Active vision therapy for pseudophakic amblyopia

PURPOSE: To study the benefit of active vision therapy using various pleoptic methods in pseudophakic amblyopic children and young adults. SETTING: Daljit Singh Eye Hospital, Amritsar, India. METHODS: This study comprised 160 consecutive pseudophakic amblyopic patients who had had iris-claw lens implantation for congenital or traumatic cataract. Their ages ranged from 3.5 to 25.0 years. Before active vision treatment, visual acuity was worse than 20/200 in 63 patients (39.3%), 20/200 in 77 (48.1%), 20/120 to 20/80 in 14 (8.7%), and 20/60 in 6 (3.7%). The methods included Haidinger brushes on the synoptophore, after images, CAM stimulator, drawings on the cheiroscope, Pigeon-Cantonnet stereoscope, video games with the amblyopic eye, and exercises for promoting eye-hand coordination. Mean duration of therapy was 6 months. RESULTS: After therapy, visual acuity was worse than 20/200 in 31 patients (19.4%), 20/200 in 38 (23.7%), 20/120 to 20/80 in 41 (25.6%), 20/60 to 20/40 in 36 (22.5%), and 20/20 in 14 (8.7%). In 20 patients (12.5%), all younger than 15 years, visual acuity decreased within 1 month after treatment stopped. However, vision was rapidly restored after another session of active vision therapy. CONCLUSIONS: Active vision therapy helped improve visual acuity in the majority of young pseudophakic amblyopes.