![Page 1: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/1.jpg)
Alvina Pauline D. Santiago, MD Pediatric Ophthalmology & Adult Strabismus Basic Course Lectures in Ophthalmology Sentro Oftalmologico Jose Rizal Philippine General Hospital September 2016
![Page 2: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/2.jpg)
![Page 3: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/3.jpg)
¡ Correspondence&disparity§ sensorybinocularcooperationbasedoncorrespondence&disparity
§ singlevisualimpression,nodepth§ binocularrivalry:diplopia§ horizontaldisparity:depthwithinPanum’sfusionalspace
![Page 4: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/4.jpg)
¡ Horopter§ locusofallobjectptsimagedoncorrespondingretinalelementsatagivenfixationdistance
¡ Panum’sfusionalspaceorareaofSBV§ regioninfrontofandatthebackofthehoropterthatstillallowsSBV
§ allowsdepthperception
![Page 5: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/5.jpg)
¡ Horopter§ Ellipticallinethatstimulate
correspondingpointsontheretina
¡ Panum’sfusionalspace§ Areainfrontandbehind
horopterwhereobjectsstimulatenoncorrespondingpointsandyetarestillfusibleasoneretinalimage
Figure from Wright’s Pediatirc Ophthalmology
![Page 6: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/6.jpg)
¡ Uncrosseddiplopia
¡ Crosseddiplopia
Figure from Wright’s Pediatirc Ophthalmology
![Page 7: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/7.jpg)
¡ Neurophysiologictheory§ visualstimulifromretinatovisualcortexmodifiedandcoded
§ only25%binocularlydrivencellsarestimulatedequally;75%gradedinfluencefromR&Leye
§ Macaquemonkey:Ar18;Rhesus:Ar17-18§ Lostbinocularneuronsdonotrecover
![Page 8: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/8.jpg)
¡ Reducedpanoramaofvision¡ Uprightposition¡ Frontaleyeposition¡ Visuomotortasksimproved¡ Depthperception¡ Orientationofbodytoenvironment
![Page 9: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/9.jpg)
From Adler’s Physiology of the Eye
![Page 10: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/10.jpg)
From Cybersight.org: Compilation of behavioral data from different studies showing the development of binocular grating acuity in humans over the first 5 postnatal years. (From Teller DY, Movshon JA: Visual development. Vision Res 26:1483, 1986.)
![Page 11: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/11.jpg)
¡ FinevisualdiscriminationcharacteristicofhighVArequiresharplyfocusedsmallobjectsasappropriatestimuli
http://www.macuhealth.com
![Page 12: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/12.jpg)
From Rosenbaum & Santiago Clinical Strabismus Management
![Page 13: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/13.jpg)
¡ 2mirrorsatelbowthatreflectimagesfrompictureslides
¡ armsmaybemovedtoaligntargetsoneachfovea
From Rosenbaum & Santiago Clinical Strabismus Management
![Page 14: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/14.jpg)
¡ Subjectiveangle§ amountindegreestheexaminermustmoveamblyoscopearmsforpatienttosee2picturesassuperimposed
§ duringbinocularviewingconditions¡ Objectiveangle
![Page 15: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/15.jpg)
¡ Subjectiveangle¡ Objectiveangle
§ deviationmeasuredbyalternateprismcovertest§ duringmonocularviewingconditions
![Page 16: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/16.jpg)
¡ Angleofanomaly§ displacementofthetruefoveafrompseudofovea§ zeroifNRC;subjective=objectiveangle§ (+)ifalternatecovertest(objectiveangle)isnotequaltosubjectiveangle
![Page 17: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/17.jpg)
¡ Firstdegree(simultaneousperception)§ Dissimilartargetspresented§ Perceivedatthesametimeinthesamevisualdirection
¡ Seconddegree¡ Thirddegree
![Page 18: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/18.jpg)
