Relearning to Fixate as an Adult with Strabismic Amblyopia: Supportive Evidence of Neuroplasticity.

Background: Neuroplasticity is the basis for accepting adult strabismic/amblyopic patients into vision therapy. Although the patient's age has a large impact on the prognosis, it is only one of the deciding factors. Patient goals/motivation, fixation, correspondence, magnitude and frequency of strab...

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Publicado en:Optometry & Visual Performance Vol. 7; no. 2; pp. 93 - 100
Autores principales: Yutaka Maki, Coates, Russell S.
Formato: case study tables/charts Journal Article
Publicado: Optometric Extension Program Apr2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2019
      vid: 7
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      pub: Optometric Extension Program
      place: Lutherville Timonium, Maryland
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        atl: Relearning to Fixate as an Adult with Strabismic Amblyopia: Supportive Evidence of Neuroplasticity.
      aug:
        au:
          Yutaka Maki
          Coates, Russell S.
        affil: UIW Rosenberg School of Optometry, San Antonio
      sug:
        subj:
          Neuronal Plasticity
          Strabismus
          Amblyopia
          Vision Disorders Therapy
          Adult
          Female
          Age Factors
          Strabismus Prognosis
          Amblyopia Prognosis
          Visual Acuity
          Motivation
          Patient Compliance
          Eye Movements Physiology
          Adult: 19-44 years
          Female
      ab: Background: Neuroplasticity is the basis for accepting adult strabismic/amblyopic patients into vision therapy. Although the patient's age has a large impact on the prognosis, it is only one of the deciding factors. Patient goals/motivation, fixation, correspondence, magnitude and frequency of strabismus, suppression, degree of fusion, etc. also have a significant impact on the patient's prognosis. Case Report: A 34-year-old Caucasian female with long-standing strabismus and amblyopia presented with a goal to improve her vision OS. Best-corrected visual acuities (BCVA) were 20/20 OD, 20/100-2 OS at distance and 20/20 OD, 20/80-2 OS at near. Other pertinent findings included: 4-6 PD constant left esotropia, anomalous correspondence at near, steady central fixation OD, steady 1.5 PD nasal eccentric fixation OS, central suppression OS, flat fusion at 40 cm and 1 m, simultaneous perception (eso) at 2 m with partial suppression OS, and suppression OS at 3m. The patient was informed of a guarded prognosis, and a tensession, trial-basis course of vision therapy was initiated. The patient's degree of eccentric fixation changed to unsteady 0.5 PD nasal eccentric fixation OS after ten weeks. The patient self-discontinued the therapy program after 18 sessions (due to job constraints) with a final BCVA of 20/50-1 OS without visual symptoms. Conclusion: The significant improvement achieved in the patient's visual acuity OS was evidence of neuroplasticity in adult patients. The most probable reason for the improvement in visual acuity was the improvement of monocular fixation OS. In addition, strong motivation and compliance with vision therapy homework led to success.
      pubtype: Academic Journal
      doctype:
        case study
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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