👤 Wojciech M Ciszewski

This review evaluates the efficacy of conventional and emerging therapies for amblyopia in adults, challenging the traditional notion of limited neuroplasticity beyond childhood. The study aims to compare the effectiveness of methods such as perceptual learning, dichoptic training, virtual reality (VR), and pharmacological interventions in improving visual acuity, binocular vision, and perceptual functions. A systematic literature search was conducted in PubMed, Google Scholar, Scopus, and Web of Science (1996-2025). Keywords included amblyopia treatment, adult neuroplasticity, dichoptic training, and VR therapy. Inclusion criteria prioritized clinical trials, systematic reviews, and meta-analyses focusing on adult amblyopia. Studies on pediatric populations, animal models, and non-scientific articles were excluded. The reviewed studies indicated that conventional treatments, such as refractive correction and occlusion therapy, offer limited efficacy in adult amblyopia, with modest improvements in visual acuity. In contrast, emerging therapeutic strategies-including dichoptic training, virtual reality-based interventions, neuromodulation techniques, and selected pharmacological agents-demonstrated more substantial and sustained gains in both acuity and binocular function. These modern approaches appear to leverage neuroplasticity more effectively, particularly when combined with engaging, perceptually balanced stimuli and periodic reinforcement. The reviewed evidence indicated that although conventional therapies offer limited improvement in adults, modern neuroplasticity-based methods provide more substantial and consistent benefits. Emerging techniques such as perceptual learning, dichoptic stimulation, and VR/AR interventions demonstrate significant gains not only in visual acuity but also in binocular integration. However, heterogeneous study designs and limited long-term data highlight the need for standardized protocols and further clinical validation. Adult amblyopia therapy is feasible due to retained neuroplasticity. Emerging technologies (VR, dichoptic training) and neuromodulation outperform conventional methods, particularly for binocular vision. However, individualized protocols and long-term efficacy studies are needed. Future research should optimize cost-effective, standardized treatments for clinical adoption. Show less

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