¡ Firstdegree(simultaneousperception)¡ Seconddegree(flatfusion)
§ similartargetswithdissimilarcomponents(monocularsuppressionchecks)
¡ Thirddegree
![Page 19: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/19.jpg)
¡ Firstdegree(simultaneousperception)¡ Seconddegree(flatfusion)¡ Thirddegree(stereopsis)
§ Sametargetsas2nddegree+disparity
![Page 20: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/20.jpg)
¡ Firstdegree§ simultaneousperception
¡ 2nddegree§ flatfusion
¡ 3rddegree§ Stereopsis
From Rosenbaum & Santiago Clinical Strabismus Management
![Page 21: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/21.jpg)
¡ RE:circle¡ LE:blackdot
¡ Orthotropic¡ Blackdotincircle
From Wright’s Pediatric Ophthalmology
![Page 22: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/22.jpg)
¡ Organizationofvisualspaceissuchthatthevisualdirectionofeachfoveaisthesame
¡ Angleofanomaly=0¡ PatientswithNRCalwaysusefoveaascenterofreference
![Page 23: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/23.jpg)
¡ Toseeblackdotincircle,needtomovearmsofamblyoscopetotalof40PD
From Wright’s Pediatric Ophthalmology
![Page 24: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/24.jpg)
¡ Ifwithdenselargeregionalsuppression,nosubjectiveangle,difficulttosuperimposeimages
¡ Ifmonofixator,usetargetsforperipheralretina
![Page 25: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/25.jpg)
¡ subjectiveangle=0§ measuredunderbinocularconditions
§ Pseudofoveacompensatesforangleofdeviation
§ Nosubjectivemisalignment
From Wright’s Pediatric Ophthalmology
![Page 26: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/26.jpg)
§ pseudofoveadoesnotcompensatefullyforangleofdeviation
§ Angleofanomaly=objectiveangle-subjectiveangle
From Wright’s Pediatric Ophthalmology
![Page 27: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/27.jpg)
¡ Measuresfusionalvergengeamplitudes¡ Angleofdeviation¡ Areaofsuppression¡ Retinalcorrespondence¡ Torsion¡ Instrumentconvergence
![Page 28: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/28.jpg)
¡ Retinalcorrespondence§ singlevision:hallmark
¡ ARCvsNRC¡ Retinaldisparity&rivalry:
§ diplopiaandvisualconfusion
![Page 29: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/29.jpg)
¡ Diplopia¡ Visualconfusion¡ Suppression¡ Horrorfusionis¡ Anomalousretinalcorrespondence
![Page 30: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/30.jpg)
¡ Diplopia§ Objectofinterestseenbyfoveaofoneeyeandperipheralretinaoftheothereye
¡ Visualconfusion
§ Foveaofbotheyes(orcorrespondingretinalpoints)sees2objectsofinterestinterpretedascomingfromthesamepointinspace
![Page 31: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/31.jpg)
From Rosenbaum & Santiago Clinical Strabismus Management
![Page 32: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/32.jpg)
¡ Suppression:alterationofvisualsensationthatresultsininhibitionorpreventionofoneeye’simagefromreachingconsciousness
¡ Physiologicsuppressionpreventsphysiologicdiplopiafromreachingconsciousness
![Page 33: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/33.jpg)
¡ Central:§ pathologicextensionofretinalrivalry§ preventsfovealimageofdeviatingeyefrombeingperceived
¡ Peripheral:§ Preventsawarenessoftheimageonperipheralretina(2ndimage)
![Page 34: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/34.jpg)
Esotropia Exotropia
From Rosenbaum & Santiago Clinical Strabismus Management
![Page 35: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/35.jpg)
¡ Monocular:unidirectional§ Dominanteyealwayspredominateoverimagefromdeviatingeye
¡ Alternating:bidirectional§ Suppressionswitchesbetweenthetwoeyes
![Page 36: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/36.jpg)
¡ Facultative§ Presentonlywheneyesaredeviated
