Patch-free streaming contrast-rebalanced dichoptic cartoons versus patching for treatment of amblyopia in children aged 3 to 5 years: a pilot, randomized clinical trial.

Background: We developed and tested a dichoptic treatment designed for younger children that can be viewed freely and involves a dichoptic manipulation of a popular animation series that enables contrast-rebalancing without disrupting fusion. Our aim was to assess whether this novel amblyopia treatment is superior to patching in children aged 3-5 years.

Methods: A total of 34 children with amblyopia were randomly assigned to contrast-rebalanced dichoptic cartoons (4 hours/week) or patching (14 hours/week) for 2 weeks.

Objective assessment of control compared with clinical triple office control score in children with intermittent exotropia.

Poor control of intermittent exotropia may be used as an indication for surgery. However, control fluctuates during the day and from day to day. The standardized triple office control score (mean of three scores on a 6-point ordinal scale) is representative of repeated assessments throughout the day, but lacks validation against an objective measure of eye movements.

Slow Binocular Reading in Amblyopic Children Is a Fellow Eye Deficit.

Significance: Amblyopic children read 25% slower than their peers during binocular silent reading.

Purpose: We compared binocular reading to fellow eye reading to determine whether slow reading in amblyopic children is due to binocular inhibition; that is, the amblyopic eye is interfering during binocular reading.

Methods: In a cross-sectional study, 38 children with amblyopia and 36 age-similar control children who completed grades 1 to 6 were enrolled.

Temporal Eye-Hand Coordination During Visually Guided Reaching in 7- to 12-Year-Old Children With Strabismus.

Purpose: We recently found slow visually guided reaching in strabismic children, especially in the final approach. Here, we expand on those data by reporting saccade kinematics and temporal eye-hand coordination during visually guided reaching in children treated for strabismus compared with controls.

Methods: Thirty children diagnosed with esotropia, a form of strabismus, 7 to 12 years of age and 32 age-similar control children were enrolled.

Randomized clinical trial of streaming dichoptic movies versus patching for treatment of amblyopia in children aged 3 to 7 years.

Contrast-rebalanced dichoptic movies have been shown to be an effective binocular treatment for amblyopia in the laboratory. Yet, at-home therapy is a more practical approach. In a randomized clinical trial, we compared dichoptic movies, streamed at-home on a handheld 3D-enabled game console, versus patching as amblyopia treatment.

Reach Kinematics During Binocular Viewing in 7- to 12-Year-Old Children With Strabismus.

Purpose: Eye-hand coordination is essential for normal development and learning. Discordant binocular experience from childhood strabismus results in sensory and ocular motor impairments that can affect eye-hand coordination. We assessed reach kinematics during visually guided reaching in children treated for strabismus compared with controls.

A randomized clinical trial of contrast increment protocols for binocular amblyopia treatment.

Background: Most clinical trials of contrast-rebalanced binocular amblyopia treatment used a contrast increment protocol of 10% daily with successful play. Paired with a definition of success requiring only 15-30 min/day of gameplay, this increment protocol could allow children to reach 100% fellow eye contrast in 3-9 hours; however, this may not provide adequate therapeutic time with reduced fellow eye contrast. The purpose of this study was to compare the original protocol against three alternative contrast increment protocols designed to increase the number of treatment hours.

Factors Associated with Impaired Motor Skills in Strabismic and Anisometropic Children.

Purpose: We evaluated motor skills in children diagnosed with strabismus and anisometropia, with or without amblyopia, and explored factors associated with impairments.

Methods: A total of 143 strabismic and anisometropic children 3 to 13 years of age (96 amblyopic, 47 nonamblyopic) and a group of age-similar 35 control children completed Manual Dexterity, Aiming and Catching, and Balance tasks from the Movement Assessment Battery for Children, Second Edition. Raw scores were converted to standardized scores, and amblyopic and nonamblyopic children were compared to controls.

Baseline and Clinical Factors Associated with Response to Amblyopia Treatment in a Randomized Clinical Trial.

Significance: We sought to identify baseline and clinical factors that were predictive of the response to amblyopia treatment. We report that binocular amblyopia treatment may be especially effective for moderate amblyopia in orthotropic children.

Purpose: We previously reported results from the primary cohort (n = 28) enrolled in a randomized clinical trial (NCT02365090), which found that binocular amblyopia treatment was more effective than patching.

Binocular amblyopia treatment with contrast-rebalanced movies.

