Abstract
Following refractive surgery, some patients (less than 1%) complain of poor vision even though their refraction has been optimized. Upon examination, most of these patients exhibit binocular or accommodative disorders. This project began an investigation into whether an internet-based computer program that provides practice in binocular convergence, divergence, and fusion ranges can alleviate symptoms and improve visual function in post-Lasik patients with binocular dysfunction. Twelve patients, each 20/20 or better, were examined post-surgery for convergence range, accommodative facility, and other indicators of visual function. All had accommodative spasm and/or convergence insufficiency. Nine of the patients completed 20 or more sessions of an internet-based psychophysically rigorous visual skills training program. Sessions were 20 minutes/day, 3–5 days/ week. Binocular function improved significantly in six patients (67%). The other three also improved, but required additional in-office vision therapy to reach their therapeutic goals. The results show that binocular vision can be improved post-surgery in patients with binocular dysfunction. They also suggest that the identification of binocular disorders prior to surgery may be important, so that patients understand they may require some form of vision therapy post-surgery. Whether strengthening binocular function prior to surgery would eliminate post-surgical complaints remains to be determined.