¡ Obligatory§ Presentatalltimes,whethereyesaredeviatedoraligned
![Page 37: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/37.jpg)
![Page 38: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/38.jpg)
¡ Etymology:dullnessofvision§ Greek:▪ amblyos=dull▪ Stem:ops=vision
¡ Observer(MD)seesnothing,andthepatientseesverylittle
▪ vonGraefe
![Page 39: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/39.jpg)
¡ UnilateralorbilateraldecreaseinVAcausedbypatternvisiondeprivationorabnormalbinocularinteractionforwhichnocausecanbedetectedbyphysicalexamination,andwhichinappropriatecases,reversiblebytherapeuticmeasures
▪ vonNoorden
![Page 40: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/40.jpg)
¡ Approximately2-2.5%ofgeneralpopulationhasamblyopia
§ MilitaryRecruits 1-3.2%§ Preschoolchildren 0.5-3.5%§ Ophthalmicpatients 4-5.3%
![Page 41: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/41.jpg)
¡ Abnormalbinocularinteraction¡ Fovealpatternvisiondeprivation¡ Combinationofboth
![Page 42: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/42.jpg)
¡ Mostsensitivefirst2-3years
¡ Decreasesuntilage6-7years§ completevisualmaturation
§ retinocorticalpathwaysandvisualcentersresistanttoabnormalvisualinput
From Adler’s Physiology of the Eye
![Page 43: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/43.jpg)
¡ Reversible(functional)§ Strabismicamblyopia§ Anisometropic/ametropicamblyopia§ Visualdeprivationamblyopia§ Idiopathicamblyopia§ Toxic/Nutritionalamblyopia
¡ Irreversible(organic)§ Amblyopiainnystagmus§ Otherocularpathologies
![Page 44: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/44.jpg)
¡ HigherprevalenceinETthanXTbecauseofnasotemporalasymmetryofretinocorticalprojections
¡ ET:foveaofdeviatingeyecompeteswithstrongtemporalfield
¡ XT:foveacompeteswithweakernasalfield
![Page 45: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/45.jpg)
¡ alwaysunilateral,§ causedbyactiveinhibitionofretinocorticalpathwayoriginatingfromfoveaofdeviatingeyeduetovisualconfusion
§ lackofadequatestimulationofthefovea¡ Durationofstrabismusratherthanageattimestrabismusdevelopscorrelatesmorecloselywithamblyopia
![Page 46: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/46.jpg)
® Double vision: diplopia ® obj of interest seen by fovea of one eye
and peripheral retina of other eye ® Visual confusion
® fovea of each eye sees 2 different obj interpreted by brain to be in the same visual direction
![Page 47: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/47.jpg)
From Rosenbaum & Santiago Clinical Strabismus Management
![Page 48: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/48.jpg)
Esotropia Exotropia
From Rosenbaum & Santiago Clinical Strabismus Management
![Page 49: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/49.jpg)
NORMAL Figure from Wright’s Pediatirc Ophthalmology
![Page 50: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/50.jpg)
¡ EccentricFixation¡ AnomalousCorrespondence¡ Lossoffusion¡ Retinaldisparityandrivalry¡ Crowdingphenomenon¡ Smoothpursuitasymmetry
![Page 51: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/51.jpg)
¡ Bothoccurtoeliminatevisualconfusionfromdissimilarretinalimages
¡ Suppressionoccursonlyunderbinocularconditions
¡ Amblyopiapersistsafterclosureoffixatingeye
![Page 52: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/52.jpg)
¡ Activeinhibitionoffovea¡ Eliminatesensoryinterferencecausedbysuperimpositionofafocusedanddefocusedimage(abnormalbinocularinteraction)
¡ Aniseikoniamaybeafactor¡ Fovealpatternvisiondeprivation
![Page 53: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/53.jpg)
¡ Disuseorunderstimulationofretina¡ Unilateralmoreseverethanbilateral¡ Bothpatternvisiondeprivationandabnormalbinocularinteractionarefactorsinmonocular
