Treatment Of Amblyopia In Children Research Articles

The Feasibility of an Educational Cartoon Video for Improving Adherence with Amblyopia Treatment in Children.

Previous studies have shown that it is necessary to evaluate adherence during the treatment process, using educational intervention methods which have been shown to improve adherence with patching treatment. A previous study reported that an educational cartoon had significantly improved adherence with patching. However, this black-white cartoon is not commercially available. This study investigates the feasibility of a 4-minute educational cartoon video in improving adherence with patching therapy for amblyopic children. Children (3 to 10 years old) with unilateral amblyopia who were prescribed 2 hours or 6 hours of patching per day were enrolled. Objective adherence to the treatment was tracked using a microsensor. Children returned after 4 weeks ± 2 days to measure adherence. Participants with adherence ≤50% were eligible to watch the educational cartoon video. They continued with the previously prescribed treatment (2 hours or 6 hours patching) for an additional week to evaluate the follow-up adherence. A total of 27 participants were enrolled. The mean age (SD) was 6.6 (1.5) years. Twenty-two participants (12 in the 2 hours patching group and 10 in the 6 hours patching group) had adherence ≤50% and watched our cartoon video. The cartoon video improved mean adherence (SD) from 29.6% (11.9%) to 56.8% (12.1%) in all 22 participants from both regimens (paired 2-tailed t-test, t= -11, P < 0.000). The Educational cartoon video is feasible for use in a clinical setting. These data showed a trend of improvement in adherence with both patching regimens in children after watching the educational cartoon video.

A clinical trial on phakic intraocular lens for the treatment of refractive amblyopia in children and adolescents.

To analyze the demographics and clinical outcomes of posterior chamber phakic intraocular (IOL) implantation for refractive amblyopia in children and adolescents. A prospective interventional study was performed on children and adolescents with amblyopia at a tertiary eye care center from January 2021 to August 2022. Twenty-three eyes of 21 anisomyopic and isomyopic amblyopia patients operated for posterior chamber phakic IOL (Eyecryl phakic IOL) as a treatment for amblyopia were included in the study. Patient demographics, pre- and postoperative visual acuity, cycloplegic refraction, anterior and posterior segment examination, intraocular pressure, pachymetry, contrast sensitivity, endothelial count, and patient satisfaction scores were evaluated. Patients were followed up at day 1, 6 weeks, 3 months, and 1 year after surgery, and visual outcomes and complications were documented. The mean age of patients was 14.16 ± 3.49 years (range: 10-19 years). The mean intraocular lens power was - 12.20 diopter spherical (DS) in 23 eyes and - 2.25 diopter cylindrical (DC) in four patients. The mean unaided distant visual acuity (UDVA) and best-corrected visual acuity (BCVA) were 1.39 ± 0.25 and 0.40 ± 0.21 preoperatively on the log of minimum angle of resolution (logMAR) chart. Postoperatively, the visual acuity improved by 2.6 lines in 3 months period and maintained till 1 year. Postsurgery, contrast sensitivity in the amblyopic eyes significantly improved, and the average endothelial loss recorded was 5.78% at 1 year, which was statistically insignificant. Patient satisfaction score was statistically significant, with 4.736/5 recorded on the Likert scale. Posterior chamber phakic IOL is a safe, effective, and alternative method for treating amblyopia patients who are noncompliant with glasses, contact lenses, and keratorefractive procedures.

Evaluating the Psychological Impacts of Patching Treatment on Parents in Qassim Region, Saudi Arabia

BACKGROUND: The previous studies showed that patching treatment for amblyopia in children may have adverse psychological effects on children and families. AIM: The aim of the study was to investigate the reliability and validity of an Arabic version of the Amblyopia Treatment Index questionnaire and to evaluate the psychosocial impacts of patching treatment on parents of amblyopic children. METHODS: This was a cross-sectional study of 239 parents or guardians of amblyopic children who had at least five weeks of patching treatment experience in the past 6 months before enrolment. Eligible parent was either enrolled in the study from Qassim University Medical City eye clinics or referred by optometrists and ophthalmologists from 6 hospitals in Qassim province. Twenty parents were asked to repeat the same questionnaire after 14 days ± 2 days for test-retest reliability. RESULTS: The findings showed good internal validity and reliability for the Arabic version of the Amblyopia Treatment Index questionnaire among Saudi amblyopic patients. The factor analysis revealed that 16 of 21 items were strongly correlated through the questionnaire’s internal consistency ≥0.5 under three factors. Seven items were strongly correlated with the factor of adverse effects of amblyopia treatment. Similarly, seven items were strongly correlated with the lack of amblyopia treatment adherence, and only two were strongly correlated with the factor of social stigma. Reliability tested by Cronbach’s α coefficient showed good internal reliability and consistency (0.774). Cronbach’s α coefficient for the three factors was 0.734 for adverse effect, 0.644 for lack of treatment adherence, and 0.723 for social stigma. There is no significant association between parents’ education level and the final questionnaire score. CONCLUSION: The Arabic version of the amblyopia treatment index questionnaire showed high validity and reliability for factors related to patching therapy and was useful for Saudi children. Treatment of amblyopia in the Saudi community is strongly affected by adverse effects, adherence, and social stigma of adhesive patching.

