Amblyopia and binocular vision

The review presents new insights into the mechanisms of development of amblyopia. There is objective evidence that amblyopia develops simultaneously as the monocular and as the binocular deficit of visual processing and that decrease in monocular visual acuity and disorders of binocular and stereoscopic vision take place. Given the ever-increasing evidence of fundamental and clinical studies, it is most likely that the binocular dysfunction is primary, and the decrease of monocular visual acuity is secondary in this disease. Amblyopia is a binocular pathology, and binocular interaction plays a critical role in the pathogenesis of strabismic, anisometropic and combined amblyopia. Accordingly, it seems appropriate to start the treatment with the restoration of binocular vision, which also leads to the recovery of the amblyopic eye. Visual dysfunction in amblyopia is often associated with the emergence of powerful suppression while watching with both eyes. Suppression converts the structurally binocular system into a functionally monocular one. Therefore, the elimination of suppression should be considered the first and the most necessary step to restore binocular vision. Quantification of suppression is a critically significant step for the development of new methods of treatment of amblyopia, including those based on the perception of global motion, associated with the function of the extrastriate dorsal visual cortex. The new understanding of amblyopia becomes the basis for a large amount of diverse research targeted to the development of more effective treatment methods, which will focus primarily on the elimination of suppression and restoration of binocular vision // Russian ophthalmological journal. 2017; 10 (2): 97-102. (in Russian). doi: 10.21516/2072-0076-2017-10-2-97-102