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Binocular Vision Training as an Active Treatment of Lazy Eye!

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Binocular dichoptic vision training

In this blog post, we will explore the concept of binocular vision training and its potential as a game-changer in the management of lazy eye. We have already discussed active treatment options for amblyopia in general in one of our previous blogs and we will now go into further details on binocular vision training with dichoptic training.

Overview of Lazy Eye

Lazy eye, also known as amblyopia, is a common vision disorder that affects both children and adults. It occurs when there is a significant difference in vision between the eyes, leading to one eye becoming weaker and less dominant.

Lazy Eye Treatment

Traditionally, the primary treatment for lazy eye involved wearing an eye patch over the stronger eye to force the weaker eye to work harder. However, recent advancements in vision therapy have introduced binocular vision training as an active and effective treatment option.

What is Binocular Vision Training?

Binocular vision refers to the ability of both eyes to work together as a team, creating a single, unified image in the brain.

Binocular dichoptic training is a type of vision training in which different stimuli are presented to each eye.

Steps to Improve Binocular Vision in Amblyopia

Ideally, lower contrast stimuli are presented to the healthy eye and higher contrast stimuli to the amblyopic eye in order to compensate for decreased visual function in amblyopic eye.

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Having one successfully completed the required task, the contrast offset is then slowly reduced until the contrast of images presented to the healthy eye equals to those presented to the amblyopic eye.

”Binocular vision refers to the ability of both eyes to work together as a team, creating a single, unified image in the brain.”

Optimizing Binocular Vision Training for Kids: Tackling the Contrast Offset Challenge

In reality though, an ideal contrast offset is sometimes very hard to determine, especially in younger children. Thus, many vision training systems do not bother with the contrast offset and present different images to each eye, without the contrast offset.

Vision training tasks must be designed the way that it is impossible to complete them correctly if one is only using one of their eyes. This way, the suppression in the visual cortex of the amblyopic eye is slowly reduced and binocularity is restored.

Dichoptic Training vs. Patching in Amblyopia Treatment

Indeed, it is believed that reduction of suppression in the amblyopic eye achieved by dichoptic training yields better results than the forced use of amblyopic eye (i.e. patching). Admittedly, there are not many studies that undoubtedly prove that dichoptic training is more effective than patching as the first step of amblyopia treatment.

In fact, none of the studies have yet shown that dichoptic training is superior to patching in restoring visual acuity of the amblyopic eye. What the studies have shown, though, is that binocular (dichoptic) training is more effective in restoring binocular function than patching. Read about other benefits of vision training here.

Most Important Binocular Training Studies

In this paragraph, we shall describe the most important randomized, controlled studies that dealt with the efficiency of binocular vision training.

Holmes and co-workers reported in 2018 that while improvement is achieved faster with the addition of binocular training to continued spectacle correction, there were no significant differences at the end of the study compared to continued spectacle correction alone.

In the study by Manh and co-workers from 2018, they argued that binocular training is not superior to patching, although low compliance in binocular vision training group makes those results questionable. Similarly, the compliance to binocular training was a great issue also in a study by Holmes and co-workers from 2016. Thus, we must all aim to make vision training exercises as interesting as possible for the kids.

”Due to compliance issues, we must aim to make vision exercises as fun as possible for the kids.”

A child doing binocular vision therapy on her tablet.
Binocular eye exercises

Another interesting report was published by Kelly and co-workers in 2016. Their results clearly show that visual acuity improvements are achieved faster with binocular vision training than with patching if the final outcome is somewhat similar. They also recommend binocular training as an additional option for treating amblyopia, combined with patching.

What those studies prove is the fact that no binocular training alone is superior to correct refractive correction and patching, which is no surprise. What those studies also prove, though, is the fact that improvement can be achieved faster and be more successful if we add binocular vision training to standard treatment options such as correct refractive correction and patching. A randomized controlled study that directly compares the improvements in ‘’patching plus binocular training’’ group versus ‘’patching alone’’ group is needed perhaps more than ever in order to establish standardized protocols for binocular training.

AmblyPlay uses Binocular Vision Training

Through innovative binocular vision training method and advanced algorithm, AmblyoPlay helps individuals with binocular vision disorders, such as amblyopia (lazy eye), strabismus (squint), convergence insufficiency, diplopia (double vision), and others.

