VISUAL AND BINOCULAR OUTCOMES OF MULTIMODAL THERAPY IN ADULT AMBLYOPIA: A CASE REPORT

Background: Amblyopia is often considered resistant to treatment after the critical period, and adult intervention is uncommon. Vision therapy (VT) and syntonic phototherapy have each been reported to improve visual acuity, contrast sensitivity, and binocular function, but combined programs in adults remain sparsely documented, particularly with quantified suppression and stereopsis outcomes.
Case presentation: A 23-year-old male with long-standing right eye visual impairment, high anisometropia, suppression, and reduced stereopsis was diagnosed with right anisometropic amblyopia (baseline best-corrected visual acuity [BCVA] 6/15 in the right eye, 6/6 in the left eye. He completed 30 office-based sessions, progressing from monocular stimulation to dichoptic anti-suppression training, each followed by 20 minutes of Alpha Delta filter syntonic phototherapy, then 4 months of home-based therapy. By session 30, BCVA of the right eye improved to 6/6⁻², suppression resolved, 4 prism base-out testing became negative, stereopsis improved from 400″ to 200″, and right eye contrast sensitivity rose from 1.05 to 1.35 logCS (left eye) 1.50 throughout. At session 18, suppression and stereopsis were unchanged despite BCVA of 6/9. At 2 and 4 months, BCVA remained 6/6⁻¹, contrast sensitivity reached 1.50 logCS, and stereoacuity improved to 100″ and then 80″, possibly reflecting continued home practice, delayed learning, or measurement variability. No adverse events occurred.
Conclusion: Meaningful functional recovery is achievable in adult anisometropic amblyopia using vision therapy combined with syntonic phototherapy. As syntonic phototherapy was an adjunct, its independent effect cannot be determined. Controlled studies are warranted.