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Arblaster GE, Davis H, Buckley D, Barnes S. Patient perspectives on their outcomes from strabismus surgery undertaken for psychosocial reasons. Eye (Lond) 2024; 38:2926-2931. [PMID: 38907014 PMCID: PMC11461868 DOI: 10.1038/s41433-024-03189-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 05/10/2024] [Accepted: 06/17/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Strabismus surgery undertaken for psychosocial reasons aims to align the eyes in a straighter position, reduce the psychosocial symptoms experienced and improve health related quality of life (HRQoL). Greater evidence of the postoperative outcomes in adults undergoing strabismus surgery for psychosocial reasons is required to inform funding and commissioning decisions about strabismus surgery. METHODS Semi-structured interviews were conducted with adults who had previously undergone strabismus surgery for psychosocial reasons to explore their perceptions of their postoperative outcomes. Maximum variation sampling was used to recruit males and females, younger and older participants. Interviews were transcribed and analysed using thematic analysis following the principles of grounded theory. RESULTS Thirteen adults were recruited and interviewed, mean 12.2 months postoperatively (range 4.5-20 months). Participants reported a range of improvements in vision, task performance, physical symptoms and confidence and emotions. Some worsening of physical symptoms was reported. CONCLUSION Despite undergoing strabismus surgery for psychosocial reasons, a range of improvements in vision, task performance and physical symptoms were reported by adult patients postoperatively, in addition to the expected improvements in confidence and emotions.
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Affiliation(s)
- Gemma E Arblaster
- School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Sheffield, UK.
- Orthoptic Department, Ophthalmology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
| | - Helen Davis
- School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Sheffield, UK
| | - David Buckley
- School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Sheffield, UK
| | - Sarah Barnes
- School of Medicine and Population Health, University of Sheffield, Sheffield, UK
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Hernández-Rodríguez CJ, Ferrer-Soldevila P, Artola-Roig A, Piñero DP. Rehabilitation of amblyopia using a digital platform for visual training combined with patching in children: a prospective study. Graefes Arch Clin Exp Ophthalmol 2024; 262:3007-3020. [PMID: 38578335 PMCID: PMC11377642 DOI: 10.1007/s00417-024-06475-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/06/2024] Open
Abstract
PURPOSE To assess the possible benefits of the use of perceptual learning and dichoptic therapy combined with patching in children with amblyopia over the use of only patching. METHODS Quasi-experimental multicentric study including 52 amblyopic children. Patients who improved their visual acuity (VA) by combining spectacles and patching were included in patching group (PG: 20 subjects), whereas those that did not improved with patching performed visual training (perceptual learning + dichoptic therapy) combined with patching, being assigned to the visual treatment group (VT: 32 subjects). Changes in VA, contrast sensitivity (CS), and stereopsis were monitored during a 6-month follow-up in each group. RESULTS Significant improvements in VA were found in both groups at 1 month (p < 0.01). The total improvement of VA was 0.18 ± 0.16 and 0.31 ± 0.35 logMAR in PG and VT groups, respectively (p = 0.317). The Wilcoxon effect size was slightly higher in VT (0.48 vs. 0.54) at 6 months. An enhancement in CS was observed in the amblyopic eye of the VT group for all spatial frequencies at 1 month (p < 0.001). Likewise, the binocular function score also increased significantly in VT group (p = 0.002). A prediction equation of VA improvement at 1 month in VT group was obtained by multiple linear regression analysis (p < 0.001, R2 = 0.747). CONCLUSIONS A combined treatment of visual training and patching is effective for obtaining a predictable improvement of VA, CS, and binocularity in patching-resistant amblyopic children.
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Affiliation(s)
- Carlos J Hernández-Rodríguez
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig S/N 03016, San Vicente del Raspeig, Alicante, Spain
- Clinical Optometry Unit, Department of Ophthalmology, Ribera Virgen de La Caridad Hospital, Cartagena, Spain
| | | | - Alberto Artola-Roig
- Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
| | - David P Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig S/N 03016, San Vicente del Raspeig, Alicante, Spain.
- Clinical Optometry Unit, Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain.
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Candy TR, Cormack LK. Recent understanding of binocular vision in the natural environment with clinical implications. Prog Retin Eye Res 2021; 88:101014. [PMID: 34624515 PMCID: PMC8983798 DOI: 10.1016/j.preteyeres.2021.101014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/26/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
Technological advances in recent decades have allowed us to measure both the information available to the visual system in the natural environment and the rich array of behaviors that the visual system supports. This review highlights the tasks undertaken by the binocular visual system in particular and how, for much of human activity, these tasks differ from those considered when an observer fixates a static target on the midline. The everyday motor and perceptual challenges involved in generating a stable, useful binocular percept of the environment are discussed, together with how these challenges are but minimally addressed by much of current clinical interpretation of binocular function. The implications for new technology, such as virtual reality, are also highlighted in terms of clinical and basic research application.
