Amblyopia Therapy with MCS
1.A comfortable room ,( of size 1 meter/ 1.5 Meter) with ambient lighting conditions, and least disturbance, preferably air conditioned , in hot places
2.A Laser pointer, ( preferably red or blue), eye patch and a height adjustable chair.
3.Place the stimulator on the wall, at a height of 3 or 3 1/2 feet from the ground. Do not hang it too low or too high as the central red light should be at eye level , in primary position ,of the patient, for all patients of different heights.
4.We suggest a voltage stabilizer to the whole room.
6.Each session lasts for 30 minutes and hence a comfortable room is very important with supervision. A very hot room or very cold room or where a lot of people are walking around will be distractive to the patient and may affect the results of treatment, as the concentration of the patient during the exercise is very essential, for good results.
Patient Selection Criteria
1.Check the distance vision in each eye with two different vision charts and record the distance visual acuity (DIGITAL SNELLEN AND LOGMAR chart)
2.Check crowding card vision in each eye
3.Record the near visual acuity (SNELLEN AND LOGMAR)
4.We suggest a duochrome test to verify the accuracy of the correction given.
5.Do a cycloplegic refraction, in all patients prior to starting and change the glasses to the needed prescription(if required)
6.In cases of anisometropia, you may need to fit a contact lens for the eye or eyes, to remove the main cause of Amblyopia.
(Check vision in standard repeatable conditions. Record visual acuity , separately for each eye with and without, correction in place)7.Then with proper correction in place , check the WORTH FOUR TEST for distance and near. Record the findings carefully.
8.Then record the STEREOPSIS on Langs plates or the stereo fly test and record the findings carefully
9.VEP and PERG should be done and record the findings
Maintain a separate record for each patient with dates of the exercise done and time. Each session takes about half an hour. For a given patient two or three sessions (MAX) can be done
You must always ensure the patients are indeed following your instructions all the time. Before starting the exercise, ask the patient to write a paragraph on a white paper, some information like his name , Age and sex, and date of starting the exercise and at the end of each exercise , let him write the same.( 5 or 6 lines).
just below the previous paragraph. This way you can easily assess the improvement in handwriting, suggestive of improved hand eye coordination.
Video recording before start of treatment and after completion of the treatment can be done
PROCEDURE:1.Make the patient sit 1metre from the SMS, ensuring that the red light at the centre of the SMS, is at the eye level, with pateint’s eye in primary position.
2.Give the patient the laser pointer with the instructions that he or she must quickly point the light that comes on. The patient has to be quick and should not miss any of the lights that come on in a random sequence. Each light that comes on lasts for 500 milliseconds, and deeply amblyopic patients may have difficulty, for a session or two. Don’t worry, they will soon see the improvement, themselves.
3.COVERT ATTENTION METHOD
In dense Amblyopia, start with normal eye for a minute or two for the patient to understand the exercise. Then patch the normal eye or eye with good vision Let the patient do the exercise with amblyopic eye for 20 Minutes(450 times LC).. Then leave both the eyes open and do the exercise, for 6 minutes(400 times LC). Then remove the patch and patch the amblyopic eye for 5 minutes(250 times LC). Repeat the exercise, with the normal eye, or eye with better vision That completes a session.
4.OVERT ATTENTION METHOD (DONE WITH THE LASER POINTER)
- Amblyopic eye-15 Mins
- Binocular- 7 Mins
- Sound eyes-5 Mins
4.Let the patient go for a walk and have a drink and come back in half hour or so for second session.
5.Then leave him free for 3 minutes and check his vision and binocular vision and stereopsis etc. Record the findings. Record the feeling of the patient as well, if he can see better now after the session.
Therapy Schedule
- a) 1 Session/Day for 15 days(during holidays if willing)
- b) Weekly one session-4 weeks(1 month)or for 3 months if daily exercise not done
- c) 1 Session/every fortnightly (1 month)
- d)1 Session/month ( 2 months)
- e)After 4 months -1 Session
- f)After 6 months -1 Session
-VEP AND PERG- 3500 RS
-COST FOR 1 SESSION OF STIMULATION EXERCISE-750 RS
The instrument can be used to treat the following conditions.
1.Bilateral Ametropic amblyopia
2.Anisometropic Amblyopia without associated strabismus
3. Strabismic amblyopia, prior to or after surgery
4.Resistant amblyopia, after strabismus surgery
5.To improve stereopsis in cases of successfully operated squint with no stereopsis
6.To improve stereopsis, lost due to other causes
7.To improve hand eye coordination
8.To reduce recurrence of squint after surgery in IDS
9. To treat and or reduce the Nystagmus of all types
10.To treat ocular problems in cerebral palsy children
11. Can be tried in cases of decreased vision due to unknown causes
12.Can be tried in Optic nerve problems as well