Abstract
Objective: To find out how much visual improvement is possible in severe amblyopia using full-time occlusion therapy and if improvement is influenced by the patient’s age. Methods: A trial of 115 consecutive cases with unilateral, severe amblyopia was conducted at a tertiary referral center from Jan 2010 to Oct 2012. Patients were divided into three age groups: 3-7 years (n= 38), 8-12 years (n=41), 13-35 years (n=36). After a complete ophthalmological examination by a single ophthalmologist, cases with organic visual loss were excluded; cases with previous part-time occlusion therapy that had failed were included in the study. Patients were given optimal refractive correction for a month, followed by full-time occlusion therapy along with near visual activities for 3-4 hours/day. The therapy was continued until maximum visual recovery was achieved (6/6 Snellen’s). Therapy was gradually reduced and stopped. Patients were followed-up regularly for the next 18 months. Results: There was 100% success in the 3-7 year group, 92.68% in the 8-12 year group and 97.22% in the 13-35 year group. Conclusion: Visual improvement is possible in almost all patients with severe amblyopia irrespective of their age with full-time occlusion therapy.
Highlights
Amblyopia, (‘blunt vision’ in Ancient Greek), known as lazy eye[1], is a visual deficiency in an eye that is otherwise physically normal, or that is greater than would be expected from any structural abnormalities of the eye
Improvement in visual acuity noted with full-time occlusion therapy was 6/6 Snellen’s in 38/38 (100% success) in group A
This study shows that any severity of amblyopia can be reversed at any age with full-time occlusion therapy
Summary
Amblyopia, (‘blunt vision’ in Ancient Greek), known as lazy eye[1], is a visual deficiency in an eye that is otherwise physically normal, or that is greater than would be expected from any structural abnormalities of the eye. It is thought that amblyopia results from inadequate stimulation of the fovea or peripheral retina and/or abnormal binocular interaction, resulting in different visual input from the foveae[2]. Amblyopia results in the loss of binocular vision, which is manifested as absent stereoscopic depth perception, poor spatial acuity, low contrast sensitivity and reduced sensitivity to motion[5]. This can be detected clinically by assessing whether the patient has difficulty seeing three-dimensional images on autostereograms[6]
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