It was long thought that treating amblyopia, the medical term for lazy-eye, after the "critical age" of 8-12 years old was not possible. Unfortunately, many optometrists and ophthalmologists still believe, refer to, and share this outdated view. Research, clinical trials, and well-documented patient cases, now show that amblyopia can be treated well into adult hood.
In an excerpt from Stereopsis and amblyopia: A mini-review. Levi et al explain, "Brain plasticity is known to peak during a critical period in early childhood and to decrease thereafter (Bavelier et al., 2010; Movshon & Van Sluyters, 1981; Wiesel, 1982)." They go on to explain that this highlights the effectiveness of early intervention but the assumption that plasticity ends after a critical period has been detrimental to patient care.
Levi et al lament, "Amblyopic patients over the age of seven are often told that they will never be able to recover visual acuity or stereovision because their visual system is beyond the critical period for binocular vision. Young brains are certainly much more plastic than older ones, yet the last 15 years have shown that significant plasticity can still be induced beyond the critical period if appropriate input is provided." They share multiple references supporting this claim: Baroncelli, Maffei, & Sale, 2011; Bavelier et al., 2010; Hess, Thompson, & Baker, 2014; Levi, 2012; Levi & Li, 2009; Levi & Polat, 1996; Morishita & Hensch, 2008; Wong, 2012.
Though it can be more difficult to treat adults, there is evidence that improvements in acuity, depth perception, and vergence ability are all possible through vision therapy, eye surgery, and visual perceptual training. Amblyopia is treated through a combination of lenses and active vision therapy including Vivid Vision.
Dubbed “Stereo Sue” by neurologist Oliver Sacks in a New Yorker article by that name, Dr. Susan Barry is the author of the book Fixing My Gaze which describes her astonishing experience of gaining 3D stereovision after a lifetime of seeing in only two dimensions.
Dr. Barry was cross-eyed from early infancy and had three surgeries as a child that, according to her, "made my eyes look more or less straight." Dr. Barry did not develop stereovision until age 48 when she underwent optometric vision therapy under the guidance of a developmental optometrist. As a neurobiologist, Dr. Barry is in a unique position to tell her life story because she can, and does, give scientific explanations for why her eyes and brain could not produce 3-D images, and how she fixed that problem.
There is overwhelming evidence suggesting that presenting the images to the eyes in a therapeutic manner (such as Vivid Vision) rehabilitates the brain to a level that allows both eyes to be used together and thus, no lazy eye! Vivid Vision uses dichoptic training to treat lazy eye in adults successfully. Often times, patients with amblyopia as an adult are left without treatment with the assumption of the "critical period. The critical period has been debunked time and time again, yet some practitioners continue to use this as a basis for not treating adult patients. The good news is, since Vivid Vision started, we have heard hundreds of success stories from adults around the world who have had the opportunity to use the software in-clinic and at home. Those stories can be found in the blog section of our website. You can also find them at the bottom of this page.
Video games have long been used in the entertainment category. Now, more than ever before, they are being used to rehabilitate not just lazy eye, but anxiety, physical therapy, etc. Wouldn't you want to play video games and treat your eyes at the same time? That is why Vivid Vision was created! To allow folks, to train their brain to use both eyes while being actively engaged. Our video game is not only fun and engaging but it is also working to help train the patient's brain to recognize images from both eyes. Gone are the days of the eye patch! Now we actively engage both eyes, even eye surgery may be a thing of the past! Of course, the type of video game is going to matter when treating lazy eye in adults (and kids). That is why Vivid Vision was specifically designed to focus specifically on elements of therapy that are most suited for the treatment of lazy eye.
When we think about vision therapy, most think of how to motivate children to do the required activities. However, when an adult comes in for vision therapy, a lot of the time they are intrinsically motived to do all of the activities. Vivid Vision makes that motivation that much easier to have for adults because they know they are treating their lazy eye with quality software that they are excited to use every day. Even adults can have compliance issues with patching. Can you imagine patching your good eye while you work? There are very few if any of us that can bear to have our good eye patched while working. Vivid Vision doesn't require a patch because the software is actively engaging both eyes and thus the brain. Lazy eye treatment is highly dependant on compliance of the patient. Having a video game to play makes vision therapy that much easier to enjoy and thus comply with.
Many adults have indicated that having a lazy eye causes them stress and low self-esteem, especially in the workplace. Adults with lazy eye are often not able to become pilots or other professions that require the use of both eyes together. Once an adult patient is able to treat the lazy eye, the possibilities of career open. This often gives people the confidence it takes to seek a new career. Often times before vision therapy, adults who have lazy eye are looked at and made fun of. This can be debilitating to some adults, leaving them with low self-esteem, anxiety, etc. Blurry vision is also a huge factor for patients with lazy eye. Having that visual blur means that the adult patient is reliant on their glasses or contacts to see. Most adults with lazy eye have been wearing their glasses or contacts for so long that it is like second nature to have them. However, most patients will switch to contacts, again because of self-esteem.
Stereo Sue Barry: www.stereosue.com/who-is-stereo-sue/
Bavelier, D., Levi, D. M., Li, R. W., Dan, Y., & Hensch, T. K. (2010). Removing brakes on adult brain plasticity: From molecular to behavioral interventions. The Journal of Neuroscience, 30(45), 14964–14971. Accessed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992973/
Baroncelli, L., Maffei, L., & Sale, A. (2011). New perspectives in amblyopia therapy on adults: A critical role for the excitatory/inhibitory balance. Frontiers in Cellular Neuroscience, 5, 25. Accessed: https://www.frontiersin.org/articles/10.3389/fncel.2011.00025/full
Hess, R. F., Thompson, B., & Baker, D. H. (2014). Binocular vision in amblyopia: Structure, suppression and plasticity. Ophthalmic and Physiological Optics, 34(2), 146–162. Accessed: https://www.ncbi.nlm.nih.gov/pubmed/24588532
Levi, D. M. (2012). Prentice award lecture 2011: Removing the brakes on plasticity in the amblyopic brain. Optometry and Vision Science, 89(6), 827–838. Accessed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3369432/
Levi, D. M., & Li, R. W. (2009). Perceptual learning as a potential treatment for amblyopia: A mini-review. Vision Research, 49(21), 2535–2549. Accessed: https://www.ncbi.nlm.nih.gov/pubmed/19250947
Levi, D. M., & Polat, U. (1996). Neural plasticity in adults with amblyopia. Proceedings of the National Academy of Sciences of the United States of America, 93(13), 6830–6834. Accessed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC39113/
Morishita, H., & Hensch, T. K. (2008). Critical period revisited: Impact on vision. Current Opinion in Neurobiology, 18(1), 101–107. Accessed: https://www.ncbi.nlm.nih.gov/pubmed/18534841
Movshon, J. A., & Van Sluyters, R. C. (1981). Visual neural development. Annual Review of Psychology, 32, 477–522. Accessed: https://www.annualreviews.org/doi/abs/10.1146/annurev.ps.32.020181.002401
Wiesel, T. (1982). Postnatal development of the visual cortex and the influence of environment. Nature, 299, 583–591. Accessed: https://www.nature.com/articles/299583a0