This post was written by Dr. Robin Price. Dr. Price practices in Pleasant Grove, Utah. He is a member of the Board of Directors of the College of Optometrists in Vision Development (COVD).
Yes, Nicholas, there is hope for a lazy eye!
A few years ago Dr. Susan Barry, author of the book “Fixing My Gaze: A Scientist’s Journey into Seeing in Three Dimensions,” wrote of the danger of false hopelessness.
“False hopelessness is just as bad as false hope. When a person in authority tells you that something is impossible, then you are set up to fail,” she wrote. Dr. Barry speaks of the damage that can be done when doctors sometimes tell patients that there is no remedy, there is no cure, or there is no hope.
Nick was just such a patient. He had been diagnosed with amblyopia at age 6. Amblyopia is the medical term used when the vision in one of the eyes is reduced because the eye and the brain are not working together properly. The eye itself looks normal, but it is not being used normally because the brain is favoring the other eye. This condition is also sometimes called lazy eye. Nick had been patching one eye off and on for two years. His visual acuity would improve somewhat, they would reduce or stop patching, then his visual acuity in the amblyopic eye would regress. His doctor would have them re-commence patching, only to have the same result over and over again. In addition, he was never able to appreciate stereovision, or 3-D vision. His brain would suppress, or ignore, the image from one eye, leaving the world two-dimensional to him. After two years of this patching-only regimen, his eye doctor told him that nothing more could be done. He also told him that he would never be able to do things like fly a plane that required good visual acuity and binocular vision. Not only did Nick feel that he failed at making his amblyopic eye better, but now someone had also taken away his dream of being a pilot.
Fortunately for Nick, his parents did not give up. They researched various treatments for amblyopia, and found studies by the National Eye Institute showing that amblyopia could be treated successfully beyond age 8, even into adulthood. They found that research was being done comparing other forms of treatment besides patching only.
After their research, they sought out our clinic for optometric vision therapy. Vision therapy is a doctor-prescribed and supervised regimen of activities and exercises designed to correct vision problems that cannot be adequately treated by glasses, contact lenses, or surgery. Just as there is physical therapy and speech therapy, there is vision therapy—exercises for the eyes and brain designed to help a patient develop his or her visual skills.
An important part of Nick’s therapy was helping his brain learn to use both eyes together as a team. These types of exercises have been part of optometric vision therapy for decades, and the concept is illustrated in the following article, entitled Effectively Reducing Sensory Eye Dominance with a Push-Pull Perceptual Learning Protocol. Published in the well-regarded journal, Current Biology, the article discusses the effects of “push-only” training vs. “push-pull” training. Push-only would be patching only in which the amblyopic eye is stimulated, but the other eye is completely patched. Push-pull involves activities designed to stimulate the amblyopic eye while the other eye is still seeing. In other words, the amblyopic eye is forced to see the detail while the other eye still is able to see the background information.
This helps explain why Nick’s progress was never sustained after discontinuing patching. The results of this research support the need for binocular activities in order to have long-lasting outcomes in the treatment of amblyopia. After 4 months of optometric vision therapy, Nick’s visual acuity was stable, and in addition, he was now seeing 3-D! He passed all the stereovision tests, and as a bonus he was able to go to a 3-D movie and actually appreciate things flying out at him!
So yes, Nick, there is hope. And don’t give up on any of your dreams. The sky’s the limit!