Amblyopia In Adults Research Articles

Landolt C-Tests With "Fixed" Arcmin Separations Detect Amblyopia But Underestimate Crowding in Moderate-to-Severe Amblyopic Children and Adults.

Crowding is exaggerated in central vision of strabismic amblyopia, impacting on reading ability. Crowding magnitude and interocular differences (IODs) in acuity are indicators for detection, assessment, and monitoring of treatment. Lateral masking (including contour interaction) also affects acuity and can mimic or ameliorate crowding. We investigated lateral masking/contour interaction and crowding impact on crowding magnitude and IOD measures in healthy and amblyopic pediatric and juvenile/adult groups using two Landolt C-tests with "fixed" arcmin separations. Acuity (logMAR) was measured with Landolt C-tests with specified 2.6' ("crowded") and 35' ("uncrowded") separations. Crowding magnitudes (crowded - uncrowded acuities) and IODs were calculated. Participants were 69 subjects with strabismic amblyopia (n = 39 pediatric, i.e. children ≤8years of age), 31 subjects with anisometropic amblyopia (n = 14 pediatric), and 76 healthy controls (n = 36 pediatric). Subjects with amblyopia were subgrouped by acuity as low severity (<0.4 logMAR) or high severity (≥0.4 logMAR) using the 35' separation C-test. Crowding magnitudes were greater in strabismic than in anisometropic amblyopia and control/fellow eyes. They were higher in pediatric control/fellow eyes than in juvenile/adult eyes. In high severity strabismic amblyopia, crowding magnitudes progressively and significantly reduced (slope = -0.17 ± 0.07, P < 0.05) with worsening acuity. IODs for this group were higher on the 2.6' C-test, but lower than expected. In high severity pediatric subjects with anisometropic amblyopia, seven of eight had lower IODs measured with the "crowded" than the "uncrowded" C-tests. These C-tests detect amblyopia but underestimate crowding in children and adults with high severity strabismic amblyopia. Separate isolated optotype acuity and crowding distance tests may better target specific functions, while minimizing the impact of masking.

Treatment of amblyopia: an update

Abstract Amblyopia, the primary cause of one-sided vision impairment among children globally, occurs at a rate of 3.7%. It stems from early visual deprivation or inadequate focusing in one eye, creating an unevenness in visual information sent to the brain’s visual cortex. Consequently, vision diminishes in the affected eye, impacting the coordination between both eyes. When signals from one eye are unclear, the brain inhibits input from that eye, disrupting the visual pathway. Apart from impacting visual coordination, amblyopia can influence tasks like eye-hand coordination, reading, and an individual’s self-perception. Several therapies have emerged for treating amblyopia in both children and adults. Traditional treatments mainly penalized the stronger eye through patching or medicinal penalization. Yet, these methods have limitations concerning their effectiveness and patient comfort, affecting individuals and their families. Recent studies indicate that people with amblyopia retain binocular cortical mechanisms responsive to varying visual stimuli levels. As a result, a more practical approach might involve simultaneously stimulating both eyes to enhance vision in the weaker eye, diminish suppression, and bolster binocular vision.

A pilot non-randomized trial of smartphone-based anaglyph system for treatment of adult amblyopia through VR (Virtual Reality).

To evaluate the effectiveness of amblyopia treatment through a smartphone-based anaglyph system by virtual reality (VR) in adult patients. A total of 10 subjects diagnosed with anisometropic amblyopia were enrolled during the study period. Best Corrected Visual Acuity (BCVA), stereoacuity, and contrast acuity were evaluated during three visits (at presentation, 3 months and 6 months) of smartphone-based anaglyph video run in the VR mode. All the amblyogenic factors including stereopsis, color vision, and contrast acuity were compared using Friedman two-way analysis of variance. Statistical significance was considered if P < 0.05. Mean BCVA in amblyopic eye improved significantly from a logMAR value of 0.73 ± 0.64 before Virtual reality vision therapy (VRVT) to a post-training VRVT value of 0.48 ± 0.44 (P < 0.01). Mean stereoacuity changed from a value of 560.00 ± 301.58 before VRVT to a value of 263.00 ± 143.58 seconds of arc after training (VRVT) (P < 0.01). Mean accommodation changes from a value of 15.00 ± 7.40 before training or VRVT to value of 12.60 ± 6.10 cm after training (P < 0.01). Mean contrast acuity changes from a value of 1.21 ± 0.72 at presentation to a value of 1.52 ± 0.49 log unit after VRVT. A smartphone-based anaglyph system using VR vision therapy appears to be an effective treatment option for amblyopia in adults.