Background: Binocular amblyopia treatments promote visual acuity recovery and binocularity by rebalancing the signal strength of dichoptic images. Most require active participation by the amblyopic child to play a game or perform a repetitive visual task. The purpose of this study was to investigate a passive form of binocular treatment with contrast-rebalanced dichoptic movies.

Improved Binocular Outcomes Following Binocular Treatment for Childhood Amblyopia.

Purpose: Childhood amblyopia can be treated with binocular games or movies that rebalance contrast between the eyes, which is thought to reduce depth of interocular suppression so the child can experience binocular vision. While visual acuity gains have been reported following binocular treatment, studies rarely report gains in binocular outcomes (i.e.

Slow reading in children with anisometropic amblyopia is associated with fixation instability and increased saccades.

Background: Previous studies show slow reading in strabismic amblyopia. We recently identified amblyopia, not strabismus, as the key factor in slow reading in children. No studies have focused on reading in amblyopic children without strabismus.

Binocular iPad Game vs Patching for Treatment of Amblyopia in Children: A Randomized Clinical Trial.

Importance: Fellow eye patching has long been the standard treatment for amblyopia, but it does not always restore 20/20 vision or teach the eyes to work together. Amblyopia can be treated with binocular games that rebalance contrast between the eyes so that a child may overcome suppression. However, it is unclear whether binocular treatment is comparable to patching in treating amblyopia.

High specificity of the Pediatric Vision Scanner in a private pediatric primary care setting.

Purpose: To determine the specificity of the Pediatric Vision Scanner, a binocular retinal birefringence scanner, in its intended setting, a pediatric primary care office.

Methods: A total of 102 preschool children (age 2-6 years) were screened during a well-child pediatric visit using the Pediatric Vision Scanner and the SureSight Autorefractor and completed a masked comprehensive pediatric ophthalmic examination (gold standard examination).

Results: Based on the gold standard examination, one child had anisometropic amblyopia, and the remaining 101 had no amblyopia or strabismus.

Dichoptic movie viewing treats childhood amblyopia.

Background: Contrast-balanced dichoptic experience with perceptual-learning tasks or simple games has been shown to improve visual acuity significantly in amblyopia. However, these tasks are intensive and repetitive, and up to 40% of unsupervised patients are noncompliant. We investigated the efficacy of a potentially more engaging movie method to provide contrast-balanced binocular experience via complementary dichoptic stimulation.

Uses of the Inferior Oblique Muscle in Strabismus Surgery.

Inferior oblique muscle weakening is typically performed for overaction of the muscle. In this article, we review inferior oblique muscle anatomy, different weakening procedures, and recent surgical techniques that take advantage of the muscle's unique anatomy for the treatment of additional indications such as excyclotorsion and hypertropia in primary gaze.

Binocular iPad treatment for amblyopia in preschool children.

Background: Recent experimental evidence supports a role for binocular visual experience in the treatment of amblyopia. The purpose of this study was to determine whether repeated binocular visual experience with dichoptic iPad games could effectively treat amblyopia in preschool children.

Methods: A total of 50 consecutive amblyopic preschool children 3-6.

Beyond screening for risk factors: objective detection of strabismus and amblyopia.

Importance: Commercially available automated vision screening devices assess refractive risk factors, not amblyopia or strabismus, underreferring affected children and overreferring healthy children. Nearly half of affected children are not identified until after age 5 years, when treatment is less effective.

Objectives: To determine the diagnostic accuracy of the Pediatric Vision Scanner (PVS), a binocular retinal birefringence scanner, to objectively identify strabismus and amblyopia, and to compare retinal birefringence screening with a widely used automated pediatric screening device.

Apodized diffractive intraocular lens implantation after laser in situ keratomileusis with or without subsequent excimer laser enhancement.

Purpose: To evaluate the long-term refractive and visual outcomes of apodized diffractive multifocal intraocular lens (IOL) implantation after myopic laser in situ keratomileusis (LASIK) with or without subsequent excimer laser enhancement.

Setting: University of Texas Southwestern Medical Center at Dallas, Texas, USA.

Design: Comparative case series.

Limbal relaxing incisions at the time of apodized diffractive multifocal intraocular lens implantation to reduce astigmatism with or without subsequent laser in situ keratomileusis.

Purpose: To evaluate the visual and refractive outcomes of limbal relaxing incisions (LRIs) to reduce astigmatism at the time of apodized diffractive multifocal intraocular lens (IOL) implantation.

Setting: University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA.

Methods: This retrospective review comprised consecutive patients who had LRIs at the time of lens extraction and AcrySof ReSTOR IOL implantation.