Novel and emerging active treatments for amblyopia include dichoptic training, performing perceptual learning tasks, or playing action video games.
29 However, whereas understanding of the mechanisms underlying improvements in functional performance from these treatments is limited, it has been suggested that associated improvements in higher order global visual attention may play a role.
29 Dichoptic training presents concurrent visual activity to both the amblyopic and fellow eye, by varying the relative contrast of visual targets to promote simultaneous binocular perception (that is, reduce interocular suppression).
42–44 Although some studies report that visual acuity, binocular function, and binocularly performed timed manual dexterity proficiency all improve following relatively short durations of dichoptic treatment,
27,28,43 other randomized controlled treatment trials have not shown significant improvements in VA with home-based dichoptic therapy.
45,46 Variable adherence to therapy has been speculated as a potential source of difference between studies and individual variability in responses to therapy within studies.
47,48 Perceptual learning describes the improvement on a sensory task by repeated practice, and has been shown to transfer to improvements in other aspects of visual function, which is suggested to be from higher-order cognitive learning.
49 Interestingly, there is little difference in VA outcomes among the active amblyopia treatment methods, implying that improvement to some extent may ensue, as long as the amblyopic eye is given opportunity to engage, either on its own or simultaneously, with the dominant eye. Action video gaming has also been shown to alter a range of visual skills in visually normal adults, including VA, stereoacuity, and different aspects of visual attention, including UFOV and attentional blink.
50 Potentially, targeting the higher-order visual attention processes may be driving the success seen in older children and adults in emerging active amblyopia treatment methods.
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