Harnessing brain plasticity to improve binocular vision in amblyopia: An evidence-based update.

Amblyopia is a developmental visual disorder resulting from atypical binocular experience in early childhood that leads to abnormal visual cortex development and vision impairment. Recovery from amblyopia requires significant visual cortex neuroplasticity, i.e. the ability of the central nervous system and its synaptic connections to adapt their structure and function. There is a high level of neuroplasticity in early development and, historically, neuroplastic responses to changes in visual experience were thought to be restricted to a "critical period" in early life. However, as our review now shows, the evidence is growing that plasticity of the adult visual system can also be harnessed to improve vision in amblyopia. Amblyopia treatment involves correcting refractive error to ensure clear and equal retinal image formation in both eyes, then, if necessary, promoting the use of the amblyopic eye by hindering or reducing visual input from the better eye through patching or pharmacologic therapy. Early treatment in children can lead to visual acuity gains and the development of binocular vision in some cases; however, many children do not respond to treatment, and many adults with amblyopia have historically been untreated or undertreated. Here we review the current evidence on how dichoptic training can be used as a novel binocular therapeutic approach to facilitate visual processing of input from the amblyopic eye and can simultaneously engage both eyes in a training task that requires binocular integration. It is a novel and promising treatment for amblyopia in both children and adults.

Durable recovery from amblyopia with donepezil

An elevated threshold for neuroplasticity limits visual gains with treatment of residual amblyopia in older children and adults. Acetylcholinesterase inhibitors (AChEI) can enable visual neuroplasticity and promote recovery from amblyopia in adult mice. Motivated by these promising findings, we sought to determine whether donepezil, a commercially available AChEI, can enable recovery in older children and adults with residual amblyopia. In this open-label pilot efficacy study, 16 participants (mean age 16 years; range 9–37 years) with residual anisometropic and/or strabismic amblyopia were treated with daily oral donepezil for 12 weeks. Donepezil dosage was started at 2.5 or 5.0 mg based on age and increased by 2.5 mg if the amblyopic eye visual acuity did not improve by 1 line from the visit 4 weeks prior for a maximum dosage of 7.5 or 10 mg. Participants < 18 years of age further patched the dominant eye. The primary outcome was visual acuity in the amblyopic eye at 22 weeks, 10 weeks after treatment was discontinued. Mean amblyopic eye visual acuity improved 1.2 lines (range 0.0–3.0), and 4/16 (25%) improved by ≥ 2 lines after 12 weeks of treatment. Gains were maintained 10 weeks after cessation of donepezil and were similar for children and adults. Adverse events were mild and self-limited. Residual amblyopia improves in older children and adults treated with donepezil, supporting the concept that the critical window of visual cortical plasticity can be pharmacologically manipulated to treat amblyopia. Placebo-controlled studies are needed.

Prevalence of residual amblyopia in adulthood and its association on educational outcome and quality of life in the Northern Finland Birth Cohort.

The purpose of the current study was to evaluate the prevalence of residual amblyopia in adults in a population screened and treated in childhood. We also wanted to evaluate the association of amblyopia on school success, level of education, and quality of life. This is a follow-up study of 2708 subjects of the Northern Finland Birth Cohort. At the age of 46, the subjects took part in ophthalmic examinations, including the measurement of best-corrected visual acuity (BCVA) and refraction. Residual amblyopia was defined as BCVA 20/30 or less (logMAR ≥0.2) in one or both eyes or a two-line interocular visual acuity difference and absence of any pathological ocular factors. The quality of life was assessed with a 15D questionnaire, and educational outcome, school success, and episodic memory with a CANTAB-PAL (paired associates learning) test were evaluated. The prevalence of amblyopia in the current adult population aged 46 years was 1.3% (n= 36). At 14 years, the amblyopia subjects had had significant differences in mean spherical equivalent between the amblyopic and fellow eye and strabismus more often than controls. No significant differences were observed in the CANTAB-PAL test or in educational outcome. However, amblyopia subjects had significant difficulties in the 15D questionnaire in terms of vision (54% vs. 34%, p= 0.01). Due to screening and treatment in childhood, the number of adults with residual amblyopia was low. Despite minor visual impairment and discomfort, they cope very well in life in terms of educational outcome and quality of life.

