Macular degeneration is the leading cause of blindness in older adults in the United States. Approximately 20 million adults in […]
Purpose
Amblyopes do not reliably show relative afferent pupillary defects with full-field stimulation, but amblyopia has cortical involvement; hence, stimuli that engage cortex may be able to reveal pupil defects in amblyopes.
Methods
Pupillary responses were acquired with a binocular infrared pupillometer (RAPDx, Konan Medical USA, Irvine, CA) from 15 amblyopic subjects (anisometropic and small-angle strabismic) and 10 age-matched control subjects. Stimuli were a full-field white flash (330 cd/m2) or a small (4 degrees) annulus at one of three contrast levels (0.3, 0.6, and 1.8) on a dim background (6.2 cd/m2). Stimulus duration was 100 milliseconds, and the interstimulus duration was 2000 milliseconds.
Results
In all four stimulus conditions, the difference in percent contraction amplitude for right versus left eye stimulation was more variable across amblyopes than across control subjects. Amblyopic eyes did not show a specific deficit for the full-field flash. However, the mid-contrast (0.6) annulus stimulus revealed a deficit in the amblyopic eye, whereas the size of the deficit did not correlate with the type or depth of the amblyopia.
Conclusions
Targets of appropriate pattern, brightness, and contrast that select for cortical contributions to the pupil response may be useful for eliciting pupil defects in amblyopic patients. Pupil analysis in this population could prove useful for diagnostic or prognostic value, for example, to determine which amblyopes will respond best to treatment.
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Family Vision Clinic changed our lives! My daughter was frequently car sick, and she was getting headaches every day, often painful enough that they brought her to tears. We saw a string of doctors and therapists, but we made no progress. Finally, we found Dr. Levi Zurcher and his eye therapist Rain. After ten weeks of eye therapy my daughter no longer gets headaches, and she no longer gets car sick. Daily tears are a thing of the past. I really can’t say enough about this clinic. It was fascinating to watch Dr. Zurcher work. For the first time, someone who knew what they were doing was intently studying my daughter, really trying to figure out all of her eye issues, and his therapist Rain is one of the most patient and lovely people that I’ve ever had the good fortune to meet. We’re finished with eye therapy—yay!—and I have switched to American Family Vision Clinic for all of my family’s other eye health needs.
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Macular degeneration is the leading cause of blindness in older adults in the United States. Approximately 20 million adults in […]
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