Monday, January 23, 2012

How to rehabilitate a lazy eye while promoting binocularity?

According to my research traditional amblyopia treatment (patching the dominant eye) is not beneficial for eye teaming and what it might do for the acuity in a lazy eye it will destroy on the binocular front. Moreover, improvements in acuity will often only be of a temporary nature and be lost once patching treatment is stopped because the visual system will go back to its old ways and mostly ignore that particular eye's input. Patching is as ineffective as it is impractical.

So what's to be done? 
If you want to promote integrating the amblyopic  eye into the visual system, you have to use it while putting the dominant eye in a disadvantage BUT NOT FULLY OCCLUDING IT. This in combination with other exercise will promote eye coordination because both eyes are opened. Allowing light to enter both eyes is very important.

More advanced techniques of treating amblyopia allow patients, especially children, to have faster and better results with little or no eye patching. One technique illustrated below called 'piercing a straw' works on eye-hand coordination while using various prism glasses. This is only one of many techniques based on the latest neuroscience that could be used to integrate a lazy eye into the visual system with minimal patching. 

Source: Wow vision therapy - Dr Fortenbacher

Once someone understands the underlying principles of the visual system and binocular vision the possibilities of practicing those are endless. Amblyopia is caused by a disruption in binocular vision in infancy and/or early toddlerhood. The latest research shows that the brain of an amblyopic person functions as though  they are only a "one-eyed" person. The goal is to properly integrate the inferior eye in the visual system of the brain and with a tad of creativity necessity can be combined with pleasure.  

This video is produced by Dr. Fortenbacher and his Wow Vision Therapy practice. Check him out on or He does an excellent job explaining his work in an accessible fashion.

A while later another video was published on the Wow Vision Therapy facebook page showing the same little girl experience 3D vision for the very first time in her life. It's just awesome. At session 17, Caroline's treatment has effectively "removed the brakes from her strabismic flat vision". Office-based optometric vision therapy has stimulated the development of her visual brain enough to enable her to experience "stereopsis" for the first time in her life in a 3-D movie. Prior to her treatment, Caroline came to us with a unilateral strabismus, right esotropia and amblyopia. She suppressed her right eye and was stereo blind. While vision therapy is not simply about looking at 3-D movies, this example is showing how Caroline is able to transfer her developing binocular vision ability into seeing the depth in a 3-D movie. Therefore, Caroline is enjoying seeing images popping off the screen of a 3-D movie as the reward of having binocular vision.

Since possibilities are infinite, I came up with my own modest way of stimulating my inferior eye. Every so often I put a RYSER FILTER on my glasses blurring my dominant right eye and consequently forcing my inferior eye in a more prominent position. Although my inferior eye is also quite good, otherwise I wouldn't be having double vision, applying the filter on my glasses feels kind of funny. It's a lot more tiring to function this way, so even though I have double vision the right eye still mostly runs the bingo. Doing this I try to insert some balance into my visual brain and produce equitable binocular vision over time. I only do this for a limited amount of time because it is just too exhausting after a while and forcing doesn't help. Vision therapy takes time and patience, especially with adults.


  1. Thank you for this post. My 2 year old just starting doing this type of patching and he has "activities" he needs to be doing too! It makes so much more sense than regular patching .

  2. As parents we tend to be complacent if the child is not having any problems but sometimes eye problems can be asymptomatic and regular eye screening is required to detect problems early.

    famous people with lazy eye