¡ Onlypatternvisiondeprivationinbinocular
![Page 54: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/54.jpg)
Causes AbNbinoc Form interaction Deprivation
Strabismus + -Anisometropia + +VisualDeprivationUnilateral + +Bilateral - +
![Page 55: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/55.jpg)
¡ Superimposedfunctionalcomponentcanbeimprovedwithamblyopiatherapy
¡ Wrongorientationofretinalreceptors?¡ Changesinlateralgeniculatenucleusandstriatecortex
![Page 56: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/56.jpg)
¡ Fixationpreference§ butmanynormalpatientshavefixationpreference
¡ Crossedfixation§ doesnotalwaysimplyabsenceofamblyopia
![Page 57: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/57.jpg)
Figure from Wright’s Pediatirc Ophthalmology
![Page 58: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/58.jpg)
Figure from Wright’s Pediatirc Ophthalmology
![Page 59: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/59.jpg)
Figure from Wright’s Pediatirc Ophthalmology
![Page 60: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/60.jpg)
¡ Visualacuity§ differenceinacuityin2eyes§ butcertainsmalldifferenceexistinnormalpopulation
§ differenceof2linesformostclinicalpurposes
![Page 61: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/61.jpg)
¡ Occlusionorpatchingeveninnystagmus¡ 1weekperyearoflifethenreevaluate
§ doesnotsignifyendoftherapy§ evaluateocclusionamblyopia
¡ Fulltimevsparttime¡ Roleoftapering
![Page 62: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/62.jpg)
¡ 3-6weeksinolderchildbecauseofschool¡ Rationale:
§ forcetousethebadeye§ allowsneuralcircuitrytobereestablished
![Page 63: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/63.jpg)
![Page 64: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/64.jpg)
¡ Penalization§ Atropine(Hunter,JohnsHopkinsprotocol)§ Opticalpenalization(overplus:fogging)§ Neutraldensityfilters§ Blurringbettereyebyanymeans
![Page 65: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/65.jpg)
¡ Stageofmaturityofvisualconnectionsatwhichabnormalvisualexperiencebegan
¡ Typeofabnormalvisualexperience§ amblyopiamorecommoninETthanXT§ mayberelatedtonasotemporalasymmetry(strongertemporalhemifield)
![Page 66: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/66.jpg)
¡ Durationofdeprivation¡ Ageatwhichtreatmentwasstarted¡ Compliance¡ Neurologicstatus¡ Psychologicalandpsychosocialconsiderations
![Page 67: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/67.jpg)
¡ Patientcompliance&acceptance¡ Parentalunderstandingofrationale¡ Parent-childdynamics¡ Poorfollow-up¡ Smartchildrenmemorizecharts!¡ Differingmethodsofassessment¡ Whentostoppatching?
![Page 68: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/68.jpg)
¡ Singleoptotypeimprovesmorerapidlythanlineacuity
¡ Crowdinghasprognosticvalue¡ SingleEacuityrepresentstruepotential¡ Differentcharts,differentresults
![Page 69: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/69.jpg)
From Adler’s Physiology of the Eye
![Page 70: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/70.jpg)
Figure from von Noorden’s Binocular Vision
![Page 71: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/71.jpg)
¡ Maximizeamblyopiatreatmentpriortostraighteningeyes
¡ Enhancesfusion-lock¡ Morepracticaltostartpatching,continueevenaftersurgery
![Page 72: 2016 I. Binocular Vision & Retinal Correspondence; II Amblyopia](https://reader031.vdocuments.pub/reader031/viewer/2022021814/58f0d36c1a28ab00398b4573/html5/thumbnails/72.jpg)
¡ Rosenbaum&Santiago:ClinicalStrabismusManagement
¡ VonNoorden:BinocularVisionandOcularMotility
¡ Wright:PediatricOphthalmologyandStrabismus¡ Taylor:PediatricOphthalmology¡ Nelson:PediatricOphthalmology¡ Moses&Hart:Adler’sPhysiologyoftheEye¡ PEDIGAmblyopiaStudies