Amblyopia and binocular vision

Amblyopia is the most common cause of monocular visual loss in children, affecting 1.3%–3.6% of children. Current treatments are effective in reducing the visual acuity deficit but many amblyopic individuals are left with residual visual acuity deficits, ocular motor abnormalities, deficient fine motor skills, and risk for recurrent amblyopia. Using a combination of psychophysical, electrophysiological, imaging, risk factor analysis, and fine motor skill assessment, the primary role of binocular dysfunction in the genesis of amblyopia and the constellation of visual and motor deficits that accompany the visual acuity deficit has been identified. These findings motivated us to evaluate a new, binocular approach to amblyopia treatment with the goals of reducing or eliminating residual and recurrent amblyopia and of improving the deficient ocular motor function and fine motor skills that accompany amblyopia. ► There is now a substantial clinical trial evidence base for amblyopia treatment. ► Residual and recurrent amblyopia are common. ► We identified the central role of binocular vision in the genesis of amblyopia. ► New amblyopia treatments target the primary binocular dysfunction.