Vision Therapy and Lazy Eye Treatment

Susan Barry Tedx Talk 2012
https://flic.kr/p/bgj2Da

Here’s a post I made on the Vision Therapy Parents Unite Facebook group answering a parents question about whether vision therapy could help even thought a previous eye doctor had told them “nothing more could be done” to treat her son’s amblyopia (lazy eye). I think it may be of interest to others also.

Amblyopia can create some significant difficulties with high level 3D vision, fine depth perception, and detailed visually guided hand and body movements. This might put someone at a relative disadvantage to their peers in tasks which benefit from detailed hand movements guided by fine 3D vision.

However, visual perception and visual-motor skills involve much more than just 3D/stereo vision, and individuals are often very good at compensating for areas of weakness with other skills. For example, amblyopia reduces the ability to visually perceive empty pockets of space directly, flattening the perception of depth more towards a flat plane. However, individuals can use other visual cues to compensate and perceive the space indirectly. So we don’t see an increased rate of car accidents in people with amblyopia, even though they are at a “relative disadvantage” to their peers.

Vision therapy would definitely be reasonable to try again and I would put it high on my list of things to consider. We know from many case reports like Professor Susan Barry’s as well as others in the basic vision science and optometric literature that vision therapy can be a very powerful tool to help establish or strengthen stereo/3D vision as well as other visual skills. It is sometimes able to accomplish things that other treatments cannot.

The idea (still commonly taught in some neuroscience classes and medical schools) that amblyopia cannot be improved past the “critical period” ending around 8 years old because the brain didn’t develop the proper wiring to see in 3D now has very strong evidence showing it to be incorrect.

However, just as no surgery works every time and no surgeon can guarantee their surgery will make things better every time, you must realize that vision therapy isn’t magical either and can’t give perfect 3D vision to every patient every time. Sometimes I succeed wonderfully with my patients and other times nothing seems to help. I have yet to find a foolproof way to always predict what will happen, and sometimes my patients and I just have to take a risk and try. Best of luck to you!