Improvement in Vernier acuity in adults with amblyopia. Practice makes better.

PURPOSE To determine the nature and limits of visual improvement through repetitive practice in human adults with naturally occurring amblyopia. METHODS A key measure the authors used was a psychophysical estimate of Vernier acuity; persons with amblyopia have marked deficits in Vernier acuity that are highly correlated with their loss of Snellen acuity. The experiment consisted of three phases: pretraining measurements of Vernier acuity and a second task (either line-detection thresholds or Snellen acuity) in each eye with the lines at two orientations; a training phase in which observers repetitively trained on the Vernier task at a specific line orientation until each had completed 4000 to 5000 trials; and posttraining measurements (identical to those in the first phase). Two groups of amblyopic observers were tested: novice observers (n = 6), who had no experience in making psychophysical judgments with their amblyopic eyes, and experienced observers (n = 5), who had previous experience in making Vernier judgments with their amblyopic eyes (with the lines at a different orientation) using the signal-detection methodology. RESULTS The authors found that strong and significant improvement in Vernier acuity occurs in the trained orientation in all observers. Learning was generally strongest at the trained orientation but may partially have been transferred to other orientations (n = 4). Significant learning was transferred partially to the other eye (at the trained orientation) in two observers with anisometropic amblyopia. Improvement in Vernier acuity did not transfer to an untrained detection task. In two observers, the improvement in Vernier acuity was accompanied by a commensurate improvement in Snellen acuity. CONCLUSIONS Some adults with amblyopia retain a significant degree of neural plasticity. Although several observers (primarily novices) showed evidence of generalized learning, several amblyopic patients showed evidence for improvement that was orientation and task specific. In this latter group of observers, the improvement appeared to reflect alterations that were, at least in part, in early neural processes that were orientation specific and were localized beyond the site of convergence of the two eyes.