New perspective posits amblyopia secondary to binocular problems
Recent developments imply it may be time to change the current view of amblyopia. Laboratory findings show that the adult cortex is more adaptable than previously thought and that amblyopia may be secondary to binocular problems.
Take-home message: Recent developments imply it may be time to change the current view of amblyopia. Laboratory findings show that the adult cortex is more adaptable than previously thought and that amblyopia may be secondary to binocular problems.
By Nancy Groves; Reviewed by Robert F. Hess, PhD, DSc
Montréal-Long-held beliefs about the etiology of a medical condition and its treatment change as new evidence develops-and this shift is happening with
The current view is that amblyopia is the primary problem and that treatment typically should consist of occluding the good eye to force the amblyopic eye to work-an approach applicable mainly to children.
However, a new perspective is that amblyopia is secondary to binocular problems, that a binocularly based treatment is preferable to patching, and that treatment could be extended to all ages, said Robert F. Hess, PhD, DSc, professor and director, McGill Vision Research Unit, Department of Ophthalmology, McGill University, Montréal, Québec, Canada.
Paradigm shift
A number of laboratory advances over the past decade have called the widely accepted paradigm of amblyopia into question, Dr. Hess said.
One of these advances is the theory that the adult cortex is plastic or adaptable.
“There’s plenty of evidence now that in adults, the visual cortex is still capable of substantial change,” Dr. Hess said.
Therefore, reliance on a treatment restricted to children makes no sense.
The amblyopic cortex is also plastic, as demonstrated by the restoration of visual function in adults following a few minutes of magnetic or current stimulation. Evidence shows that the more severe the amblyopia, the greater the improvement.
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