Recent Advances in Management of Amblyopia

Amblyopia is the most common cause of monocular vision loss in children. Global incidence is 3.7%. It may be due to early deprivation of vision or defocus in one eye, reflects an imbalance of input from the eyes to visual cortex .Not only monocular vision is reduced but binocular vision is also affected. Fellow Human brain is designed to allow both eyes to work together. If signals from one eye are blurred, brain blocks the visual input from that eye. In the visual pathway, the synapses are broken due to disuse of amblyopic eye. Along with visual coordination deficit, eye to hand and reading can be affected and selfperception may be diminished. A variety of amblyopia therapy options have been developed to treat amblyopia in children and adults. Amblyopia therapy options have traditionally been limited to penalization of non-amblyopic eye with either patching or medicinal penalization. Traditional approaches to diagnose and treatment have limited effectiveness, are uncomfortable for the patients and their families. Recent evidences shows that amblyopes possess binocular cortical mechanisms for both threshold and supra-threshold stimuli. Hence strategy may be based on binocular stimulation methods, aims to stimulate either eye leading to a concomitant improvement in monocular vision with reduction in suppression and strengthening of binocular vision.

Single Center to Evaluate and Compare Anisometropic Amblyopia in Adults Using Blood Oxygenation Level-Dependent Functional Magnetic Resonance Imaging and Diffusion Kurtosis Imaging.

BackgroundAnisometropic amblyopia results from the unequal ability to focus between the right and left eyes. Blood oxygenation level-dependent functional magnetic resonance imaging (BOLD-fMRI) measures the proportion of oxygenated hemoglobin in specific areas. Diffusion kurtosis imaging (DKI) is a method of diffusion tensor imaging that estimates the skewed distribution of water diffusion probability. We aimed to evaluate and compare 11 adult patients with anisometropic amblyopia (AA) with 13 normally sighted healthy controls (HC) using BOLD-fMRI and DKI.Material/MethodsEleven adults with AA (age range 20–49; mean age 29.18±8.089) and 13 HC adults (age range 22–50; mean age 28.00±5.79) were recruited. DKI scanning used a single excitation echo-planar imaging sequence and a region of interest to obtain DKI parameters for optic radiation; the corpus callosum was manually placed, including mean kurtosis (MK), fractional anisotropic (FA), and mean diffusivity (MD) values; and BOLD data used a gradient-echo echo-planar imaging sequence.ResultsThe AA group had lower MK and FA of bilateral optic radiation than the HC group (P=0.008 and P=0.006, respectively) and higher MD than the HC group (P=0.005). The MK of the corpus callosum in the AA group was lower than that of HC group (P=0.012).Compared with the non-dominant eyes of the HC group, the amblyopic eyes in the AA group had less activation range and intensity in Brodmann areas 17, 18, and 19.ConclusionsThe combined use of DKI and BOLD-fMRI detected microstructural changes associated with local visual pathways and identified damage to the visual cortex in patients with amblyopia.

Virtual reality for Treatment of Amblyopia in adults

Purpose: To observe efficacy of Virtual reality technology as a potential treatment for improving vision in anisometropic amblyopia without the need of occlusion or penalization. Study design: Experimental case series Place and Duration of study: Isra University Hospital, Hyderabad, from Nov 2020 to Oct 2021. Methods: Patients (more than 12 years of age), with Anisometropic amblyopia, were included in this study. Patients with history of strabismus, cataract or any active ocular surface disease were excluded. Unaided visual acuity, pinhole test and best-corrected visual acuity were recorded, before and after treatment. LogMAR chart was used for this purpose. Crowding phenomenon was also checked. Anterior segment and posterior segment examination was done to rule out any organic cause of disease. A head mounted device-virtual reality glasses (HMD-VR) was used 40 min daily for 03 months to improve visual acuity. All the data was recorded on a proforma. SPSS version 22.0 was used for data analysis and P-value of &lt;0.05 was considered significant. Result: Mean age of the patients was 24.2 years (range 14-35 years). Out of 14 registered cases, 08 (57.1 %) patients showed improvement after 08 weeks of initiation of treatment with VR glasses. Two (14.3%) patients showed improvement after 12 weeks and two showed no improvement, while two (14.3%) patients lost to follow up. After applying paired t test the value of p was &lt; 0.001, which was statistically significant. Conclusion: This HMD VR glasses seems to be an effective option for treatment in adults with anisometropic amblyopia.

