Visual rehabilitation indicating neuroplasticity in an esotropic adult patient with diplopia after sudden visual acuity loss in the non-amblyopic eye: A case report.
Andrzej Michalski, Katarzyna Dubas, Sławomir Nogaj and 1 others
PMID 37424479WHAT IT FOUND
A 71-year-old woman with long-standing left-eye amblyopia developed double vision after sudden vision loss in her right eye.
Three months of visual training, combined with prism glasses and patching, reduced her eye turn and improved vision in the amblyopic eye.
Key findings
01The patient's left eye visual acuity improved from 1.0 to 0.5 logMAR after three months of visual rehabilitation.
02Constant esotropia in the left eye decreased from 20 prism diopters at distance and 30 at near to 16 and 20 prism diopters respectively.
03The amount of base-out prism needed to achieve stable sensory fusion decreased for both distance and near vision.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a single case report, so the results cannot be generalized to other patients. There was no control group, so it is impossible to know if the improvement was due to the visual training, the prism glasses, natural recovery, or other factors. The study did not include objective measures of neuroplasticity (such as brain imaging changes) to prove the mechanism proposed by the authors. The follow-up period was short (three months), so it is unknown if the gains in visual acuity and alignment were sustained long-term.
Declared interests
The text does not report any conflicts of interest or funding sources.
The easy way to misread this
Do not interpret this case as evidence that visual training reliably reverses adult amblyopia or strabismus in the general population. The improvement occurred in one specific patient with a unique combination of NAION-induced loss of suppression and long-standing untreated amblyopia, and no control group was used to isolate the effect of the therapy.