Recent Advances in Screening and Treatment for Amblyopia

Abstract

Amblyopia is the most common cause of monocular visual impairment in children, with a prevalence of 2-3%. Not only is visual acuity reduced in one eye but binocular vision is affected, fellow eye deficits may be present, eye-hand coordination and reading can be affected, and self-perception may be diminished. New technologies for preschool vision screening hold promise for accessible, early, and accurate detection of amblyopia. Together with recent advances in our theoretical understanding of amblyopia and technological advances in amblyopia treatment, we anticipate improved visual outcomes for children affected by this very common eye condition. This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.

Randomized clinical trial of streaming dichoptic movies versus patching for treatment of amblyopia in children aged 3 to 7 years

“…In the movie group, but not in the patching group, children who had a clinical history of no visual acuity improvement in response to treatment with glasses and patching had a larger visual acuity improvement at the 2-week primary outcome visit than children who previously had responded to treatment with glasses and patching. This could reflect better adherence to binocular treatment in the setting of a randomized clinical trial than adherence to patching prior to enrollment or, alternatively, may result from individual differences in treatment efficacy of binocular versus patching treatments 28 .…”

“…It is possible that patching adherence was poor just prior to enrollment and may have improved as a result of participation in a randomized clinical trial 29 . Without objective compliance data, it is not possible to attribute the response to patching solely to an improvement in treatment adherence 28 , 30 .…”

Screening, Diagnosis, and Treatment of Pediatric Ocular Diseases

“…In addition to refractive correction, both physical patching of the strong eye and pharmacological penalization via atropine were found to be effective treatments [ 103 , 104 , 105 ]. Recent reviews support their continued use and demonstrate greater efficacy over alternative treatments such as optical penalization (Plano lens) [ 106 , 107 , 108 ].…”

Applications and implications for extended reality to improve binocular vision and stereopsis

“…These limitations have led to the development of several new approaches over the last decade or so, including perceptual learning, videogame play, and dichoptic/binocular treatment aimed at reducing the inhibition of the amblyopic eye and improve binocular vision and stereopsis (for reviews, see Bennett, Bex, Bauer, & Merabet, 2019 ; Birch, Kelly, & Wang, 2021 ; Brin, Chow, Carter, Oremus, Bobier, & Thompson, 2021 ; Coco-Martin et al, 2020 ; Falcone, Hunter, & Gaier, 2021 ; Foss, 2017 ; Hess & Thompson, 2015 ; Levi, 2020 ; Levi, 2022 ; Levi & Li, 2009 ). These approaches either use or could be adapted to use XR devices, which include VR, AR, and MR devices, which are immersive technologies and can swap or merge the natural environment with virtual content (e.g.…”