Abstract

Background: Recent evidence points to the use

of spectacles alone in the treatment of anisometropic

amblyopia. However, the impact of this treatment

on the restoration of binocular vision is often not

considered. 

Case Report: Patient M.Z., aged 7

years, showed 3.5D of anisometropia which was

coupled with a best corrected visual acuity of 6/38 in

the more hyperopic eye (6/6 in the non-amblyopic

eye). Spectacle lenses were prescribed using specially

designed software to alter the spectacle frame and

lens parameters to theoretically reduce the static and

dynamic aniseikonia to 1% and 3.8% respectively.

Four subsequent follow up visits were conducted over

a 2 year period where standard clinical measures of

refraction, visual acuity, and binocular vision were

conducted. The spectacles were worn consistently over

this time. Single letter acuity normalized by 5 months

while crowded acuity took longer. Improvements of

binocular vision resulted concomitantly. However,

improvement in suppression and stereo acuity continued for 2 years following the initial spectacle

correction

Conclusions: This case exemplifies how

the prescribing of spectacle lenses with consideration

of, and correction for, predicted optical aniseikonia

allowed the amelioration of amblyopia without

patching and the provision of significant levels of

binocular vision within a 1 year period. However, the

time course for the development of binocular vision

well exceeded that for the amelioration of amblyopia.