Abstract
Purpose: To compare the effect of daily occlusion of the sound eye for two hours, without and with near vision exercises, versus six hours without near vision exercises, for the management of strabismic amblyopia and to determine the different factors affecting compliance to each treatment regimen. Methods: Forty five children having unilateral strabismic amblyopia were divided equally into 3 groups. Group A received 2-hour daily occlusion. Group B received 2-hour occlusion combined with near vision exercises. Group C received 6-hour occlusion therapy. Patients were followed up for 6 months. Results: The mean logMAR improvement was -1.03+/-0.57, -0.63+/-0.66 and -0.65+/-0.66, for groups A, B and C, respectively. The difference in mean logMAR improvement was significant (P < .001) in groups A versus B and A versus C, but was insignificant (P =.748) in group B versus C. Factors affecting compliance to each occlusion regimen were related to age, socioeconomic status, life pattern and season of the year.Conclusion: The best outcome was achieved when 2-hour daily patching was combined with near vision activities. Higher compliance to two-hour occlusion with near vision exercises was attained in older, educated children. Six-hour occlusion was more suitable in younger and in uneducated children.
Highlights
Amblyopia means reduced visual acuity, which is not improved by corrective glasses, in an eye that is otherwise normal
Occlusion therapy remains the mainstay of amblyopia treatment
No study had provided conclusive data on the optimal number of patching hours, until The Pediatric Eye Disease Investigator Group (PEDIG) conducted a randomized clinical trial, to compare 2 hours versus 6 hours of daily patching combined with 1 hour of near vision exercises, for the treatment of moderate amblyopia in children 3 to 7 years of age
Summary
Amblyopia means reduced visual acuity, which is not improved by corrective glasses, in an eye that is otherwise normal. It is responsible for diminished vision in 1% to 2% of the childhood population and it is most often associated with strabismus or anisometropia [1]. Occlusion therapy remains the mainstay of amblyopia treatment. No study had provided conclusive data on the optimal number of patching hours, until The Pediatric Eye Disease Investigator Group (PEDIG) conducted a randomized clinical trial, to compare 2 hours versus 6 hours of daily patching combined with 1 hour of near vision exercises, for the treatment of moderate amblyopia in children 3 to 7 years of age. PEDIG concluded that both methods produced an improvement of visual acuity of a similar magnitude [5]
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