By utilizing engaging and interactive activities, compliance improves. AmblyoPlay encourages the brain to integrate information from both eyes, allowing for the development of strong binocular vision skills.

Dichoptic vision training
Anaglyph glasses with red and green filters are used to perform binocular training

Benefits of AmblyoPlay


1. Flexibility: AmblyoPlay offers the convenience of being able to do it from anywhere, allowing you to engage in the program at your own convenience.

2. Adaptiveness: With its algorithm-based app, AmblyoPlay customizes the activities and exercises to suit your specific needs and progress, ensuring a personalized and effective experience.

3. Motivating: AmblyoPlay incorporates engaging games and gamification techniques, which not only make the program enjoyable but also boost motivation, increasing the likelihood of consistent participation and better results.

4. Improves 6 Core Visual Skills: By targeting and enhancing six core visual skills, AmblyoPlay helps to improve your overall visual abilities, benefiting both children and adults.

5. For Everyone Above 3 Years: AmblyoPlay is designed to be accessible to individuals of all ages above three years old, making it a versatile solution for a wide range of users.

6. Time-efficient: With AmblyoPlay, there’s no need to commute to a specific location for therapy sessions. You can conveniently participate in the program from the comfort of your own home, saving time and effort.

7. Progress Tracking: AmblyoPlay enables you to monitor your progress over time, allowing you to see the improvements in your visual skills and providing valuable feedback on your journey towards better vision.

8. No Special Equipment Required: AmblyoPlay supports a wide range of platforms, eliminating the need for any specialized equipment. You can easily access the program using devices you already own, such as computers and tablets.

Get your AmblyoPlay Vision Therapy today!

Conclusion

Binocular vision training represents a significant advancement in the treatment of lazy eye, offering a more active and engaging approach compared to conventional methods. However, it is important to note that every case of lazy eye is unique, and the effectiveness of binocular vision training may vary. If you or your child has been diagnosed with lazy eye, consult with an eye care professional who can guide you through the best treatment options available.

What is binocular dichoptic training?

Binocular dichoptic training is a type of vision training in which different stimuli are presented to each eye. Ideally, lower contrast stimuli are presented to the healthy eye and higher contrast stimuli to the amblyopic eye in order to compensate for decreased visual function in amblyopic eye. 

Why is binocular dichoptic training important?

It is important in treating binocular vision disorders, such as amblyopia or strabismus. It promotes binocular vision, e.g., the ability of both eyes to work together and create a single, fused image. Furthermore, binocular dichoptic training helps stimulate and strengthen the coordination between the eyes, encouraging the development of binocular vision.

Does AmblyoPlay use binocular dichoptic approach?

Yes, it does! AmblyoPlay encourages the brain to integrate information from both eyes, allowing for the development of strong binocular vision skills.

References:

Holmes JM, Manny RE, Lazar EL, Birch EE, Kelly KR, Summers AI et al (2018) A randomized trial of binocular Dig Rush game treatment for amblyopia in children aged 7 to 12 years of age. Ophthalmology S0161-6420:32304–32302

Manh VM, Holmes JM, Lazar EL, Kraker RT, Wallace DK, Kulp MT et al (2018) A randomized trial of a binocular iPad game versus part-time patching in children aged 13 to 16 years with amblyopia. Am J Ophthalmol 186:104–115

Kelly KR, Jost RM, Dao L, Beauchamp CL, Leffler JN, Birch EE (2016) Binocular iPad game vs patching for treatment of amblyopia in children: a randomized clinical trial. JAMA Ophthalmol 134:1402–1408

Holmes JM, Manh VM, Lazar EL, Beck RW, Birch EE, Kraker RT, Crouch ER, Erzurum SA, Khuddus N et al (2016) Effect of a binocular iPad game vs part-time patching in children aged 5 to 12 years with amblyopia: a randomized clinical trial. JAMA Ophthalmol 134:1391–1400

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Why Do We Suggest a Minimum Time of 6 Months for Success?

Based on the data from over 15,000 patients using AmblyoPlay, improvements start within 4 months, while optimal results take anywhere between 6-18 months on average. The duration of required training depends on the patient’s age, the severity of the problem, accompanying diseases, and adherence to the training program.