mechanism to maintain clear view even as the object moves closer or farther.

The basic aims in the treatment and care of children with eye muscles problems and lazy eyes (amblyopia) are:

  1. Good vision in each eye.
  2. Eyes that appear cosmetically straight.
  3. Eyes that sees straight (Eyes that work together as a team).
  4. Stereopsis (3-D Vision) or depth perception.

The course of treatment includes the following singly or in combination:

  • Glasses
  • Eye drops or ointment
  • Patching
  • Surgery
  • Orthoptic training
  • Pleoptics and active vision therapy

Your eye surgeon will decide the best course of treatment suitable for your child. His orthoptist will try to educate or re-educate the two eyes to work together by breaking down the faulty visual habits and attempting to establish correct ones.

Our experience has been that the quality of results improves in direct proportion to the effort put into the orthoptic training and active vision therapy. My attitude towards the value of these visual training methods has been influenced by the efforts of my team and the children themselves who come to us for treatment.

The significance of this new field to the parents and to the child specialist is that the vision of the child with or without squint can usually be improved if treatment is begun at a very early age.

In eye practice, the most common problems are related to problems of binocular vision and ocular motility. According to reliable estimates, about 2% of the children of our country have crossed eyes. The majority of them, it is hoped are receiving treatment of one kind or the other.

The parents of the child with crossed eyes are naturally upset and worried over their child and many questions about the problem arise in their minds. The successful treatment of squint and amblyopia demands the closest cooperation between the parents and the eye surgeon. Often the eye surgeon is so busy that he does not have the time to explain the condition properly to the parents. Frequently the parents cannot fully understand such an explanation if it is given in its entirety at a single visit to the doctor’s office. The bite would be too big to chew.

Doctors in other branches of medicine other than that of the diseases of the eyes have little reason to learn about crossed eyes in any great detail. They are too busy keeping up with the advances of science in their own particular fields of interest and hence may find information of interest in these pages -information which may enable them to give sound advice on the subject when consulted by the parents of the child with crossed eyes.

This paper is written primarily for the parents, however. It is hoped that it will answer the majority of their questions- questions that they are sure to have. As a result, they can better cooperate with their eye surgeon in his treatment of their child. There are few conditions in the field of medicine that demand greater cooperation between parents and physician than the care of the child with crossed eyes with or without the presence of amblyopia (Lazy eyes). If the results of the treatment in but a single case can be improved upon, then this would not have been written in vain.



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