A low vision evaluation is in some ways similar to a regular eye exam, and in other ways entirely different. […]
Abstract
Background: Recent evidence points to the use
of spectacles alone in the treatment of anisometropic
amblyopia. However, the impact of this treatment
on the restoration of binocular vision is often not
considered.
Case Report: Patient M.Z., aged 7
years, showed 3.5D of anisometropia which was
coupled with a best corrected visual acuity of 6/38 in
the more hyperopic eye (6/6 in the non-amblyopic
eye). Spectacle lenses were prescribed using specially
designed software to alter the spectacle frame and
lens parameters to theoretically reduce the static and
dynamic aniseikonia to 1% and 3.8% respectively.
Four subsequent follow up visits were conducted over
a 2 year period where standard clinical measures of
refraction, visual acuity, and binocular vision were
conducted. The spectacles were worn consistently over
this time. Single letter acuity normalized by 5 months
while crowded acuity took longer. Improvements of
binocular vision resulted concomitantly. However,
improvement in suppression and stereo acuity continued for 2 years following the initial spectacle
correction
Conclusions: This case exemplifies how
the prescribing of spectacle lenses with consideration
of, and correction for, predicted optical aniseikonia
allowed the amelioration of amblyopia without
patching and the provision of significant levels of
binocular vision within a 1 year period. However, the
time course for the development of binocular vision
well exceeded that for the amelioration of amblyopia.
A low vision evaluation is in some ways similar to a regular eye exam, and in other ways entirely different. […]
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