I am a 36 year old male and have struggled with mild to moderate amblyopia most of my life. I am able to fuse close up and have very good hand eye coordination but at distance, such as driving, I am unable to fuse and the resulting strain worsens the eye turn. Is vision therapy still a viable option at my age?

This is an impossible question to answer without the benefit for a full, thorough vision exam. This would show the cause and severity of the amblyopia, eye turn,  and other visual problems that you may have and identify areas of possible improvement.

But even without the particulars in your case, I can say a few things generally. Because the purpose of vision therapy is to help you develop visual skills that may be lacking, there is not point in life when it is not possible to receive some benefit from vision therapy. The real question is this: Are you bothered enough by your visual problem that you would like to take the steps to improve the situation. (Case in point, this video of a 101 year old vision therapy patient.)

But I don’t want to paint vision therapy as a panacea either, because some conditions are very complicated and can take a significant amount of time, effort, and expense to improve. Some conditions are best treated with a combination of vision therapy and other methods, such as special glasses or surgery. Yet other conditions are better left untreated.

I would recommend against any of the “improve your vision” ads on TV or the internet. Many of these have elements of legitimate therapy, but they tend to over-promise and do not match the person with the appropriate therapy. Instead, only pursue therapy from a doctor with specialized training in visual function and vision therapy.

Have you read Susan Barry’s book, “Fixing My Gaze“? I very highly recommend it. You may also find this blog interesting: http://seeing3d.blogspot.com/.

If you would like more information about the evaluation or vision therapy, please do not hesitate to call and speak to Edna or myself.

Best Wishes.

-Dr. Nate

Bright Eyes Family Vision Care

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Thanks to Adventures in Amblyopia….

Dr. Bonilla-Warford
Bright Eyes Family Vision Care
Westchase, Tampa, FL
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As an eye doctor who provides vision therapy to treat amblyopia and an avid NPR fan, I was heartened to hear this story in the shower this morning:

www.npr.org – Learning To See In Stereo

There has indeed been much progress in the visual sciences and specifically in the area of amblyopia. Rigorous, well-controlled clinical studies done at institutions such as UC Berkeley have shown us that amblyopia can be treated in ways that are less burdensome, can be treated at later ages than previously thought, and with far-reaching quality of life benefits.

Certainly it will take more effort for someone like Joe or Sue to see these benefits than it would for a 4 year old who has tremendous neuroplasticity.

One element that this story gets exactly right is that vision problems like amblyopia truly are issues of neurophysiology not ocular physiology. When we when treat a patient who has amblyopia, we really are changing how their brain functions.

I am so excited to get the word out on the science behind vision therapy!

Be Well!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care
Westchase, Tampa, FL
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We’ve know for quite some time that amblyopia can be improved in older children and adults. It may take more work, but it can be done with the proper vision therapy.

Now there is evidence, at least in rats, that Prozac (fluoxetine) may actually assist in the developing the neural connections in the brain to improve visual acuity reduced due to amblyopia.

But remember two things: First, People are not rats and, at best, it will be some time before fluoxetine is studied in people. Second, whether fluoxetine is helpful or not, vision therapy is crucial in developing all the visual skills in people with amblyopia.

Read the whole article here.

Be Well!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care
Westchase, Tampa, FL
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It is well known, and intuitive, that children and adults with strabismus (crossed or wandering eyes) have greater difficulty with self image and social situations than people with straight eyes. This is partially cosmetic and partially due to self-awareness that something is “wrong” with their vision. To assist people with strabismus, there are many resources including online support groups and a blog.

A related but different condition is amblyopia (lazy eye), that occurs when the vision doesn’t develop normally in one or both eyes and vision is not clear even with the best glasses or contacts. You can’t tell a person has amblyopia by looking at them – an eye doctor has to diagnosis it. There are also online support groups for amblyopia.

Research indicates that people with amblyopia are as likely to have social issues as those with strabismus, even though there is no cosmetic concern. The study found that “a significant number of patients felt that amblyopia interfered with school (52%) and work (48%) to some degree and were generally affected in their lifestyle (50%).” Additionally, sports job choices were affected.

The study concludes with ‘Psychosocial difficulties related to amblyopia affect individuals’ self-image, work, school, and friendships. Amblyopia has a significant effect on psychosocial functioning and warrants aggressive screening, prevention and treatment during the amblyogenic years.”

As I say frequently, it is much easier to prevent amblyopia than to treat it. And fortunately, amblyopia can be prevented. Early eye exams are critical for detecting and treating amblyopia. The first exam is recommended at six months of age. If all is well, the next exams should occur at age three and before school.

Be Well!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care

The evidence continues to support what optometrists have known for years: it is possible to improve amblyopia (lazy eye) beyond childhood years. It is faster and easier to treat at younger ages, but can be treated at any age.

If you’d like to read about this latest study on adult amblyopia treatment, click here.

