Pleoptics

The Pleoptics ( pleo- , πλεῖος / πλέως Greek .: "full") includes a number of ophthalmic procedures for - treatment of functional amblyopia (- frequently apparatus amblyopia are used), however less expensive in recent decades through the development and more practical Methods have lost their importance. The focus is on the effort to regain or restore a lost foveolar, central fixation through active stimulation . It is assumed that the main physiological direction of vision is no longer bound to the fovea of the retina (point of sharpest vision), but to a peripheral point of the retina. One speaks here of eccentric fixation . In this situation, the foveola is "blocked" by what is known as a central scotoma (loss of visual field), and the person affected is no longer able to use the point of his greatest ability to resolve . The main goal of pleoptics is therefore to reduce this scotoma and to associate the main physiological direction with the foveola with central fixation.

methodology

The treatment method is part of the strabological forms of treatment, which also includes orthoptics . As a rule, special devices are used here, the pleoptophore (according to Bangerter) and the euthyscope (according to Cüppers ). With both devices, differently designed exercise treatments, including the generation of afterimages , are carried out over long periods of time , which must be supported by a corresponding occlusion treatment . Series of tests showed no significant differences in the treatment results of the two main procedures.

Another method for practicing foveolar perception is the use of the Haidinger tuft , which can be generated in haploscopes ( synoptophore , synoptometer ) using rotating polarization filters.

Complications and risks

In amblyopia treatments, various complications have been described, ranging from a deterioration in visual acuity of the occluded eye to an increase in the squint angle to temporary, rarely persistent diplopia . It is also not uncommon for recurrences to be found, which necessitates close and attentive follow-up care.

Comparative studies show no significant differences in the treatment results compared to the economically considerably more favorable occlusion treatments. Pleoptic training is therefore only used as an additional measure in the treatment of amblyopia in certain cases after a detailed examination and strict indication, and this exclusively by appropriately competent specialists, generally orthoptists . Due to the sometimes very long duration of treatment, detailed explanations and information discussions with parents and patients are essential for compliance .

literature

• Herbert Kaufmann (Ed.): Strabismus . With the collaboration of Wilfried de Decker et al. Enke, Stuttgart 1986, ISBN 3-432-95391-7 .

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