Binocular vision therapy for the treatment of Amblyopia-A review.

Amblyopia is a monocular or binocular reduction in visual acuity that results from prolonged visual deprivation in the early years of life. It is second only to refractive error as a cause of poor vision in children. The gold standard treatment of amblyopia includes patching and, less commonly, atropine penalization and filters. These therapies are aimed at improvements in the visual acuity of the amblyopic eye alone. They have compliance and psychosocial issues and gains are accrued after prolonged periods. Experimental studies have demonstrated the presence of binocular cortical communication even in amblyopes and neural plasticity in late childhood as well as adulthood. On this basis, binocular vision therapy aimed at the stimulation of both eyes rather than forced use of the amblyopic eye was developed. Such therapies involve visual tasks designed in such a way that they can be completed only by binocular viewing. These tasks vary from simple game play using red-green glasses, to engaging 3D games and movie viewing. Preliminary data suggest that binocular vision therapy has led to lasting improvements in visual acuity and can be a useful adjunct, if not replacement, to the conventional treatment of amblyopia. In this article, we aim to describe the various binocular vision therapies and review the available literature on the same.

Cosmetic iris implants - double edge sword.

Iris implants were originally described as an option to treat photophobia and glare associated with aniridia, coloboma, corectopia or any other causes of acquired or congenital iris defects. They are not designed to be used in healthy phakic eyes and not approved by regulatory bodies anywhere in the world for cosmesis. However, widespread publicity and the compulsive need for beautification has popularised the use of these implants illicitly. Implantation into phakic eyes causes mechanical irritation of angle structures leading to chronic inflammation, pigment dispersion, prolonged endothelial cell loss and compression of the trabecular meshwork. The consequences are dire, leading to presentation of such patients with serious complications involving the cornea, angle, and lens. Here we give an extensive review of available literature on cosmetic iris implants and also describe a case with bilateral cosmetic iris implants (New-ColorIris). The patient presented with corneal decompensation, glaucoma, and cataract in both eyes, seven years after the implantation and was successfully managed with explantation of the device followed by a DMEK Triple procedure.