Aug 2026· International Journal of Ophthalmology· Vol 19 8, pp.
1550-1555
· 0 citations
Medicine
TL;DR
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.
Abstract
Aim
To evaluate the effectiveness of combining patching with active vision therapy, compared to patching with placebo training on contrast sensitivity (CS) in pediatric participants with bilateral refractive amblyopia.
Methods
In this double-blind, clinical trial, 43 participants aged 5-8 with bilateral refractive amblyopia, unresponsive to spectacles, were randomly assigned to either the experimental group (active vision therapy plus patching) or the control group (placebo treatment with patching) for four months. Active therapy included anti-suppression, accommodative, vergence, and visual memory exercises. CS was measured at baseline and after four months, serving as key outcome measures.
Results
Forty participants (20 in each group) completed the study. The mean age for the experimental group (5 males) was 6.10±0.84y, and 6.50±1.15y for the control group (11 males). CS in the experimental group improved by 0.10 log (right eye), 0.14 log (left eye), and 0.07 log binocularly (P≤0.03). The control group showed no statistically significant enhancements in monocular or binocular CS (P≥0.07). Compared to the control group, the experimental group demonstrated a rate of change in monocular CS of 0.05 during follow-up time.
Conclusion
Active vision therapy leads to significant and accelerates improvements in CS among children with bilateral refractive amblyopia.
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
PURPOSE
To evaluate long‑term visual acuity (VA) trends following a structured vision therapy protocol in patients with amblyopia who had plateaued after conventional occlusion therapy.
METHODS
This prospective cohort study included 157 patients diagnosed with amblyopia who showed no further VA improvement over at least three consecutive assessments during standard patching. All participants received individualized vision therapy comprising monocular and binocular exercises, fusion training, fixation stabilization, and perceptual tasks, combined with limited daily occlusion (1-3 hours). Therapy was delivered over 15 weekly in‑clinic sessions, followed by a structured home program. Visual acuity was monitored every 6 months over a 48‑month follow‑up period.
RESULTS
A total of 177 amblyopic eyes from 157 patients (mean age 15.56 ± 10.6 years) were analyzed. Mean VA improved from 0.50 ± 0.23 at baseline to 0.70 ± 0.28 at 48 months (p < .001); 48.6% of eyes achieved a final VA of ≥0.8 decimal. Significant VA gains were observed across all age groups, with mean improvements of 0.24, 0.21, and 0.16 in decimal VA for ages ≤ 8 years, 8-18 years, and >18 years, respectively. The proportion of patients gaining ≥ 2 lines of VA was highest in the ≤8 years (62.5%) and 8-18 years (62.5%) groups, compared with 35.4% in those > 18 years. Isoametropic amblyopia showed the highest rate of ≥2‑line improvement (65.0%), followed by strabismic (63.6%) and anisometropic (44.2%) types. No statistically significant difference in visual outcomes was observed between the two protocols (Haidinger's brushes/flashing vs. adding perceptual learning; p = .385).
CONCLUSION
Vision therapy can produce clinically meaningful and durable visual improvements in amblyopic patients who no longer respond to occlusion alone. The present study also 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
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
This randomized controlled study compared efficacy and safety of a novel binocular, eye-tracking-based home amblyopia treatment (CureSight) to patching. Three cohorts (China, Israel, U.S.) enrolled 197 children aged 4 to < 9 years with anisometropic, small-angle strabismic, or mixed-mechanism amblyopia at 15 academic/community sites (modified intent-to-treat); 156 completed ≥ 60% of prescribed dosage (per-protocol). CureSight: 90 min/day, 5 days/week for 16 weeks (120 h); patching: 2 h/day, 7 days/week (224 h). In the modified intent-to-treat dataset, visual acuity improvement from baseline to week 16 in the binocular group was noninferior to the patching group (0.028 logMAR; 95% CI - 0.007 to 0.063). In the per-protocol dataset, binocular treatment was superior to patching (0.04 logMAR; 95% CI 0.004 to 0.076). Improvement was significantly affected by baseline covariates of age, baseline vision levels, and previous amblyopia treatment. There was no significant between-group difference in the magnitude of improvement in stereoacuity in either dataset. Overall, CureSight was noninferior to patching in these amblyopia types and yielded better visual outcomes in children completing ≥ 60% dosage, supporting binocular therapy as an additional first-line option.
O. Yehezkel, T. Wygnanski-Jaffe, B. Kushner et al.· Scientific Reports· 0 citations
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.
Manisha Koirala, Sanjeev Bhattarai, J. Shrestha et al.· Journal of Optometry· 0 citations
Use of a dichoptic digital therapeutic device in the treatment and management of amblyopia holds exciting potential in deprivation amblyopia, although a percentage of patients with severe amblyopia did show modest improvement.
W. Sambhariya, Courtney L. Kraus· Journal of pediatric ophthal...· 0 citations