If you are an adult with amblyopia and have been told that it is too late to be treated, call us for an appointment and, after evaluation,  we can discuss what type of benefit you might receive from treatment.

Be Well!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care

News Channel 8 has also covered the story of Kelly Harmsen and the “The EyePatch Kids” DVD. The USF students that produced the video came to Bright Eyes to videotape me and some patients for a the story. It was fun to be involved and help promote awareness of amblyopia treatment.

You can see the news segment here. (Works best with Internet Explorer).
Be Well!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care

TBO.com recently posted a story called “Patching Up a Problem.” It features the DVD ”The Eye Patch Kids” that aims to help children understand  eye patching therapy for amblyopia, also known as “lazy eye.” The story also has some video and pictures of the DVD and eye patching.

You can read the interview that that I did with Kelly Harmsen, the creator of the DVD here.

As any parent of a child with amblyopia knows, getting young, active children to wear an eye patch can be an exercise in frustration. Parents will usually try asking, pleading with, and bribing their kids to get them to wear the patch. In extreme cases, there are other amblyopia treatments that a doctor can recommend, but the tried-and-true eye patch remains the most common treatment.

Part of the reason kids don’t want to wear the patch is that they have to see out of the “lazy” eye that doesn’t see well, which can be frustrating. Also, kids feel very self-conscious with the patch on. Often, they are the only one they know with an eye patch. And, let’s face it, an eye patch really just isn’t that much fun. And no amount of logic and reason is likely to make it fun.

But I just found out about something that can make wearing an eye patch fun! It is an award-winning DVD called the “The Eye Patch Kids.” It stars a puppet named Princess and her friends, as she goes to the eye doctor and learns that she has amblyopia and needs to wear and eye patch. There is lots of silliness and singing and dancing – all the things that little kids love. And not only that, but it communicates some very important messages for children with amblyopia to hear.

I was so impressed by the video that I interviewed its creator, Kelly Harmsen, about the DVD and her experience with amblyopia:

Dr. B: Can you tell me about your family’s experience with amblyopia?
Kelly:Well, I will admit that before he was diagnosed I had no clue what it was. Now it’s a totally different thing to me because I know that they need to get help. That’s why I always tell parents that just because you don’t think your child has a vision problem doesn’t mean they don’t. If a child is born with loss of vision in one eye they don’t know better to tell you because they have been seeing like that since they were born. So they don’t know there is a problem either. That’s why it is VERY IMPORTANT for every child to get a vision screening.

Dr. B: How did the idea of producing the DVD come about?
Kelly:When Joshua was first diagnosed with Amblyopia and we got a prescription for glasses and bought the eye patch we were clueless on how to get him to wear it. When I asked the d she just said “I don’t know, but just get him to wear it.” After many days of struggling with him to wear the eye patch and him leaving it on for only 30 seconds I was very frustrated. Then one day a man came on a cartoon wearing an eye patch and my son who originally wanted nothing to do with the patch took it out of the drawer and handed it to me to put it on him. I didn’t realize at first why he wanted it on, but was very happy and put it on him immediately. Then he went back into the other room and started trying to dance and copy the man on tv with the patch on. I was jaw dropped when I saw this. Then I thought to myself, I wonder if I can take our camcorder and make a quick little movie on it to play on our TV with puppets with eye patches on for him to copy. Well it worked great and I didn’t have any problems anymore with him. Then after researching the internet I realized that there were so many other kids out there going through the same thing as my son, and that’s when I decided to make this available to all kids. So I sat down at my computer and typed up a rough draft of the script and my sister put in her two cents and then I made all the puppets, backgrounds, etc. and we hired a production company to film it.

Dr. B: Where did the name Bjort come from?
Kelly: Well actually my sister Tracy came up with it. I had made the Bjort puppets and didn’t know what to all them and when my sister saw them she just said “Bjort” and we both started laughing. Then I thought well if we laugh then I’m sure he kids will laugh. So we brought Joshua into the room and I put the puppet back on and kept saying “Bjort” and he would laugh every time so that’s when we thought we had a winner with the name.

Dr. B: What are some of the most distant/interesting places you have gotten feedback from patients/parents?
Kelly:I have been selling them all over the world. As far as Australia, Isreal, Africa, Japan, UK, etc. Unfortunately it is only filmed in English, but even in the countries where they don’t speak English they say that their child still gets the message from just watching it. I have had lots of positive feedback from parents and that makes me feel great to know that I am helping kids out just like my son. There is nothing else like it in the world.

Dr. B: What is your favorite part of the video?
Kelly:I would probably have to say “The Bjort Bop” song with me being the Bjort singing and my sister being the other Bjort in the background just acting crazy. lol. That was totally unrehearsed. I still laugh everytime I see that part knowing how it was made. My sister couldn’t move her wrist for almost a week after that.

If you are interested in purchasing the “The Eyepatch Kids” DVD or related merchandise, you can find out all about it at www.bjortandcompany.com

Be Well!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care
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