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Reply: Vision Therapy for amblyopia

We need to define better the term "eye alignment." If, after surgery, an individual's eyes...

Posted by srb00

We need to define better the term "eye alignment." If, after surgery, an individual's eyes are aligned to within 8 prism diopters, then the person's eyes will usually appear cosmetically straight. In addition, the individual may enjoy some crude stereopsis. However, most adults with strabismus also have a vertical misalignment between their two eyes, and this vertical mismatch will prevent the individual from fusing the images between the two eyes and seeing in stereo depth.

To coordinate the two eyes well, one doesn't keep the eyes "straight" all the time. One must turn in the eyes to aim both of them at a near target and turn out the eyes from this converged position to aim both eyes at a far target. If the two eyes are not aimed at the same spatial location, then stereopsis will not result. These disparity vergence movements develop in a child with normal vision within the first months of life but have not developed well in someone with a lifelong strabismus. Thus, after surgery, the patient may simply go back to their entrenched visual habits of looking at a target with one eye and turning the other, especially because the eye turn makes it easier to suppress the strabismic eye's image. After surgery, therefore, optometric vision therapy is necessary for the individual to take advantage of the better eye alignment and to learn to make disparity vergence movements. Only then will he or she be able to acquire stereopsis. Moreover, once the individual is able to fuse, then he or she is more likely to use her eyes in a coordinated fashion and keep the eyes aligned. Thus, a combination of approaches is, in many cases, the best way to treat strabismus.

I had an excellent eye surgeon and good cosmetic results from my surgery. Nevertheless, after my surgeries, my eyes were still misaligned by 8 prism diopters for a far target and by 25 prism diopters for a near one. Moreover, I had a vertical misalignment of 3 to 5.5 prism diopters for near and far viewing respectively. Thus, I was not able to fuse images from my two eyes at any viewing distance. Through optometric vision therapy, I eliminated the horizontal misalignment for both near and far. My eyes look and are much more aligned than prior to vision therapy, and I enjoy dramatically better vision and stereopsis.View Thread

Posted bysrb00

12 Replies | Reply | Watch This DiscussionReport This| Share this:Vision Therapy for amblyopia We need to define better the term "eye alignment." If, after surgery, an individual's eyes...

Includes Expert Content

Reply: Vision Therapy for amblyopia

I am Sue Barry, Stereo Sue. Indeed, my stereo acuity is subnormal but is stable and...

Posted by srb00

12 Replies | Reply | Watch This DiscussionReport This| Share this:Vision Therapy for amblyopia I am Sue Barry, Stereo Sue. Indeed, my stereo acuity is subnormal but is stable and...

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