Dedicated Dad partners with doc to save daughter’s sight

lazy eye amblyopiaFive years ago, Dan Lee had planned a big outing with his newly adopted daughter Manisha Sapkota, a 14-year-old from Nepal.

“I was excited to take her to see ‘Toy Story 3D’ — her first 3D movie,” recalls Dan. But Lee was puzzled by his daughter’s response when he asked her what she thought.

“It was OK,” Manisha told her dad.

A few months later, Manisha’s lukewarm response made more sense. During her first physical exam in the U.S. at the Boston Children’s Hospital Martha Eliot Health Center, the doctor suggested Manisha might have amblyopia, or “lazy eye,” in her left eye.

“She told us she couldn’t see anything when the other eye was covered. I thought she was playing. I was shocked,” says Dan.

Manisha was referred to Dr. Amy Moy, director of optometry at Martha Eliot.

“Usually, optometrists see children for their first visit at age 3 or 4, but that’s not the case in Nepal,” explains Moy.

As Dan thought about his new daughter’s medical history, the diagnosis started to make sense. Manisha had probably been born with a lazy left eye that was never diagnosed. Because she didn’t use the eye, her vision worsened. But for Manisha, seeing the world through one eye was normal.

Rigorous testing confirmed the diagnosis — Manisha had lazy eye. Her vision in the left eye was 20/200 — close to the cutoff for legal blindness.

Treating Manisha’s lazy eye

The Lees followed the standard treatment for lazy eye, covering Manisha’s good right eye after school to force the left eye to work.

“It’s worth trying to patch the lazy eye in older children, because there is always a chance that their vision will improve, but the prognosis is harder to predict,” says Moy.

Manisha’s vision did not improve with patching.

Lee was unwilling to accept Manisha’s fate. He started doing his own research into the condition and found a study that suggested a novel way of treating adults with lazy eye.

Like the conventional treatment for childhood lazy eye, the experimental approach involves forcing the eyes to work together. Instead of patching the good eye, the treatment shows a different image to each eye. The eyes (and the brain) are encouraged to work together using a typical source of teenage motivation — 3D video games.

“I asked Dr. Moy if she could guide us through the treatment,” says Lee. Moy agreed.

“I had never intentionally prescribed video games to a family before, but Dan was so motivated to try it,” adds Moy.

Lee’s first attempt did not go over very well with Manisha.

The research suggested a first-person, 3D video game might be motivating. Lee decided to teach his daughter how to play “Call of Duty,” a first-person shooter game.

“The shooting was stressful, and it was annoying because I couldn’t see with both eyes,” says Manisha.

Lee was undeterred. He introduced Manisha to “Portal,” a first-person puzzle game that was calmer and non-violent.

Over the course of the next few months, the strategy worked. Manisha’s vision improved to 20/50. Today, Manisha, a college freshman studying elementary education and psychology, wears contact lenses. Her vision is 20/20 vision in her right eye and 20/50 in her left eye.

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Learn more about the Martha Eliot Health Center. Optometrists at Martha Eliot provide preventative vision care for patients from newborn through adulthood.