Improving visuomotor and visuocognitive outcomes in deprivation amblyopia with binocular treatment
BACKGROUND: Deprivation amblyopia, due to congenital and infantile cataracts, is likely to have significant, widespread effects on developing visuomotor and visuocognitive abilities and self-perception. Recent animal models challenge the dominant theory that a cataract deprives the developing visual cortex of input during a critical period; a cataract does not only “turn off” input but also results in discordant spontaneous activity, akin to the decorrelation of monocular images experienced in strabismic and anisometropic amblyopia. Thus, as in strabismic and anisometropic amblyopia, we may expect to find widespread effects on developing visuomotor and visuocognitive abilities in deprivation amblyopia that may be responsive to the new binocular approach to amblyopia treatment.
GAP: Because the etiology of deprivation amblyopia has been viewed as distinct from strabismic and anisometropic amblyopia, there is only a scant evidence base on the consequences and rehabilitation of deprivation amblyopia.
Hypothesis 1: Deprivation amblyopia has quantifiable and significant effects on developing visuomotor and visuocognitive abilities.
Hypothesis 2: Deprivation amblyopia can be treated with contrast-balanced binocular games.
METHODS: Children (age 3-14 years) with a history of visually significant congenital or infantile cataracts will be enrolled. Aim 1 is a cross-sectional evaluation of visuomotor skills, visuocognitive skills, self-perception, visual acuity, binocular function, and fixation stability; Aim 2 is a randomized clinical trial of binocular treatment vs. patching in deprivation amblyopia.
IMPACT: These data will guide the design of school accommodations and interventions to promote academic success and potentially open a new avenue for deprivation amblyopia treatment to surmount obstacles to proficient visuomotor skills, reading, and self-perception.