Monroe “Puggy” Farmer – Part 4

In Part 3 I showed why the patient with amblyopia has visual deficits beyond visual acuity.  For many years behavioral optometrists referred to vision as a learned process, and some teachers such as Susan Schocket readily grasp the significance of this to education.  Given that vision scientists have defined amblyopia as a developmental disorder of spatial vision, it simply isn’t good enough to judge a “cure” for the condition based on sharper sight that enables identifying smaller letters on or near the 20/20 line of an eye chart.

If we practice what we preach, then the most effective way to treat amblyopia should be the same way we approach developmental disorders.  The approach at we take clinically to delays in visual development are not to emphasize more traditional “eyeball stuff” like focusing and eye tracking.  It’s to emphasize visual processing or perception and cognition (a tip of the cap here to the incomparable therapy team of Linda & Bob Sanet).  And sure enough, vision science now supports that the key component of improvement in amblyopia therapy comes through perceptual learning.  The year was 2006 when Dr. Jeff Cooper joined me for a Symposium at the American Academy of Optometry on the applications of computers to vision therapy.  I served as the editor for a series of papers for OEP on the subject, one key set written by Dr. Bill Ludlam on the Optimum System for amblyopia therapy, and the other by Dr. Cooper.  I asked Jeff to send me his slides in advance for the Symposium, and when I opened his email I called him in a panic because one of the key slides looked like machine language.

I was soon to learn that this was only one of 12 programs that were part of the new Amblyopia iNet Program.  As soon as we began to use it, the program’s utility in aiding perceptual learning was immediately evident.  So much so, that we began using the program for children who had learning issues even in the absence of amblyopia.

- Leonard J. Press, O.D., FCOVD, FAAO