Drugs for strabismus and amblyopia: Connecting our eyes again

pills of different shapes and colors[See end of article for photo credit.]
Wouldn’t it be super if we could just pop a pill and it would do something in our brains to connect our eyes properly again? Recent comments on our January 5, 2006, post shared a brief personal experience regarding an antidepressant that seemed to help, as well as a link to a research article related to drug treatment for strabismus and amblyopia.

The research article mentions three classes of drugs that might have a role in the treatment. Most of us have heard of Botox injections (botulinum toxin) which is the first class the article lists. The second class is the “autonomic agents (atropine, miotics).” These drugs are said to help by “by altering the refractive state of the treated eye” as an alternative to optical correction (miotics) and patching (atropine). For help in understanding the “refractive state” mentioned in the article, I found this item:
Eye Anatomy – Refractive.

The third class is “the neurotransmitter precursor levodopa and the related compound citicoline” which the article says, “have been demonstrated to improve vision in amblyopic eyes.” The item goes on to say that the “therapeutic role of these centrally acting agents in the clinical management of amblyopia remains unproven.” You can read the entire article on Pub Med:
The role of drug treatment in children with strabismus and amblyopia.

icon of pillsIn several interesting comments to our item posted to Eyes Apart on January 5, 2006, entitled New treatment for adults with amblyopia, “david” has been sharing his search for help with amblyopia. Recently “david” commented that he had been taking an antidepressant, Wellbutrin SR 150mg for 2 weeks and that he did a search because the Wellbutrin seemed to be helping his drifting eye.

He found the pub med link (above) and offered this additional explanation: “Wellbutrin is a NDRI (norepenepherine and dopamine reuptake inhibitor) meaning that D & N reuptake is blocked so that more D & N is available to bind to receptors in the brain. Levodopa (l-dopa) is the precursor to dopamine. It is metabolized to dopamine in the brain.”

“It’s been helping a lot with the floating eye, “david” wrote. I feel as though both eyes are working together again.” He also noted in a later comment that, “It’s difficult to say what’s responsible for what I’m experiencing. It could either be a direct result of the increased dopamine or a side-effect of not being ‘depressed.’ I do notice that it’s more difficult to keep the amblyopic eye focused when I’m tired, but since I’m more alert while on the antidepressant, it takes little effort to keep the eyes aligned.”

Unfortunately, a couple days later, “david” told us in another comment that, “I’m no longer able to see well. It only lasted a day.” You can read all comments on that item by “david” as well as others, or add your own comment, here.

“Shaun” in our Eyes Apart Support Group noted that he had been taking a different antidepressant, “Paxil CR and it has helped tremendously, but not in any improvement in my eyesight, I’m referring to social anxiety. It definitely helps.”

As a personal note, in some discussion at our Eyes Apart Support Group I wrote that I used to take Sudafed occasionally for sinus congestion (when it used to contain pseudoephedrine), and that I always noticed that my vision improved when I took it. I used to think there was some sort of connection with the pseudoephedrine and strabismus. But I finally decided that the pseudoephedrine made me able to focus better because it increased my alertness.

Perhaps “david,” and “Shaun” and I have provided our own little very unscientific research tidbit here. Seems if you can find a drug to make us less tired and more alert we can focus better. If it also helps us be less anxious, we may be able to function better socially. Focus and function. Maybe some day someone will do a study on this and make that pill for strabismus possible after all!

Have you had an experience of your strabismus being helped by pills or oral medications? If so, please share it in the comments area of this post.

Photo credit: dima v

6 thoughts on “Drugs for strabismus and amblyopia: Connecting our eyes again”

  1. From “Gail” by way of Lois (admin)

    That’s really fascinating about the connections between amblyopia and dopamine. I found one study where after L-dopa, acuity increased specifically in the amblyopic eye of test subjects, not the other eye, nor the eyes of normal-vision subjects, but the visual cortex associated with the amblyopic eye was *less* active with increased acuity after L-dopa–maybe it’s less work when the eyes are working better together? It’s just amazing to me that a centrally acting agent could affect how the eyes function together…. but I guess when you think about it, it’s such a brain thing to begin with.

    Gail shared this link where she found the information above: The effects of L-dopa on the functional magnetic resonance imaging response of patients with amblyopia: a pilot study.

    Gail also wrote: “Interesting about your experiences with sudafed. My husband takes it whenever he feels a migraine, even an occular migraine coming on & that almost always stops it cold, but he’s never encountered anyone else it works in that way for.”

    [Lois’s note: Sudafed has helped my headaches also…sometimes. Other times my headaches have been best helped with Tylenol, Motrin, or Excedrin Migraine, and sometimes I’ve been best helped with triptans (Rx meds like Imitrex or Maxalt.) I’m not sure why one works best one time and it requires a different med another time. I’m learning that my problem is not totally related to my eyes, but also to some TMJ from a previous accident, so perhaps that explains it.]

  2. Is there an exam code that might get ins coverage for the condition of convergence problems[ older adult amblyopic]. i’m seeing an od, and have a genl exam code for first exam vist/92004. it was an extensive visit[ 2 + hrs for $250.] w/ lots of specific testing. also got the diagnostic codes of 367.0 and 367.4. I like her, and think the vision training they offer could be good, but think they are a smidge provincial insurance-wise. they have gone the route of not doing any of the insurance; i understand the hair pulling paperwork as a retired chiro myself.., but i think i might be able to get some ins consideration w/ appropriate codes. anyone have any experience?

  3. Could anyone possibly tell me why drugs like hydrocodone or subutex, but also an upper like adderal have helped correct my lazy eye? I feel like more research should go into this if no one knows why this works for me. I’ve been using these substances to fix it for two years. I stumbled upon these drugs and how they affect my eye on accident. I didn’t know going into it that it would have any effect on my eye, but it definitely has. It saved me through semesters of college. I’d really like some help and to possibly help others. Thank you.

  4. Laura, you mentioned that you stumbled on these drugs and their affect on your eye by accident. Is a medical doctor prescribing these drugs to fix your eye now? I have never heard of these drugs being used for lazy eye.
    Lois

  5. That’s the problem. Where I get them is irrelevant to the question I asked. I just want to know how they work, or how/why they fix my amblyopia. I thought maybe you or someone would have some insight into this.

  6. This is in regards to the last posting. I googled Adderal and it turns out it is a phenethylamine. Here in North America, you can freely buy phenethylamine (PEA) as a food supplement (an energy-booster), which I did. As a sideeffect, I also notice I can more easily keep my eyes together. PEA boosts dopamine, perhaps dopamine helps synchronicity in nerve firing and thus helps keep both eyes together. I have numerous strabismus surgeries, and if they have been in vain, I would be very upset. More research is needed.

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