How Does the Brain Change in Binocular Vision Therapy?

In a newly released TEDxNJIT presentation, Tara Alvarez, Ph.D., overviews her ongoing research into using fMRI to pinpoint brain changes in vision therapy.  She centers on three theories of potential mechanisms for neuroplasticity:

  1. Improved neural synchronization – therapy is analogous to a conductor in an orchestra who facilitates the synchronization of the musicians
  2. Neural recruitment – therapy persuades neurons which did not previously participate in a task to now participate
  3. Improved functional connectivity – therapy improves the connections between neural sites, hence the communication between brain regions.

Dr. Alvarez is collaborating with Dr. Mitchell Scheiman, and in the video she notes that in the landmark CITT study of which he was the principal investigator, home-alone therapy was no better than placebo.  A significant reason for this, she speculates is that the currently available home-alone therapy is gosh-awful boring and compliance is therefore lacking.  Another potential reason is  the patient may not be doing the therapy optimally because of lack of feedback from a therapist.  The interdisciplinary team that Alvarez has formed to study this includes: Biomedical Engineering, Optometry, Sports Medicine, Gaming Design, Vision Science, Psychology, and Functional Imaging.  NJIT magazine did a feature story on this project in their Fall issue.

The concept appears to be a research spin-off of the emerging Oculus Rift technology for binocular VT pioneered by VividVision.  But instead of using a video controller, the Alvarez  group is using Raspberry Pie.


Just wanted to see if you’re paying attention!  Actually, as Dr. Alvarez explains, they integrated the Oculus Rift with eye tracking using the Raspberry Pi and NoIR cameras, and combined it with gaming technology.


Dr. Alvarez finishes her presentation by emphasizing that their goal is not to replace office-based optometric therapy, but to better augment what children of all ages are being asked to do at home.

Optometrists in the vicinity of Newark, NJ, are encouraged to refer potential patients to participate in the Alvarez/Scheiman NJIT collaboration.  To be enrolled in the project, the patients must be young adults age 18 to 35 years who have no history of head injury or prior vision therapy.  Dr. Scheiman will administer a baseline examination at NJIT to confirm their eligibility for the study, which will include the CISS (CI Symptom Survey), phoria, NPC, vergence ranges, and random dot stereopsis.  The initial project study involves a combination of weekly traditional in-office therapy combined with the immersive binocular gaming therapy at home.

5 thoughts on “How Does the Brain Change in Binocular Vision Therapy?

  1. This is such an exciting concept! I’m an adult vision therapy patient and I definitely felt that I made better progress when I was regularly seeing a therapist even though I try to keep up with doing exercises at home now. Home-based therapy is challenging for all the reasons mentioned. I think a video game that would provide feedback and also be more fun is a great idea. I hope it becomes a reality and I have s chance to try it someday!

  2. So much more to say about this. In fact, it will be presented in a paper at the KISS meeting in a few weeks. If we look just at the research in neurology about the corpus callosum, we have anatomical studies describing some of what vision therapy does to brain function. Neuroscientists did all the work for us, and we just have to share it.

    • And if I may elaborate, we did alot of background work for neuroscientists as well. I was pleased to see Hess, one of the early proponents of ramping up BV therapy for amblyopia, reference a paper I did on the concept of BV therapy games for strabismus/amblyopia published in the COVD journal 35 years ago!
      Press LJ. Electronic games and strabismus therapy. J Optom Vis Devel 1981 ;12(3) :35-3

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