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Unilateral Cataracts: Is Successful Amblyopia Therapy Compatible with Binocular Vision?

Correspondence: Requests for reprints should be addressed to: Mara Sketchley, O.C.(C.), 621—10833 160th St., Surrey, BC, Canada V4N 1P3. e-mail: msketchley{at}hotmail.com

Background and Purpose: Two case studies are used to illustrate the importance of balancing the postsurgical achievement of high-level visual acuity with the acquisition of stereopsis in cases of unilateral cataract. Traditional management will be reviewed and limited occlusion therapy will be discussed. A structured occlusion regime that allows for increased binocular opportunity is promoted for use upon cataract removal.

Patients and Method: Two cases are reviewed in which a unilateral cataract was removed and a full-time intensive patching schedule was followed.

Results: Both patients reviewed have no measurable depth perception and are bothered by intractable diplopia.

Conclusion: Promoting good visual acuity in unilateral cataract management is the primary objective. Good visual acuity can be achieved with reduction of occlusion intensity in order to allow for some form of binocularity to develop, lowering the risk for strabismus and intractable diplopia.

Key words: unilateral infantile cataract, limited occlusion schedule, amblyopia, binocular development