Monocular fixation in a binocular field (MFBF), the gold standard for treating amblyopia and an alternative to patching for amblyopia

Published on
December 28, 2022

2 to 3 out of every 100 children suffer from amblyopia, one of the most common causes of vision problems in children.

For a long time, patching was considered the mainstream treatment for lazy eye or amblyopia. In the event that a patient's right or left eye cannot be corrected to 20/20, then a patch is recommended to put over the better seeing eye. During that time, the brain is forced to pay attention to the weaker eye. 

In theory, the brain would develop a better connection with the weaker eye over time, and once the patch was removed, both eyes would again be able to work together as a team. One of the challenges with patching was and is compliance, meaning getting a child to wear the patch for extended periods of time. Another challenge of patching was the ability to achieve the best results with patching alone, which while effective at reconnecting the weaker eyes connection to the brain, was not as effective at integrating the weaker eye into the binocular (two eyes) visual system. 

However, based on the findings of many studies on amblyopia, we now know that there is a more effective treatment option besides patching alone. In the vision therapy room, we often use this concept, known as monocular fixation in a binocular field (MFBF).

What is monocular fixation in a binocular field (MFBF)? How is it used for children with amblyopia (lazy eye)?

Monocular fixation in a binocular field basically means training one eye at a time while both eyes are open. In vision therapy, we may be able to train the amblyopic eye through the use of filters or polarization, while the other eye is still open and receiving visual information.

An example of a vision therapy activity involves a child wearing red and green filters, also known as anaglyph glasses, and completing a maze that is designed using red ink. Consequently, the amblyopic eye is being trained and it will be able to see the maze while the other eye will be able to see the hand and the marker as you trace along the mace. It is a great alternative as children who are non-compliant with patching find it more fun. Furthermore, it does not require parents to constantly monitor their children like patching does. Additionally this treatment by its nature trains the brain to integrate the weaker eye in coordination with the stronger eye, this is the crucial aspect, and the aspect that was most missing from traditional approaches that used patching alone. 

What are the different symptoms of lazy eye?

A child with amblyopia may:

  • Frequently bump into something on a particular side.
  • Experience a large difference between your farsighted and nearsighted vision.
  • Give preference to one side of the body.
  • Have droopy eyelids.
  • Squint a lot or close one eye.
  • Tilt their head to one side.

Schedule a pediatric functional eye exam in Chattanooga with our pediatric optometrist

If your child has been diagnosed with amblyopia also known as lazy eye, and it's affecting their academic performance, but they're reluctant to wear a patch or not getting the best results from patching, they may be able to benefit from monocular fixation in a binocular field (MFBF). To schedule a pediatric functional eye exam, please call (423) 710 3965. Parents who want a thorough evaluation of their child's vision or are concerned about a potential underlying vision problem, visit our clinic from all over Tennessee, and we are proud to be a leading provider of pediatric vision services for patients from Hixson, Chattanooga, Cleveland, and Middle Valley.

If you or your child is exhibiting symptoms of a vision problem take our visual skills assessment

At our pediatric and specialty eye center in Hixson TN, under the leadership of Dr. Heather McBryar FCOVD, we provide children and adults with life changing treatment for amblyopia (lazy eye). 


Vision therapy is well worth the response, time and effort. Our Son had a hard time focusing and writing neatly. After vision therapy Seth could complete a task in half the time if previously took. His abilities to focus improved greatly and so did his handwriting.

Also, he was better at listening. As a parent, we wanted learning to be fun for our Son, and vision therapy made this possible.

Amanda T.

Vision Therapy is well worth the expense, time and effort. Our son had a hard time focusing handwriting neatly. After vision therapy Seth could complete a task in half the time it previously took his abilities to focus and improved greatly and so did his handwriting.

Also, he was better at listening. As a parent you wanted learning to be fun for our son and vision therapy made this possible.

Alexa H.

Vision Therapy has given or son the tools he needs to be able to scan and read the written word more effectively and efficiently.

He love working with John and these working sessions give him the motivation to gladly work on his homework assignments.

It amazed us to see the difference in the tracking of his eyes and along a line of it's from the beginning to the end of the treatment.

Dr. McBryar , Kristen and John  are all marvelous and we would recommend them to anyone I only wish that we would have found them sooner!

Charlotte M.

Prior to coming to the institute for vision development my son complained of daily headaches. Therapy has eliminated his headaches completely. I love knowing my son is able to learn pain-free for the rest of his life because of the work that has been done over just a few weeks in this office. He he absolutely loved coming that didn't even feel like going to a doctor or therapy. We are grateful for the relief he was able to find by coming here.

Thank you!

Olivia C.

Seems much less frustrated with life

Reads non-stop and fast

Spelling abilities have been hugely improved

Seems much more confident

Thank You!!!

Kelly O.

When we first came to the practice, my son did not have huge issues, but lots of small ones- trouble with reading, sports (hitting the baseball consistently), coordination, etc- that were not easily detectable,but when put together presented issues. The staff here were all very professional and loving towards him. While I was concerned in the reading, my son was concerned with the athletic side. Seeing improvement night off the bat gave him confidence that i have nor seen in him and made him want to not only Come to therapy, but also made him want to work hard. He has surpassed his grade level and above in reading and hit his first home run this year! Thank you!!!

Alice M.
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