Jul 2026· Journal of Optometry· Vol 19, pp. 100624· 0 citations· 31 references
Medicine
TL;DR
AVT with occlusion was associated with greater improvements in functional visuomotor task performance and visual outcomes in children with anisometropic amblyopia, supporting its role as a function-oriented adjunct to conventional therapy.
Abstract
Purpose To evaluate the association between Active Vision Therapy (AVT) combined with occlusion and occlusion-only therapy in task-based saccadic and pursuit visuomotor performance and visual outcomes in children with anisometropic amblyopia. Methods Forty children (median age=9years, IQR=7–11) with persistent anisometropic amblyopia after six weeks of spectacle adaptation were alternately assigned to AVT–occlusion (n = 23) or occlusion-only (n = 17). BCVA, stereopsis, contrast sensitivity, and task-based saccadic and smooth pursuit performance were measured at baseline, three weeks, six weeks, and three months. AVT included structured monocular and binocular exercises using Vision Training System 4 and Cheiroscope, while occlusion involved daily patching of the fellow eye. Repeated-measures ANOVA and Friedman tests evaluated changes over time, partial Spearman correlations adjusted for group examined associations between oculomotor and visual improvements. Results Both groups improved in BCVA, and task-based saccadic and smooth pursuit performance (p < 0.05) in the AVT–occlusion group. Significant time × therapy interactions were found for BCVA, task-based saccadic and smooth pursuit performance, and contrast sensitivity (p ≤ 0.03). At three months, AVT–occlusion outperformed occlusion-only in BCVA (−0.13 logMAR, p = 0.01), task-based saccadic response time (−0.78 ms equivalent, P < 0.001) and task-based smooth pursuit performance (4.68%, p = 0.03), and contrast sensitivity (0.06 log-units, p = 0.005). Greater gain in task-based saccadic (ρ=-0.43, p = 0.006) and smooth pursuit (ρ=-0.53, p = 0.001) performance correlated with BCVA improvement; faster saccadic response performance (ρ=0.35, p = 0.026) correlated with better stereopsis. Conclusions AVT with occlusion was associated with greater improvements in functional visuomotor task performance and visual outcomes in children with anisometropic amblyopia, supporting its role as a function-oriented adjunct to conventional therapy.
Purpose To evaluate changes in visual acuity (VA) and stereoacuity in children with amblyopia following monocular or stereopsis training delivered alongside standard clinical care and to examine factors associated with training-related improvements in visual outcomes. Methods Forty-three children with amblyopia (7.3–14.8 years; 37 anisometropic, five strabismic, and one mixed) completed approximately 29 sessions of either monocular training (grating acuity or motion discrimination targeting the amblyopic eye, n = 23) or binocular stereopsis training (dichoptic disparity discrimination, n = 20). All participants continued standard clinical management, including optical correction and prescribed patching. Pre- and post-training assessments included amblyopic-eye VA, interocular acuity difference (IOD), and Randot stereoacuity. Results Both training protocols produced significant task-specific learning. Amblyopic-eye VA improved significantly in both groups, with no evidence of differential effects between training approaches. Stereoacuity also improved in both groups, with significantly greater gains following stereopsis training than monocular training. Exploratory analyses indicated that poorer baseline amblyopic-eye VA was associated with larger VA gains; however, this association did not survive correction for multiple comparisons. Stereoacuity improvement was not significantly associated with baseline VA, IOD, age, or changes in VA. Conclusions Visual training combined with standard clinical care improved amblyopic-eye VA and stereoacuity in children with amblyopia. Although both training approaches yielded comparable gains in VA, stereopsis training produced larger improvements in stereoacuity, supporting its potential role in addressing residual binocular deficits after conventional treatment.
PURPOSE
To evaluate binocular visual function in amblyopic patients who achieved optimal visual acuity following treatment with either conventional patching alone or combined patching and structured Active vision therapy (AVT).
METHODS
This retrospective chart review included 67 patients with non strabismic refractive amblyopia (31 patching; 36 combined treatment) who achieved best-corrected visual acuity (BCVA) ≤0.17 logMAR in both eyes after treatment. The combined treatment consisted of patching with structured active vision therapy incorporating anti-suppression, accommodative, vergence, and visuomotor exercises. Post-treatment assessment included stereoacuity (log seconds of arc), vergence parameters (phoria, near point of convergence, fusional vergence), accommodative lag, accommodative facility (monocular and binocular), and binocular sensory status. Within-group changes were analyzed using Wilcoxon signed-rank tests; between-group comparisons were performed using Mann-Whitney U tests. Effect sizes (r) were calculated for intergroup comparisons.
RESULTS
Both groups demonstrated significant reduction in accommodative lag (p < .001). Post-treatment stereoacuity was significantly better in the combined treatment group (p < .001; r = 0.724). The combined treatment group also showed superior vergence function, with larger positive fusional vergence amplitudes (r = 0.60) and improved near point of convergence (r = 0.488). Monocular and binocular accommodative facility were significantly higher in the combined treatment group (r = 0.656 and r = 0.690, respectively). Treatment duration was significantly shorter in the combined treatment group (p < .001).
CONCLUSIONS
Combined patching and structured AVT group was associated with superior binocular vision function outcomes and reduced treatment duration. However, due to the non-randomized, retrospective design of the study, findings should be interpreted with caution. AVT is a more intensive treatment requiring greater motivation, adherence, supervision, and access to care.
Santosh Chhetri, Aashish Kant Shah, U. Belbase et al.· Strabismus· 0 citations
Luminopia demonstrated significant improvements in Registry patients with severe amblyopia, particularly in treatment-naive patients, supporting its use as a viable treatment option that may address key limitations of traditional approaches.
Courtney L. Kraus, A. Godfrey, E. Gaier et al.· Journal of AAPOS· 1 citation
Vision therapy can produce clinically meaningful and durable visual improvements in amblyopic patients who no longer respond to occlusion alone, and supports extending amblyopia treatment into adolescence and adulthood, while emphasizing the need for tailored approaches based on the etiology of amblyopia and age.
Hassan Hashemi, Alireza Jamali, E. Jafarzadehpur et al.· Strabismus· 0 citations
Active vision therapy leads to significant and accelerates improvements in CS among children with bilateral refractive amblyopia and demonstrates a rate of change in monocular CS of 0.05 during follow-up time.
Saeed Rahmani, Saeedeh Hoseinmenni, C. Dehghani et al.· International Journal of Oph...· 0 citations
Administering vision therapy in conjunction with patching significantly improved VA, stereo acuity, and accommodation facility in bilateral refractive amblyopia compared to patching alone.
Saeedeh Hoseinmenni, S. Rahmani, Ebrahim Jafarzadehpour et al.· Journal of Ophthalmic & Visi...· 0 citations
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