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William R. Bobier OD, PhD, FAAO, MBCOa ; Peter J. Shaw, OD

A consideration of binocular parameters in the spectacle correction of anisometropic amblyopia: A Case Report

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Background: Recent evidence points to the use

of spectacles alone in the treatment of anisometropic

amblyopia. However, the impact of this treatment

on the restoration of binocular vision is often not



Case Report: Patient M.Z., aged 7

years, showed 3.5D of anisometropia which was

coupled with a best corrected visual acuity of 6/38 in

the more hyperopic eye (6/6 in the non-amblyopic

eye). Spectacle lenses were prescribed using specially

designed software to alter the spectacle frame and

lens parameters to theoretically reduce the static and

dynamic aniseikonia to 1% and 3.8% respectively.

Four subsequent follow up visits were conducted over

a 2 year period where standard clinical measures of

refraction, visual acuity, and binocular vision were

conducted. The spectacles were worn consistently over

this time. Single letter acuity normalized by 5 months

while crowded acuity took longer. Improvements of

binocular vision resulted concomitantly. However,

improvement in suppression and stereo acuity continued for 2 years following the initial spectacle



Conclusions: This case exemplifies how

the prescribing of spectacle lenses with consideration

of, and correction for, predicted optical aniseikonia

allowed the amelioration of amblyopia without

patching and the provision of significant levels of

binocular vision within a 1 year period. However, the

time course for the development of binocular vision

well exceeded that for the amelioration of amblyopia.


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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