Our guest blogger today is Seth Panattoni.  He is an optometric vision therapist and works with Dr. Benjamin Winters, FCOVD in Yakima, WA.  

After surfing the web and going through blog after blog pertaining to concerns over amblyopia and strabismus, I hope to shed a brighter spotlight on these two visual diagnoses in the hopes that more and more parents (and people in general) can be better informed of not just these impairments, but also their options when it comes to treating them.

What Is It?

Often in life when dealing with a new concept, it helps to define that word in the simplest way possible. Let us start with amblyopia.  Amblyopia, put simply, is having reduced vision in one eye which did not develop normally as a child. Why is this a problem? The brain receives input (images) from both eyes in order to create a clear 3-D picture from which we live with. In the case of an eye that is underdeveloped, the picture it sends to the brain is so different, blurry, or distorted that the brain decides to turn that eye off in favor of going with just the one good eye. Coming back to our question of why this is an issue, it is because if one eye is not getting used, it is getting weaker when it should be developing. This is especially true in the crucial childhood years.

Amblyopia takes a few different forms, based on what is causing the reduced vision.

  • The most noticeable is Strabismus, which is simply an eye turned in any direction other than its natural centrally aligned position. This misaligned eye causes double vision and blurred images, which the brain will eventually choose to switch off in favor of the developed (aligned) eye.
  • Another form is caused by unequal focus of the eyes, a condition called anisometropia. Simply explained, one eye is perhaps far-sighted while the other is much less far-sighted. This results in the brain using the eye that has the path of least resistance. It is more easily treatable than the physical symptoms of a strabismic eye.
  • A third form is deprivation, from something blocking the visual input.  A good example is a cataract. In this case, one eye is clouded and because it is not sending much visual information, ends up being turned off by the brain.

How Do You Treat It?

After scouring many, many websites, blogs, and forums, the main question out there when it comes to this topic is, “How do you treat Amblyopia and Strabismus?” Put very simply you have two options in front of you: Surgery or Vision Therapy.

If you elect to have Strabismus Surgery….

  • Understand this is almost purely done for cosmetic enhancement. Contrary to what many believe, surgery does not fix your vision, it just straightens out the turned eye. Being underdeveloped and for the most part unused for a long period of time has made the turned eye still very much in need of strengthening, despite now being straight.
  • Understand that one surgery, in many cases, will not be an immediate fix. Many patients report having multiple surgeries in order to get the desired effect from the afflicted eye.
  • Know that the average cost of strabismus surgery is anywhere from $2,000-$6,000

If you elect to do Vision Therapy….

  •  Understand this takes time, especially for patients with strabismus.  Strabismic patients are usually the longest and slowest on the progress meter.
  • Understand that Vision Therapy is more than a cosmetic fix. It also adds acuity, depth perception, binocular teaming, accurate fixation and tracking, and enhanced accommodation to the affected eye(s).
  • The average cost of a Vision Therapy session runs on average of $100-$150.

 A Better Perspective

Amblyopia is a condition that affects around 2-3% of all Americans. Many of them think that surgery is their only option, and while it is true that surgery can straighten the eye, it is not the best way to correct vision. Vision is not just being able to read 20/20 off of a letter chart. Vision is the ability to see, interact, and understand the world around you through many different types of seeing that include depth perception, accommodation (focusing), visual-perception, and oculomotor (eye movements).

Strabismus surgery cannot give you better vision. It can give you a better appearance, physically speaking, but it is vision therapy that has come on strong over the past few years to revolutionize the way we can enhance our vision. To all you parents of children with amblyopia, adults still living with it, and individuals who are just reading about this for the first time, as a vision therapist I want to tell you that you can save a lot of time and money and end up in a better place by opting for therapy over surgery.  This is not to say that those of us in the therapy world do not completely ignore the merits and uses of strabismus surgery. Surgery in the right cases is a preferable option but that is best discussed with a qualified doctor of optometry. Do not just take my word for it, though. Follow this link for some amazing success stories from real people who have graduated through the therapy program at Washington Vision Therapy Center in Yakima, WA. These are but a sample from one location, and there are many to look to, of what vision therapy can do for your visual system.

Vision Therapy is a rapidly expanding field of optometry that has a lot of scientific proof on its side that it, in fact, works. While many still dismiss therapy as an ineffective treatment, the fact is that more and more people are seeing and experiencing very real success and referring more and more children and afflicted adults for vision therapy. The evidence in defense of vision therapy is growing and I hope to make this a future topic on the COVD blog.  To those with amblyopia, strabismus, and many other diagnoses, it is our hope that you will now be better informed as to your options regarding treatment, and especially how effective the treatment options are that you consider. Please do not hesitate to leave a comment or seek out a COVD certified professional for further answers.

Learn more about strabismus and amblyopia:

Amblyopia or Lazy Eye

I’m the Data!

It’s Not About the Patch

Strabismus Surgery Outcomes

The Cure

Is Surgery Enough

Brain Research: Treating Amblyopia in Teens