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Primary Open-Angle Glaucoma With Improved Visual Outcomes Following Audio-Luminous Biofeedback Training: A Case
Ghaliah Nsour1, Anah Julia Andreoli1, Samuel Markowitz1
1Department of Ophthalmology and Vision Sciences, The University of Toronto/Toronto Western Hospital, Toronto, Ontario, Canada.
The American Journal of Case Reports
|June 19, 2026
Summary
Audio-luminous biofeedback training (BT) improved vision in an 82-year-old man with advanced glaucoma. This non-invasive vision rehabilitation method enhanced visual acuity and reading speed, offering functional benefits.
Area of Science:
- Ophthalmology
- Neuroscience
- Rehabilitation Medicine
Background:
- Audio-luminous biofeedback training (BT) is a non-invasive vision rehabilitation technique.
- It combines visual stimuli with auditory feedback using micro-perimeter devices.
- Previous studies have shown BT's efficacy in patients with nystagmus, macular disease, and brain injury.
Purpose of the Study:
- To report the case of an 82-year-old man with bilateral primary open-angle glaucoma.
- To describe the visual outcomes following audio-luminous biofeedback training.
Main Methods:
- The patient underwent four 20-minute sessions of BT targeting a trained retinal locus.
- Best-corrected visual acuity (BCVA), contrast sensitivity, reading speed, fixation stability, and stereopsis were assessed before and after training.
- Macular MAIA microperimetry was used to evaluate visual field sensitivity.
Main Results:
- Post-training BCVA improved from 20/25 to 20/20 in the right eye and 20/100 to 20/60 in the left eye.
- Significant gains were observed in contrast sensitivity, reading speed, fixation stability, and stereopsis.
- The patient reported symptomatic improvement and discontinued the use of an occlusive patch.
Conclusions:
- Audio-luminous BT can be a valuable adjunct therapy for advanced glaucoma.
- The training offers functional benefits without adverse effects, particularly in therapy-resistant cases.
- Further research is needed to explore long-term outcomes and neurophysiological mechanisms.
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