Vision Therapy/Orthoptics among Three to Seven Year Old Children

Vision Therapy/Orthoptics(VT/O) is a package of treatments that enables patients to achieve the maximum level of visual performance.The aim was to determine the effect of three months vision therapy/orthoptics on best corrected visual acuity (BCVA), fusion, stereopsis and ocular alignment in 3-7 year old children. In this randomized clinical trial study, 80 children with amblyopia and/or non-paralytic horizontal deviations were randomly divided into intervention and control groups. Intervention group was treated by vision therapy/orthoptics for three months. These modalities included patch, red filter, sector patch, over minus lens, prism and synoptophore exercises. Controls were treated by only patching for the same period. Pre and post-treatment BCVA, fusion, stereopsis and alignment were compared. Visual performance was classified as excellent (BCVA≥20/30, deviation≤10pd and stereopsis≤70sec/are), acceptable (BCVA≥20/30, deviation ≤10pd and stereopsis 70 to 3000sec/are) and unsatisfactory (BCVA<20/30, deviation>10pd and no stereopsis). A total of 80 cases (56 girls and 24 boys) with the mean age of 5.6±1.4 years entered the study. Although more improvement of fusion and stereopsis was seen in the intervention group (P<0.001 for both groups), there was no significant differences in BCVA and alignment between two groups. Also the difference of visual performance was not statistically significant between two groups, whereas the improvement was significant in each group (P<0.001, for both groups). Vision therapy/orthoptics treatment can be effective for improving sensory status in 3 to 7 year old children with amblyopia and/or strabismus. Further studies with larger sample sizes and focusing on accommodation and fusional amplitude are warranted.