Toward using effective elements in adults’ amblyopia treatment in a virtual reality-based gamified binocular application

The common method for treating amblyopia (lazy eye) in adults is binocular therapy implemented as simple computer games. However, it lacks the maximum therapeutic elements effective in treating amblyopia and uses expensive stereoscopes and virtual reality (VR) glasses, limiting widespread use. Also, gamification can be incorporated into these games to keep patients’ motivation over a stable period. The features that have the potential to be included in binocular games are identified and included in a VR-based gamified binocular application with a more straightforward implementation than the games presented so far. The game is implemented on smartphones to increase accessibility. Color and size of game components, CAM stimulator, and binocular therapy using VR were identified and incorporated in a VR zombie first-person shooter game. Eight experts evaluated the game with a questionnaire designed based on Nielsen's heuristics evaluation and therapeutic aspects. The initial tests with experts indicated the game’s potential application as a therapeutic tool for improving visual acuity and vision’s contrast and depth. Also, the game has the potential application in increasing motivation and interaction. After rigorous evaluations with patients, the game can be used outside clinics by adjusting it to the patients’ eyes in advance and remotely.

Crowding changes appearance systematically in peripheral, amblyopic, and developing vision.

Visual crowding is the disruptive effect of clutter on object recognition. Although most prominent in adult peripheral vision, crowding also disrupts foveal vision in typically developing children and those with strabismic amblyopia. Do these crowding effects share the same mechanism? Here we exploit observations that crowded errors in peripheral vision are not random: Target objects appear either averaged with the flankers (assimilation) or replaced by them (substitution). If amblyopic and developmental crowding share the same mechanism, then their errors should be similarly systematic. We tested foveal vision in children aged 3 to 8 years with typical vision or strabismic amblyopia and peripheral vision in typical adults. The perceptual effects of crowding were measured by requiring observers to adjust a reference stimulus to match the perceived orientation of a target “Vac-Man” element. When the target was surrounded by flankers that differed by ± 30°, all three groups (adults and children with typical or amblyopic vision) reported orientations between the target and flankers (assimilation). Errors were reduced with ± 90° differences but primarily matched the flanker orientation (substitution) when they did occur. A population pooling model of crowding successfully simulated this pattern of errors in all three groups. We conclude that the perceptual effects of amblyopic and developing crowding are systematic and resemble the near periphery in adults, suggesting a common underlying mechanism.

Laser keratomileusis in treatment of anisometropic amblyopia in adults.

To compare and evaluate improvement in corrected distant visual acuity (CDVA) between myopia and hyperopia after laser in situ keratomileusis (LASIK) in adult patients with anisometropic amblyopia. This prospective clinical study included 103 amblyopic eyes (103 patients), which underwent LASIK correction of refractive error from January 2013 to January 2018. Uncorrected distance visual acuity (UDVA), CDVA, spherical equivalent (SE), postoperative astigmatism, and intraocular pressure were evaluated at time points of 1, 6, and 12 months. Patients were divided into two groups according to refractive error. Group 1: Forty-six patients with myopia and Group 2: Fifty-seven patients with hyperopia. Mean CDVA (logarithm of the minimum angle of resolution [logMAR]) preoperatively was 0.23 ± 0.16 in Group 1 and 0.40 ± 0.19 in Group 2. Postoperative CDVA (logMAR) was 0.17 ± 0.13 in Group 1 and 0.32 ± 0.17 in Group 2. There was statistically significant increase in UDVA (P < 0.0001) postoperatively and no change during the follow-up period of 12 months in both groups. Group 1 showed more expectable results, 95% of variability SE achieved was dependent on SE intended (R2 = 0.95), while in Group 2, the percentage was slightly lower of expected 87% (R2 = 0.87). There was statistical significance in respect of CDVA change postoperatively and preoperatively in both groups. Correlation factors are low, in Group 1 r = -0.53 and in Group 2 r = -0.39. LASIK can improve CDVA in a considerable portion of amblyopic eyes, both myopic and hyperopic. Eyes with better initial CDVA and those with myopia were associated with greater improvement in postoperative CDVA.

Anaglyphic Three-Dimensional Movie: A Simple Binocular Method to Treat Anisometropic or Strabismic Amblyopia in Adults.

