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Perceptual Learning as a Treatment for Amblyopia

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perceptual learning

Amblyopia is the most prevalent cause of preventable childhood blindness, with a prevalence of 1-5%. It is also one of the most common causes of unilateral visual impairment that lasts into adulthood. In this blog post, we will explore perceptual learning as an approach to treating amblyopia.

What is Amblyopia?

Amblyopia is a neurodevelopmental condition of the visual system. It is caused by an abnormal binocular vision experience. Amblyopia occurs when the brain favors one eye over the other, leading to reduced vision in the neglected eye. This condition often arises during the critical period of visual development in early childhood, and if left untreated, it can result in permanent vision impairment.

Traditional Treatment Methods for Lazy Eye

Historically, conventional treatments for amblyopia have involved patching the stronger eye, forcing the brain to rely on the weaker eye and promoting visual stimulation. Corrective lenses may also be prescribed to address refractive errors. While these methods have proven effective to some extent, they often come with challenges, including poor compliance, discomfort, and social stigma, particularly for children.

Loss of Binocularity

Despite the fact that amblyopia results in a variety of monocular deficits (e.g. visual acuity), it has been proven that loss of binocularity is one of the amblyopia defining characteristics. Nowadays, this has led to increased interest in the development of amblyopia treatments that directly address binocular dysfunction. In other words, treatments that promote binocular vision and reduce inhibitory interactions within the visual cortex.

Perceptual learning refers to any rather stable change in the perception of a subject as a result of the experience with one or more stimulus.

Dichoptic Therapy

Dichoptic therapy (DT from now on) is one of the most common methods for inducing perceptual learning (PL from now on) in amblyopia treatment. Anti-suppression dichoptic training is a treatment for binocular vision that involves reducing suppression in the visual cortex.

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How Dichoptic Approach Reduces Suppression in the Eyes?

Dichoptic therapy reduces suppression by simultaneously providing stimuli that are perceived differently in each eye.

Dichoptic amblyopia treatment in AmblyoPlay Vision Therapy.
Dichoptic Treatment Approach in AmblyoPlay Vision Therapy

In the subject of visual cognition, various computers programs and video games have been extensively utilized to increase selective visual attention and some visuospatial skills.

For more than a decade, video games of various types have been used in optometry and ophthalmology to cure amblyopia. The concept behind using video games to treat amblyopia is that it can help to increase visual functions including visual acuity and stereo acuity.

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Binocular Restoration: Evidence from Recent Studies on Perceptual Learning

Recent studies have found some evidence of various types of perceptual learning based amblyopia treatments (monocular training with grating contrast detection tasks, monocular viewing of action movies and video games, anti-suppression DT, stereopsis training, and so on), particularly with the restoration of binocular functions, though these are still under investigation.

The major goal of this research was to look at the most recent studies on perceptual learning based amblyopia treatments and try to figure out what role they play in these new treatments. In addition, the findings of recent studies comparing traditional occlusion therapy with new types of perceptive treatment were examined in order to determine whether a perceptual learning strategy in amblyopia is required.

The Gamified Approach: Boosting Motivation and Compliance in Active Therapy Choices

As a result, the trials published in the last 6 years state some consistent aspects regarding the idea that amblyopia treatment could be aimed at recovering visual functions using new active strategies such as perceptive learning, utilizing technological resources that we now have, such as video games or virtual reality.

Different clinical trials have shown that a notable increase can be accomplished by an extensive range of stimulus, tasks, and length of the perceptual learning based training.

The systematic review of recent studies discovered evidence of a new type of amblyopia treatment that uses dichoptic treatment with or without the use of video games to apparently stimulate the binocular system through perceptual training.

In general, studies conducted in the past indicate that this type of treatment is beneficial in enhancing some visual functions including VA in adults who have passed the critical time. This could be due, at least in part, to the format utilized in this type of active therapy, and some researchers have argued that gamification was used to boost patient motivation and compliance.

Looking Forward: Future Directions and Considerations in Perceptual Learning for Amblyopia

Nonetheless, additional controlled and random clinical trials might be done to learn more about which visual functions are more efficient and how long the effects of this type of treatment based on perceptual learning would last over time. Based on the findings of many studies, it appears reasonable to prescribe this type of active therapy as a supplement to various passive therapy choices.

Conclusion

Perceptual learning represents hope for those affected by amblyopia. By harnessing the brain’s remarkable ability to adapt and learn, we may usher in a new era of personalized and effective treatments. As research progresses and technology advances, perceptual learning could very well be the key to unlocking a clearer and brighter future for individuals with amblyopia.

Frequently Asked Questions

How do perceptual learning-based amblyopia treatments differ from traditional approaches like occlusion therapy?

Perceptual learning-based amblyopia treatments take a more dynamic and active approach compared to traditional occlusion therapy. While occlusion therapy involves patching the stronger eye to force the weaker eye to work, perceptual learning employs targeted visual exercises.

What evidence supports the effectiveness of perceptual learning-based treatments in restoring binocular functions in amblyopic individuals?

Recent studies show promise in using perceptual learning, including tasks like stereopsis training and anti-suppression DT, to enhance visual functions and stimulate the binocular system. However, further research is needed to confirm long-term effectiveness.

Are there indications that perceptual learning strategies could surpass traditional occlusion therapy in amblyopia treatment?

Some studies suggest advantages with perceptual learning, such as increased patient engagement through gamification. Ongoing research is vital to determine if these strategies offer superior efficacy and long-term benefits compared to traditional occlusion therapy.

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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.