Recovering Vision andBinocularity in a Presbyopic Patientwith Amblyopia

This is a case report of a 41-year-old male with presbyopia and previously untreated amblyopia. Because of his age, well beyond the so-called critical period, conventional thinking has been that the chances for improvement in amblyopia and binocular integration are limited. In light of recent research defining the role of brain plasticity in amblyopia, an office-based vision therapy program of 25 sessions was implemented under the supervision of an optometrist. Significant results of vision therapy were noted as structural normalization in subfoveal choroidal thickness, functional normalization of visual acuity, and improvement in stereopsis (<480 sec of arc to 100 sec of arc). Active vision therapy serves to manage amblyopia while simultaneously recovering binocular vision, higher order visual function, and stereopsis. Following the introduction of procedures in perceptual learning, treatment of adult amblyopia has been receiving greater attention. While controlled studies remain to be done, this case report adds to the body of literature showing that significant structural and functional changes can be obtained well into adulthood with excellent clinical outcome through optometric vision therapy.