Purpose:To evaluate the efficacy of anaglyphic three-dimensional movies to treat adults with anisometropic or strabismic amblyopia.Methods:This is an interventional case series. The seven cases were put on a trial frame containing subjective refraction, fogging plus lenses for the dominant eye, correcting prism, and anaglyphic red-cyan plastic spectacles. Patients participated in 20 sessions of 1.5 h of anaglyphic three-dimensional animated movie watching in the office. Significant visual acuity (VA) improvement was defined as improvement ≥0.2 in logMAR values. Change in octaves of stereopsis was defined as halving the arcsec or 0.3 change in log arcsec.Results:The average age was 26.9 ± 10.0 (16–42) years. The mean VA in amblyopic eye improved significantly from 0.42 ± 0.19 (0.15–0.7) logMAR to 0.25 ± 0.15 (0.1–0.5) logMAR after completion of sessions (P = 0.02), and four cases showed significant VA improvement. The mean stereoacuity improved significantly from 2.6 ± 0.3 (2.1–2.9) log arcsec to 2.1 ± 0.5 (1.7–2.9) log arcsec (P = 0.04). Four cases showed ≥2 octaves improvements in stereopsis.Conclusion:A simple and readily available method of amblyopia treatment can be effective in some adult cases.

Adherence to home-based videogame treatment for amblyopia in children and adults

ABSTRACT Clinical relevance: Home-based videogame treatments are increasingly popular for amblyopia treatment. However, at-home treatments tend to be done in short sessions and with frequent disruptions, which may reduce the effectiveness of binocular visual stimulation. These treatment adherence patterns need to be accounted for when considering dose-response relationships and treatment effectiveness. Background: Home-based videogame treatments are increasingly being used for various sensory conditions, including amblyopia (‘lazy eye’), but treatment adherence continues to limit success. To examine detailed behavioural patterns associated with home-based videogame treatment, we analysed in detail the videogame adherence data from the Binocular tReatment of Amblyopia with VideOgames (BRAVO) clinical trial (ACTRN12613001004752). Methods: Children (7-12 years), teenagers (13-17 years) and adults (≥ 18 years) with unilateral amblyopia were loaned iPod Touch devices with either an active treatment or placebo videogame and instructed to play for a total of 1-2 hours/day for six weeks at home. Objectively-recorded adherence data from device software were used to analyse adherence patterns such as session length, daily distribution of gameplay, use of the pause function, and differences between age groups. Objectively-recorded adherence was also compared to subjectively-reported adherence from paper-based diaries. Results: One hundred and five of the 115 randomised participants completed six weeks of videogame training. Average adherence was 65% (SD 37%) of the minimum hours prescribed. Game training was generally performed in short sessions (mean 21.5, SD 11.2 minutes), mostly in the evening, with frequent pauses (median every 4.1 minutes, IQR 6.1). Children played in significantly shorter sessions and paused more frequently than older age groups (p < 0.0001). Participants tended to over-report adherence in subjective diaries compared to objectively-recorded gameplay time. Conclusion: Adherence to home-based videogame treatment was characterised by short sessions interspersed with frequent pauses, suggesting regular disengagement. This complicates dose-response calculations and may interfere with the effectiveness of treatments like binocular treatments for amblyopia, which require sustained visual stimulation.

Rethinking amblyopia 2020

Recent work has transformed our ideas about the neural mechanisms, behavioral consequences and effective therapies for amblyopia. Since the 1700′s, the clinical treatment for amblyopia has consisted of patching or penalizing the strong eye, to force the “lazy” amblyopic eye, to work. This treatment has generally been limited to infants and young children during a sensitive period of development. Over the last 20 years we have learned much about the nature and neural mechanisms underlying the loss of spatial and binocular vision in amblyopia, and that a degree of neural plasticity persists well beyond the sensitive period. Importantly, the last decade has seen a resurgence of research into new approaches to the treatment of amblyopia both in children and adults, which emphasize that monocular therapies may not be the most effective for the fundamentally binocular disorder that is amblyopia. These approaches include perceptual learning, video game play and binocular methods aimed at reducing inhibition of the amblyopic eye by the strong fellow eye, and enhancing binocular fusion and stereopsis. This review focuses on the what we’ve learned over the past 20 years or so, and will highlight both the successes of these new treatment approaches in labs around the world, and their failures in clinical trials. Reconciling these results raises important new questions that may help to focus future directions.

