Amblyopia Research Supports Treatment Without Patching
New amblyopia research shows that treatment using both eyes is better than patching alone!
For ages, the majority of amblyopia research and treatment has focused on two areas: the use of glasses to provide the clearest vision possible and the use of an eye patch to force the amblyopic (weaker) eye to see. Patching sometimes worked, however, when it failed no other options were available.
The problem in patching is twofold:
1) Patching is very negative for self-esteem! (It can be like a form of torture for some patients.) It is understandable when you image covering up your good eye and seeing everything blurry for hours on end. You are forced to use an eye that you are not comfortable using, without having any idea how to intentionally move or change focus in that eye. You are just supposed to figure it out. Patients resist patching, avoid visually demanding activities, get frustrated more easily, and often “cheat” or “peek” from behind their patch.
As the American Optometric Association’s Amblyopia Patient Care Guideline says, “Noncompliance with occlusion represents a significant factor in occlusion failures, especially in patients over 8 years of age in whom up to 50 percent noncompliance is common.”
2) Patching alone does not solve the underlying problem. Amblyopia is a brain problem and is not a situation where one eye is normal and the other is lazy. Amblyopia is a situation where one eye is struggling to focus clearly or stay pointed in the right direction, and the other eye is overpowering like a bully. Yes, literally. The bully eye steals the brain connections from the weaker eye and uses them for itself. So while patching helps the weaker eye reinforce brain connections and see more clearly, it does not teach the bully eye to be nice.
The same happens with binocular vision (using both eyes). Patients who only use patching, often find the amblyopia returns when the patching stops, because they never learned to use both eyes together. It’s easy for the eyes to slip back into old (bad) habits resulting in more patching over and over. At some point, it would seem easier to just give up and accept less than ideal vision.
The good news is the amblyopia Tetris study has showed that amblyopic treatment not with patching, but by treating both eyes (binocular), it improved.
I am happy to report that there has been a recent spate of studies concerning the binocular treatment of amblyopia. Vision therapy Optometrists have believed for years that amblyopia was primarily a binocular problem, and therefore require binocular treatment solutions. We have clinically observed 1) faster treatment of amblyopia with binocular vision therapy and 2) less regression of eyesight and 3) happier patients. We are excited to see excellent new research that supports this view, mostly done by ophthalmologists and neuroscientists.
If you would like to make an appointment to have yourself or child evaluated call Nova Vision Care at 937-320-0300 or visit our website www.novavisioncare.com.
Some links to some of the research are below
http://www.sciencedirect.com/science/article/pii/S1350946212000754
http://onlinelibrary.wiley.com/doi/10.1111/opo.12123/pdf
https://www.hindawi.com/journals/joph/2014/615213/