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Affiliation(s)
- T Rowan Candy
- School of Optometry, Programs in Vision Science, Neuroscience and Cognitive Science, Indiana University, 800 East Atwater Avenue, Bloomington, IN, 47405, USA.
| | - Lawrence K Cormack
- Department of Psychology, Institute for Neuroscience, and Center for Perceptual Systems, The University of Texas at Austin, Austin, TX, 78712, USA.
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Chow A, Silva AE, Tsang K, Ng G, Ho C, Thompson B. Binocular Integration of Perceptually Suppressed Visual Information in Amblyopia. Invest Ophthalmol Vis Sci 2021; 62:11. [PMID: 34515731 PMCID: PMC8444466 DOI: 10.1167/iovs.62.12.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 08/20/2021] [Indexed: 01/01/2023] Open
Abstract
Purpose The purpose of this study was to assess whether motion information from suppressed amblyopic eyes can influence visual perception. Methods Participants with normal vision (n = 20) and with amblyopia (n = 20; 11 anisometropic and 9 strabismic/mixed) viewed dichoptic, orthogonal drifting gratings through a mirror stereoscope. Participants continuously reported form and motion percepts as gratings rivaled for 60 seconds. Responses were binned into categories ranging from binocular integration to complete suppression. Periods when the grating presented to the nondominant/amblyopic eye was suppressed were analyzed further to determine the extent of binocular integration of motion. Results Individuals with amblyopia experienced longer periods of non-preferred eye suppression than controls. When the non-preferred eye grating was suppressed, binocular integration of motion occurred 48.1 ± 6.2% and 31.2 ± 5.8% of the time in control and amblyopic participants, respectively. Periods of motion integration from the suppressed eye were significantly non-zero for both groups. Conclusions Visual information seen only by a suppressed amblyopic eye can be binocularly integrated and influence the overall visual percept. These findings reveal that visual information subjected to interocular suppression can still contribute to binocular vision and suggest the use of appropriate optical correction for the amblyopic eye to improve image quality for binocular combination.
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Affiliation(s)
- Amy Chow
- Department of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Andrew E. Silva
- Department of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Katelyn Tsang
- Department of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Gabriel Ng
- Mount Pleasant Optometry Centre, Vancouver, British Columbia, Canada
| | - Cindy Ho
- Mount Pleasant Optometry Centre, Vancouver, British Columbia, Canada
| | - Benjamin Thompson
- Department of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
- Center for Eye and Vision Research, 17W Science Park, Hong Kong
- Liggins Institute, University of Auckland, Auckland, New Zealand
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Milla M, Piñero DP. Characterization, passive and active treatment in strabismic amblyopia: a narrative review. Int J Ophthalmol 2020; 13:1132-1147. [PMID: 32685403 PMCID: PMC7321947 DOI: 10.18240/ijo.2020.07.18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 03/15/2020] [Indexed: 12/22/2022] Open
Abstract
Strabismic amblyopia is characterized by a distorted spatial perception. In this condition, the neurofunctional disorder occurring during first years of life provoke several monocular and binocular anomalies such as crowding, deficits in the accommodative response, contrast sensitivity, and ocular motility abilities. The inhibition of the binocular function of the brain by the misaligned amblyopic eye induces a binocular imbalance leading to interocular suppression and the reduction or lack of stereoacuity. Passive treatments such as occlusion, optical and/or pharmacological penalization, and Bangerter foils has been demonstrated to be potentially useful treatments for strabismic amblyopia. Recent researches have proved new pharmacological options to improve and maintain visual acuity after occlusion treatment in strabismic amblyopia. Likewise, the active vision therapy, in the last years, is becoming a very relevant therapeutic option in combination with passive treatments, especially during and after monocular therapy, in the attempt of recovering the imbalanced binocular vision.
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Affiliation(s)
- Myriam Milla
- Department of Optometry, OFTALVIST Alicante, Alicante 03016, Spain
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, San Vicente del Raspeig, Alicante 03690, Spain
| | - David P. Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, San Vicente del Raspeig, Alicante 03690, Spain
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Chow A, Giaschi D, Thompson B. Dichoptic Attentive Motion Tracking is Biased Toward the Nonamblyopic Eye in Strabismic Amblyopia. ACTA ACUST UNITED AC 2018; 59:4572-4580. [DOI: 10.1167/iovs.18-25236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Amy Chow
- Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Deborah Giaschi
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Benjamin Thompson
- Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
- Optometry and Vision Science, University of Auckland, Auckland, New Zealand
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