Clinical Profile of Amblyopia in Young Adults

Clinical Profile of Amblyopia in Young Adults

Clinical Profile of Amblyopia in Young Adults

Aim: To study clinical profile of amblyopic patients in relation to refractive status, socio economic status, use of glasses and social impact on society. Results: Myopes improving with spectacles are 45% and mixed astigmatism 69%. Most common age group for detection of amblyopia in young adults is 21-30 years(47.1%) with predominance of female(55.7%) belonging from middle class families (81.4%) having studied mostly from Government Marathi medium school(45.7%) with previously not using given glasses(57.1%) and with taken amblyopia of only (7.1%) and with spectacles maximum correction with mixed astigmatism (54.2%) between 6/36-6/9 in right eye (43%) and in left eye (30%) . Hypermetropies’ improving to 6/12 is only 13%. So there’s very few cases improving with the spectacles in hypermetropes in amblyopia. Interpretation: Lack of school screening programs and awareness for health check-up delays the diagnosis of amblyopia leading to non-improvement of vision and due to lack of knowledge and social stigma girls especially avoid wearing glasses even after prescribing leading to amblyopia. Conclusion: School health camps, proper health education, timely examination, and proper use of spectacles is must.

Prevalencia de ametropías y ambliopías en adultos chilenos: ¿necesaria prevención? Ametropías y ambliopías en Chile

Prevalencia de ametropías y ambliopías en adultos chilenos: ¿necesaria prevención? Ametropías y ambliopías en Chile

A review of the treatment of anisometropic amblyopia in adults using dichoptic therapy

Background: In recent years, it has been established that the suppression of the amblyopic eye by the fellow eye is the major cause of amblyopia. New behavioural therapies like dichoptic therapy attempt to reduce suppression in amblyopic adults who have passed the critical stage of visual cortex development. Anisometropic amblyopia has the highest prevalence of amblyopia, and managing this condition in adults may lead to improvement in the quality of life. Aim: The purpose of the review is to assess the impact of this novel treatment of amblyopia, with particular focus on using dichoptic therapy for anisometropic amblyopia in adults. Methods: A literature search was conducted on articles published in the last 20 years, and papers were sourced from databases such as Elsevier, Science Direct and PubMed using the reference manager Mendeley. (The search was performed from December 2017 to December 2018.) Results: Evidence from located studies in adults with anisometropic or mixed amblyopia managed with new behavioural treatments including dichoptic therapy showed some significant improvement in the best-corrected distance visual acuity, stereopsis and contrast sensitivity whilst improving or restoring optimal binocular vision. Conclusion: Adults with anisometropic and/or mixed amblyopia can benefit from dichoptic therapy with a unique approach to improve binocularity concurrently. The therapy represents a viable option for managing amblyopia in adults and can be administered as office-based or home-based treatment in a timely manner that could improve the quality of life for such patients.

Contribution of Short-Time Occlusion of the Amblyopic Eye to a Passive Dichoptic Video Treatment for Amblyopia beyond the Critical Period.

Dichoptic movie viewing has been shown to significantly improve visual acuity in amblyopia in children. Moreover, short-term occlusion of the amblyopic eye can transiently increase its contribution to binocular fusion in adults. In this study, we first asked whether dichoptic movie viewing could improve the visual function of amblyopic subjects beyond the critical period. Secondly, we tested if this effect could be enhanced by short-term monocular occlusion of the amblyopic eye. 17 subjects presenting stable functional amblyopia participated in this study. 10 subjects followed 6 sessions of 1.5 hour of dichoptic movie viewing (nonpatched group), and 7 subjects, prior to each of these sessions, had to wear an occluding patch over the amblyopic eye for two hours (patched group). Best-corrected visual acuity, monocular contrast sensitivity, interocular balance, and stereoacuity were measured before and after the training. For the nonpatched group, mean amblyopic eye visual acuity significantly improved from 0.54 to 0.46 logMAR (p < 0.05). For the patched group, mean amblyopic eye visual acuity significantly improved from 0.62 to 0.43 logMAR (p < 0.05). Stereoacuity improved significantly when the data of both groups were combined. No significant improvement was observed for the other visual functions tested. Our training procedure combines modern video technologies and recent fundamental findings in human plasticity: (i) long-term plasticity induced by dichoptic movie viewing and (ii) short-term adaptation induced by temporary monocular occlusion. This passive dichoptic movie training approach is shown to significantly improve visual acuity of subjects beyond the critical period. The addition of a short-term monocular occlusion to the dichoptic training shows promising trends but was not significant for the sample size used here. The passive movie approach combined with interocular contrast balancing even over such a short period as 2 weeks has potential as a clinical therapy to treat amblyopia in older children and adults.