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Role of Dichoptic Therapy in Amblyopia

by | Jul 1, 2024 | Manuscripts | 0 comments

Lakshmi Priya R.S., B.Optom, Fellowship in Clinical Optometry

Paediatric Optometrist, Aravind Eye Care System, Madurai, India

 

When vision in one or both eyes does not develop properly during childhood, it is known as amblyopia or lazy eye. It usually develops when a child is an infant or very young and can worsen over time if left untreated. Amblyopia is related to a neuro-developmental disorder of the visual cortex that arises from abnormal visual experiences. Adult amblyopia not only affects sight but also one’s perspective on life.

Symptoms of amblyopia include bumping into objects, squinting, frequent head tilting to either side, or drooping of the eyelid, though symptoms are not always obvious. The causes of amblyopia include strabismic amblyopia, refractive amblyopia, and deprivation amblyopia. (1)

Although there are several treatments available such as patching, penalization, and vision therapy, not every child is compliant with them. Those who do not comply with these treatments or do not respond to patching and face recurrence of amblyopia, deficits in stereopsis, absence of binocular single vision, or residual amblyopia may consider BYNOCS therapy.

BYNOCS-AmblyGo is a revolutionary cloud-based software and the latest generation technology for treating both children and adult amblyopia. (Figure 1) The program can be conveniently conducted in the clinic by in-house eye care practitioners or remotely conducted on any video platform like Zoom, Microsoft Teams, etc., as part of telemedicine. It is a therapy based on dichoptic exercises using anaglyph glasses. (1)

Who can try BYNOCS therapy?

  • The age limit is from 6 years and above without an upper age limit.
  • It can help both children and adults with amblyopia. (1)

Figure 1: Bynocs. (n.d.). Remote Management of Adult Amblyopia. (2)

Working Principle:

Dichoptic Principle which works as a contrast-balanced binocular vision with low contrast for the fellow eye and high contrast for the amblyopic eye. (Figure 2 and 3) (3)

Figure 2: Amblyopia Lazy Eye Treatment – Advance Vision Therapy – BynocS. (2023, December 15). Bynocs. https://www.bynocs.com/

Figure 3: Ongoing Vision therapy – Red and Blue Goggle.

Patients should have following criteria

  • Foveal fixation is recommended as it allows to focus sensory processing resources.
  • Squint-deviation under 10 prism dioptres is preferable for the better efficacy, if it is exceeding more than 10 prism dioptres the therapy could be performed under guarded visual prognosis.
  • Visual acuity should be above 6/60 and no comorbidity factors like Retinal detachment, glaucoma, nystagmus, corneal complications etc.

Conclusion:

BYNOCS provides holistic management of lazy eye and binocular vision disorders. Being a binocular treatment, it develops or improves stereopsis, improves fusion, prevents recurrence of amblyopia, enables permanent visual acuity gain, and results in around 3-4 LogMAR line visual acuity improvement noted in 30-60 sessions.(4-7) It enables people globally to achieve the best possible vision through the adoption of innovative eye care solutions. Funny game-based exercises generate great compliance with the treatment.

 

Reference:

  1. Vision therapy lazy eye | Vision therapy for lazy eye | Amblyopia Therapy. (2023, December 4). Bynocs. https://www.bynocs.com/vision-therapy-software-for-lazy-eye/
  2. Amblyopia Lazy Eye Treatment – Advance Vision Therapy – BynocS. (2024, April 5). Bynocs. https://www.bynocs.com/
  3. Chaturvedi, I., Jamil, R., & Sharma, P. (2023). Binocular vision therapy for the treatment of Amblyopia-A review. Indian journal of ophthalmology, 71(5), 1797–1803.
  4. Abdal, M. O., Bhombal, F., Nankani, G. J., Nankani, S. G., Lad, S., Dholam, A., Kumari, R., Mahajan, J., & Piñero, D. P. (2022). Evaluation of the efficacy of a new dichoptic digital platform to treat the anisometropic and isometropic amblyopia. Brain Sciences, 12(7), 815.
  5. Hess, R. F., & Thompson, B. (2015). Amblyopia and the binocular approach to its therapy. Vision research, 114, 4–16.
  6. Yen M. Y. (2017). Therapy for Amblyopia: A newer perspective. Taiwan journal of ophthalmology, 7(2), 59–61.
  7. Picotti, C., Fernández Irigaray, L., Del Rivero, A., Fariñalas, M., & Piñero, D. P. (2024). Treatment of Anisometropic Amblyopia with a Dichoptic Digital Platform in Argentinian Children and Adults. Seminars in ophthalmology, 39(1), 89–95.*Disclaimer – This writing is educational and has no commercial intention.

 

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