Effect of microprismatic eyeglasses on the character of binocular vision in children with strabismic amblyopia over treatment time
S.O. Rykov,1 Dr Sc (Med)
V.B. Mellina,2 Pediatric Ophthalmologist
1Shupyk National Medical Academy of Postgraduate Education
2Eye Microsurgery Center, Kyiv City Clinical Ophthalmologic Hospital
E-mail: Mellina111@rambler.ru
Background: Strabismic children develop early motor and/or sensory complications (amblyopia, poor fixation of the eye, impaired fusion, and impaired binocular vision). The major goals of treatment for strabismic amblyopia are to remove strabismus, to improve the vision of the amblyopic eye, and to restore the binocular vision. Prisms and apparatus-based orthoptics techniques have been used for a long time for the treatment of impairments in binocular vision. In Ukraine, the technology for manufacture of spheroprismatic lenses designed as microprismatic combination eyeglasses was developed in 2009.
Purpose: To investigate the effect of microprismatic glasses versus apparatus-based pleoptics-and-orthoptics techniques on the character of binocular vision in children with strabismic amblyopia.
Materials and Methods:  One hundred and forty nine children with strabismic amblyopia aged 4 to 18 years were included into the study. Concomitant esotropia and exotropia were found in 77 children and 11 children, respectively, of the study group, versus 54 children and 7 children, respectively, of the control group. Six children (6.8%) of the study group, versus 13 children (21.3%) of the control group were those with partially accommodative strabismus, whereas the rest were those with non-accommodative strabismus. Children of the study group were treated with microprismatic glasses, whereas those of the control group were treated with apparatus-based techniques.
Results: At 6 months, binocular single vision was obtained in 20 children (22.7%) of the study group versus only one child (3.0%) with low amblyopia of the control group. In addition, diplopia was present in 51 children (58.0%) of the study group versus 10 children (16.4%; 8 children (13.1%) at baseline) in the control group.
Conclusion: The treatment proposed for strabismic amblyopia (a) requires no additional time, (b) has good outcomes, (c) is suitable for patients, and (c) is more efficacious than conventional apparatus-based pleoptics-and-orthoptics therapy.
Key words: strabismic amblyopia, binocular character of vision, microprismatic glasses
1.    Abramov VG. [Common pediatric ocular diseases and their clinical features]. Moscow: Mobile; 1993 Russian
2.    DeSantis D. Amblyopia. Pediatr Clin North Am. 2014 Jun;61(3):505-18
Crossref   Pubmed
3.    Granet DB, Khayali S. Amblyopia and strabismus. Pediatr Ann. 2011;40:89–94
Crossref   Pubmed
4.    Van de Graaf ES. Amblyopia and strabismus questionnaire: Rasch analysis. Invest Ophthalmol Vis Sci. 2010 Dec;51(12):6898
Crossref   Pubmed
5.    Avetisov SE, Kaschenko TP, Shamshinova AM, editors. [Ocular functions and their correction in children] Moscow: Meditsina; 2005 Russian
6.    Smirnova IuV, Shishova OV, Smirnov KV. [Experience with complex treatment for childhood amblyopia]. Vestn Oftalmol. 2008 Jan-Feb;124(1):32-4 Russian
7.    Ding J, Levi DM. Rebalancing binocular vision in amblyopia. Ophthalmic Physiol Opt. 2014 Mar;34(2):199-213
Crossref   Pubmed
8.    Pratt-Johnson JA, Tillson, G. Management of Strabismus and Amblyopia. A Practical Guide. 2nd ed. New York: Thieme Medical; 2001
9.    Birch EE. Amblyopia and binocular vision. Prog Retin Eye Res. 2013 Mar;33:67-84
Crossref   Pubmed
10.    Bhola R, Keech RV, Kutschke P, et al. Recurrence of amblyopia after occlusion therapy. Ophthalmology. 2006 Nov;113(11):2097-100
11.    Flynn JT, Schiffman J, Feuer W, Corona A. The therapy of amblyopia: an analysis of the results of amblyopia therapy utilizing the pooled data of published studies. Trans Am Ophthalmol Soc. 1998; 96: 431–53
12.    Wallace DK, Pediatric Eye Disease Investigator Group, Edwards AR, Cotter SA, et al. Ophthalmology. 2006 Jun;113(6):904-12
13.    A randomized trial of increasing patching for amblyopia. Pediatric Eye Disease Investigator Group, Wallace DK, Lazar EL, Holmes JM, et al. Ophthalmology. 2013 Nov;120(11):2270-7
14.    Voinov MM. [Ocular motility abnormalities]. St Petersburg: Glavnyi Voenno-Meditsinskii Departament; 1873 Russian
15.    Evens L. History of strabismus treatment. Bull Soc Belge Ophtalmol. 1981;195:19-52
16.    Münchow W. [History of strabismus therapy]. Klin Monbl Augenheilkd. 1973 Mar;162(3):413-22 German
17.    Moore S, Stockbridge L. An evaluation of the use of Fresnel press-on prisms in childhood strabismus. Am Orthopt J. 1975;25:62–6
18.    Dal Fiume E, Navarra R. [Prismatic correction of small residual angles of strabismus]. Minerva Oftalmol. 1966 May-Jun;8(3):68-70 Italian
19.    Adams AJ, Kapash RJ, Barkan E. Visual performance and optical properties of Fresnel membrane prisms. Am J Optom Arch Am Acad Optom. 1971 Apr;48(4):289-97
20.    Avetisov SE, Kaschenko TP, Rozenblium IuZ, Friedman SIa. [Use of prisms in ophthalmology. Prisms in treatment of strabismus and ocular muscle palsy. Special methods of using prisms]. Vestn Oftalmol. 1973 Sep-Oct;5:86-90 Russian
21.    Petrov VV, Kriuchyn AA, Rykov SO, Serhiienko MM, Antonov YeYe, Mellina VB, Shanoilo SM, Shevkolenko MV: inventors; Institute for Information Recording of the NAS of Ukraine, assignee. [Combined microprysm lens]. Patent of Ukraine № 46750 A 61 В 3/08. 2010 Jan 11. Ukrainian
22.    Butenko LV, Iegupova LI. [Development and use of advanced Fresnel microprisms for diagnosis and treatment of pediatric strabismus]. Reiestratsiia, zberigannia I obrobka danykh. 2010; 1:67-72 Ukrainian