Effect of Neural Vision Therapy on Uncorrected Pseudophakic Visual Acuity

A bstract Background: Pseudophakics with monofocal lenses usually require corrective lenses for near and intermediate work in addition to occasional distance correction for optimal visual resolution at all distances. Neural vision therapy enhances visual function across a range of distances without the need for corrective lenses and may be a suitable alternative for pseudophakics with refractive error. Purpose: The present study was conducted to investigate the effect of neural vision therapy using perceptual learning, on near and distance visual acuity, in pseudophakic patients with monofocal intraocular lenses. Design: Prospective interventional non-comparative case series. Methods: The case series consisted of 30 pseudophakic patients who had received monofocal intraocular lenses and required corrective lenses for optimal visual acuity for distance, near, or both. Perceptual learning was performed using Gabor gratings of varying spatial frequency and contrast. The distance and near visual acuity, as well as contrast sensitivity, were assessed before and after the training. The visual function was monitored for a period of 3 months after intervention. Results: The mean age of patients in the series was 68.6 ± 11.05 years and included 16 women and 14 men. There was a significant improvement ( P < 0.05) in distance visual acuity [0.15 ± 0.13 to 0.05 ± 0.06 log of minimum angle of resolution (LogMAR)], near visual acuity (0.4 ± 0.09 to 0.09 ± 0.07 LogMAR), and contrast sensitivity function after the intervention (1.35 ± 0.24 to 1.83 ± 0.13 log units). Conclusion: Perceptual learning significantly improved distance and near acuity, as well as contrast sensitivity in pseudophakic patients. With no alteration in the refractive status, perceptual training improved visual function by enhancing neural processing at low signal-to-noise ratios seen in uncorrected pseudophakic eyes.