Improvement in Visual Acuity in a Patient with Nonsyndromic Retinitis Pigmentosa Following Combined Vision Therapy: A Case Report
DOI:
https://doi.org/10.47363/JORRR/2025(6)207Keywords:
Retinitis Pigmentosa, Vision Therapy, Functional Vision Rehabilitation, Syntonic Phototherapy, Binocular Vision, Visual Acuity ImprovementAbstract
Background: Retinitis Pigmentosa (RP) is a progressive hereditary retinal degenerative disorder characterized by photoreceptor loss, progressive visual field constriction, and eventual central vision impairment. We report a case of a 40-year-old female patient with retinitis pigmentosa presenting with headache, bilateral blurred vision (distance and near), poor hand-eye coordination, oculomotor dysfunction, dizziness, impaired object perception, night blindness, mobility limitations, and reading fatigue.
Case Presentation: The initial examination indicated that the patient's unaided distance visual acuity was 6/60 in the right eye (OD) and 6/48P in the left eye (OS). The near vision was recorded as N36P in the right eye and N36 in the left eye. Optical coherence tomography (OCT) revealed bilateral foveal thinning accompanied by fine epiretinal membranes. The Humphrey visual field analysis (HVF 10-2) showed severe generalized depression, along with significant localized defects.
The patient subsequently participated in a structured three-phased vision rehabilitation program, which included a total of 173 office-based sessions. The first phase lasted for 60 days, followed by 30 days of sessions each subsequent year.
Results: Following combined vision therapy, the patient demonstrated remarkable improvement. Best-corrected visual acuity (BCVA) improved to 6/18+4 bilaterally, with near vision improving to N8P with reading glasses. Stereoacuity improved from flat fusion to 140 seconds of arc. Complete resolution of asthenopic symptoms, including diplopia, headache, eyestrain, and reading fatigue, was achieved. The patient reported enhanced functional independence, improved dark adaptation, better mobility, and increased reading efficiency.
Conclusion: This longitudinal case study demonstrates significant visual acuity and binocularity and functional recovery in a patient with retinitis pigmentosa following structured, multimodal vision therapy. The success of combined therapy highlights the potential of tailored vision rehabilitation to restore binocularity and enhance quality of life in retinal degenerative conditions. These findings advocate for expanded research into comprehensive rehabilitation protocols for patients with progressive retinal disorders.
