Turning a blind eye to the less than feline-friendly work of Hubel and Wiesel and, subsequently, the primate-worrying activity of otherwise polymath Colin Blakemore, there is no doubt that the theory behind amblyopia is fascinating.
The existence of a plasticity period of development, typically assumed to be the first eight years of life, during which sight might be improved for amblyopes, and of binocular dominance columns in the visual cortex, all came from this research and offered a much better understanding of how vision works.
That said, amblyopia is still the biggest cause of unilateral sight loss in the UK, affecting up to 5% of the population. Despite efforts to reduce costs by cutting school vision screening on the grounds that monocular vision loss has no impact on a child’s development (remember the Hall report?), a significant number of children are treated each year to improve the vision in their weaker eye. This, in turn, helps their overall perception and reduces the potential of impairment later in life due to problems with their better sighted eye.
So, is it just me or does anyone else think that, after all this research and knowledge around the significance of amblyopia, treatment by patching seems a little archaic? And, even ignoring the potential for bullying, self-awareness impact and poor compliance, surely there is a more controllable way of visual deprivation treatment.
Electronic amblyopia management systems have been bubbling under the surface for years now. Specs with controllable occlusion filtering and digital game displays that bias one eye or blur the fixation target of the better eye can treat amblyopia much more accurately; and in a way that children enjoy.
So, as studies appear showing that they are more effective than patching, this has got to be another new and exciting area for eye care practitioners to be better involved with.
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