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Vision training for presbyopic nonstrabismic patients.

Home vision training was prescribed for 161 presbyopic patients (ages 45 to 89) who had vision-related symptoms and convergence insufficiency or visual skills deficiencies. Most patients required 10 weeks or less of treatment, the longest treatment period being 15 weeks. Elimination of the symptoms and improved responses on certain optometric tests was achieved by 92% of the patients. Evaluation 3 months after therapy indicated that 77 patients required additional training, the older patients requiring it more often, to retain the initial improvement.

Age Factors↗

A new method of determining the primary position of the eye using Listing's law.

A new method of determining the primary direction of regard, using Listing's law as a basis, is described. Previous techniques have required a trial-and-error experimental procedure. The present technique requires only a single measurement set of eye torsions in selected gaze directions. Experimental data to illustrate the technique are presented.

Eye↗

The effect of light flashing at 9 Hertz on rivalry suppression.

The translid binocular interactor (TBI), which presents binocularly out-of-phase lights flashing at 9 Hz, was designed to reduce suppression of amblyopes. To determine the effect of such flashing lights on rivalry suppression, subjects who showed strong suppression during binocular rivalry were exposed to a modified form of the TBI for a total of 2 2/3 hr over 4 days. A similar group of subjects was exposed to steady binocular light. The modified TBI had no effect on rivalry suppression; the changes in suppression that did occur were equivalent in the two groups.

Amblyopia↗

Convergence and divergence show large and sustained improvement after short isometric exercise.

There are conflicting reports on the effect of vergence training. In two studies using push up and prism vergence exercises the conflict is shown to result from differences in the constancy of effort. Improvement only occurs in exercises involving sustained effort in the direction being trained. The effect of alternating movements in both directions is small and inconsistent. Substantial longlasting gains in either convergence or divergence prism vergence scores can result from just 5 min of sustained effort at an angle halfway between the break and recovery points. Results for adults and children on motor-driven instruments are comparable and the scores obtained discriminate better than those from hand-turned instruments. The most likely physiological model involves potentiating processes which are specifically maximized by isometric exercise. Potentiation results in a positive feedback process, the effects of which are strong enough to precipitate strabismus and which might be deliberately manipulated in therapy of poor vergence control, if responses in the required direction can be induced.

Adult↗

Prevalence and management of divergence excess.

The prevalence of divergence excess was assessed from the records of 250 consecutive patients attending a binocular-vision clinic. The 67 cases in the sample showing divergence excess were subdivided into the following groups: (1) secondary to operations for esotropia (8 cases); (2) anisometropic amblyopes (14 cases); (3) basic (14 cases); (4) convergence weakness (13 cases); (5) divergence excess (18 cases). Treatment methods placed heavy emphasis on physiological diplopia. Of the 18 in the divergence excess category, 14 began treatment, 10 showed a satisfactory outcome, two achieved some improvement, and two discontinued treatment on their own. Divergence excess seems to respond well to nonsurgical treatment.

Adult↗

Operant conditioning of fusional convergence ranges using random dot stereograms.

In Experiment 1, four 6- to 10-year-old strabismus patients, who had failed to improve convergence ranges using traditional vision training techniques, were given convergence training using random dot stereograms (RDS). An integral part of the RDS training procedure was the incorporation of an operant conditioning procedure providing for response-contingent positive reinforcement, immediate feedback, and preprogrammed systematic changes in convergence demand during discrimination learning. Findings indicated that operant RDS convergence training produced a significant increase in convergence ranges which transferred readily to vectogram tasks and resulted in a change from exotropia to exophoria for at least one patient. In Experiment 2, it was shown that improved convergence ability was a direct result of exposure to RDS of increasing convergence demand. It was concluded that young, uncooperative, language-deficient, or inattentive patients show improved convergence ranges when such training incorporates proper stimuli and the basic principles of learning and motivation into its training regimen.

Accommodation, Ocular↗

Effect of vision training on patients who fail Sheard's criterion.

One hundred convergence insufficiency patients who did not meet Sheard's criterion at near were given a program of in-office and at-home training. The objective was to see if they would meet Sheard's criterion after training. Results were analyzed in terms of the numbers successfully meeting this criterion as well as other criteria, i.e. Percival's, elimination of symptoms, improvement of stereopsis, and elimination of fixation disparity. Of the 100 patients, 84 successfully met Sheard's criterion after therapy. Failure to meet Sheard's criterion correlated well with having subjective symptoms.

Accommodation, Ocular↗

The effect of accommodative deficiencies on the developmental level of perceptual skills.

The relation of accommodative to visual-motor perceptual abilities was investigated. patients between 5 and 13 years of age manifesting both accommodative and visual-motor perceptual deficits were given accommodative therapy. The effect of this therapy was analyzed, and the results indicated that improvement in the visual and motor perceptual abilities occurred in the 5 to 7 years, 11 month age group.

Accommodation, Ocular↗

Results of intensive CAM grating treatment in a strabismic amblyope.

CAM treatment was instituted for an 8-week period in a 10-year-old patient who failed to respond well to conventional amblyopia therapy. A small, consistent, statistically significant improvement in visual acuity was found. This improvement was attributed to a change in fixation locus and to practice effects, and not to spatial frequency/orientation-dependent "reactivation" of cortical neurons involved in the development of amblyopia.

Amblyopia↗

Congenital esotropia--a documented case report.

Criteria for defining congenital esotropia and its cure are related to a documented case history. A congenitally esotropic child had strabismus surgery at age 13 months. At 11 years of age the had 20 delta of left exotropia. One year of vision training enabled her to achieve some stereopsis but she retained a small angle asotropia whenever the controlled her exophoric tendency.

Accommodation, Ocular↗