Multiple Short Daily Periods of Normal Binocular Vision Preserve Stereopsis in Strabismus

Purpose Infantile strabismus impedes the development of stereopsis. In optically strabismic monkeys, 2 continuous hours of normal binocular vision per day has been shown to preserve near-normal stereopsis. In this study, we investigated whether, as in learning, multiple shorter periods of intervention would further boost performance. Methods To simulate infantile esotropia, infant monkeys were reared with 30 prism diopters base-in starting at 4 weeks of age. Daily periods of normal binocular vision were provided by replacing prisms with plano lenses. Altogether, 14 monkeys were prism reared: 2 with continuous prism, 2 with 2 continuous hours of normal binocular vision per day, 6 with 2 noncontinuous hours, and 4 with 1 noncontinuous hour of binocular vision each day. Seven normally reared monkeys provided control data. Behavioral methods were employed to measure spatial contrast sensitivity, eye alignment, and stereopsis. Results One monkey reared with continuous prism had poor stereopsis, and the other had no stereopsis. Ten of the 12 monkeys reared with periods of normal binocular vision had stereopsis, and those with longer and more continuous periods of binocular vision had stereopsis approaching that of normally reared monkeys. Conclusions During early development, multiple short periods of binocular vision were effective in preserving clinically significant stereopsis in monkeys. These results suggest that by providing relatively short multiple daily intervention periods, stereopsis may be preserved in strabismic human children.