ESCRS - PP27.04 - Role Of Dichoptic Therapy In Amblyopia: A Promising Intervention Beyond The Critical Period

Role Of Dichoptic Therapy In Amblyopia: A Promising Intervention Beyond The Critical Period

Published 2025 - 43rd Congress of the ESCRS

Reference: PP27.04 | Type: Free paper | DOI: 10.82333/yhxc-js22

Authors: Mohamed Hosny Abdelrahman* 1 , Jack Parker 2

1Cirnea,ParkerCorneq, AlabamaAAlabama,Afghanistan, 2Cornea,ParkerCornea, AlabamaAAlabama,Åland Islands

Purpose

To assess the effectiveness of dichoptic therapy in improving visual acuity and stereoacuity in amblyopic patients across various age groups, challenging the traditional notion of a rigid critical period for treatment.

Setting

Vision Eye Care Centre

Methods

A cohort of 27 amblyopic patients (mean age: 21 years; range: 15.5–25.5 years) was enrolled. Inclusion criteria comprised anisometropic amblyopia with full-time spectacle correction. Exclusion criteria included deprivational amblyopia, ocular comorbidities, or underlying neurological conditions. Participants underwent home-based dichoptic therapy using Bynocs software for one hour daily, five days a week.

Patients were divided into three age groups:

  1. Children (6–11 years; n=4)
  2. Adolescents (12–17 years; n=7)
  3. Adults (≥18 years; n=16)

Visual acuity was measured using logMAR units before and after therapy. Additionally, stereoacuity was assessed in participants with no baseline stereopsis. Wilcoxon signed-rank test was used for statistical analysis.

Results

Across all age groups, significant improvements in visual acuity were observed:

  • Children (6–11 years):

    • Pre-therapy logMAR: 0.50 (0.30–0.70)
    • Post-therapy logMAR: 0.20 (0.20–0.50)
    • Median improvement: 0.30 lines

  • Adolescents (12–17 years):

    • Pre-therapy logMAR: 0.50 (0.40–0.60)
    • Post-therapy logMAR: 0.10 (0.10–0.20)
    • Median improvement: 0.40 lines

  • Adults (≥18 years):

    • Pre-therapy logMAR: 0.60 (0.50–0.80)
    • Post-therapy logMAR: 0.30 (0.20–0.40)
    • Median improvement: 0.30 lines

A statistically significant improvement in visual acuity was observed in all groups (p = 0.001).

Stereopsis Outcomes: 11 out of 13 participants, who did not had stereopsis to start with, developed stereopsis, with an average improvement of 100 arcsec (40–300 arcsec).

Conclusions

This study challenges the conventional belief that amblyopia treatment is ineffective beyond early childhood. Dichoptic therapy demonstrated significant improvements in both visual acuity and stereopsis across all age groups, including adults, long after the traditionally defined critical period. These findings suggest that neural plasticity persists beyond childhood and that binocular interventions may serve as an effective treatment alternative for older amblyopic patients. Future research should focus on long-term retention of gains and optimizing therapy protocols for sustained visual improvements.