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Treatment of amblyopia as a function of age

Published online by Cambridge University Press:  16 April 2018

JONATHAN M. HOLMES  and
DENNIS M. LEVI
JONATHAN M. HOLMES*
Affiliation:
Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
DENNIS M. LEVI
Affiliation:
University of California, School of Optometry, Berkeley, California
*
*Address correspondence to: Jonathan M. Holmes, Department of Ophthalmology, Mayo Clinic, 200 First St SW, Rochester, MN 55905. E-mail: holmes.jonathan@mayo.edu
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Abstract

Although historically, treatment of amblyopia has been recommended prior to closure of a critical window in visual development, the existence and duration of that critical window is currently unclear. Moreover, there is clear evidence, both from animal and human studies of deprivation amblyopia, that there are different critical windows for different visual functions and that monocular and binocular deprivation have different neural and behavioral consequences. In view of the spectrum of critical windows for different visual functions and for different types of amblyopia, combined with individual variability in these windows, treatment of amblyopia has been increasingly offered to older children and adults. Nevertheless, treatment beyond the age of 7 years tends to be, on average, less effective than in younger children, and the high degree of variability in treatment response suggests that age is only one of many factors determining treatment response. Newly emerging treatment modalities may hold promise for more effective treatment of amblyopia at older ages. Additional studies are needed to characterize amblyopia by using new and existing clinical tests, leading to improved clinical classification and better prediction of treatment response. Attention also needs to be directed toward characterizing and measuring the impact of amblyopia on the patients’ functional vision and health-related quality of life.

Keywords

BinocularVideogamesPerceptual learningPatchingPharmacological treatmentMotor activityPhenotyping

Information

Type
Perspective
Information
Visual Neuroscience , Volume 35 , 2018 , E015
Copyright
Copyright © Cambridge University Press 2018 

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