Effect of curfew from the COVID-19 pandemic on amblyopia treatment in children in Saudi Arabia

Background: Amblyopia was defined as a reduction in the best-corrected visual acuity in one or both eyes with the presence of amblyogenic factors. Objective: The aim of this work was to investigate the effect of curfews resulting from the COVID-19 pandemic on amblyopia treatment in children. Design: A prospective longitudinal study. Methods: The study was conducted in pediatric ophthalmology clinics at a tertiary hospital in Riyadh, Saudi Arabia. Children aged 3–9 years who underwent amblyopia treatment from September 2020 to May 2021 were recruited. Visual acuity data were collected from the subjects’ record files for the first visits prior to the curfew and from the clinics for the second visits after the curfew had ended. Results: A total of 97 children with amblyopia (strabismic, anisometropic, mixed, and visual deprivation) were included. In all, 15 children did not attend the clinic for follow-up visits after the outbreak of COVID-19. The follow-up visits for most of the participants took place 4–5 months after the first visit. No significant difference in visual acuity in the amblyopic eye was found between the first and second visits ( p &gt; 0.05). No significant correlation was noted between the baseline difference in visual acuity at the first and second visits and the duration of the amblyopia treatment between the two visits. The adjusted model shows a variation of 0.18% according to the duration between the two visits. Conclusion: The findings showed no significant difference in visual acuity in amblyopic eyes between the first and second visits (before and after the COVID-19 curfew), although visual acuity was clinically improved.

Сравнительная оценка эффективности рефракционной лазерной коррекции и контактной коррекции в лечении нарушений аккомодации у детей с гиперметропической анизометропией и амблиопией

Purpose. А comparative study of accommodation disorders during the treatment of amblyopia in children with hyperopic anisometropia and amblyopia after femtolaser-assisted laser intrastromal keratomileusis (FS-LASIK) and children with contact correction. Material and methods. All of the patients were divided into two groups: I group consisted of 20 children who had FS-LASIK, performed according to indications in the amblyopic eye and II group consisted of 12 children who had contact correction. Results. After one year, the objective accommodative response (OAR) of the amblyopic eye was –1.8 ± 0.2 diopters in the 1st group and –1.42 ± 0.55 diopters in the 2nd group (рm-u = 0.04). At the end of the period, the first and second groups' objective reserves of relative accommodation (ORRA) were –1.5 ± 0.3 and –1.4 ± 0.4, respectively. The accommodogram coefficients also increased. The coefficient of accommodative response (CAO) in the first group was 0,1 ± 0,06 conv. units and microfluctuations coefficient (CMF) was 63,5 ± 4,1µF/min. CAO in the second group was within 0,0 ± 0,1 conv. units (рm-u = 0.12), CMF was 60.6 ± 4.0µF/min (рm-u = 0.05). Conclusion. The use of a soft contact lens in children provides a complete correction and improves amblyopic eye accommodation, resulting in an increase in OAR, ORRA and CMF. At the same time, the increase in OAR, CMF and CAO in children after femtosecond laser intrastromal keratomileusis in situ is more effective (p &lt; 0.05). The improvement of these indicators is associated with the provision of permanent full correction of the amblyopic eye. Keywords: anisometropia, hypermetropia, FS-LASIK, contact correction

First-dose response of part-time versus full-time occlusion therapy for the treatment of amblyopia in children

First-dose response of part-time versus full-time occlusion therapy for the treatment of amblyopia in children

A new method of amblyopia treatment in children with unstable central and eccentric fixation using biofeedback

Purpose. To develop a new method of amblyopia treatment in children with unstable central and eccentric fixation by centralizing visual fixation and increasing retinal photosensitivity in the macular region using biofeedback. Material and methods. The study included 27 patients (27 eyes) with amblyopia of various origins, aged 5 to 17 (averagely 9.15 ± 3.19 years), who were able to perform training sessions on the MP-3 Nidek microperimeter (Japan). In addition to standard examination, all patients underwent binocular status assessment using a four-point test, macular electroretinography, microperimetry, optical coherence tomography (OCT). The treatment, carried out on the microperimeter using visual (flickering checkerboard pattern) and sound signal biofeedback, consisted of 10—15 sessions, 10—12 minutes each. All patients were examined before treatment cycle, immediately upon the end of the cycle, and also 1 and 3 months after it. Results. Preliminary results showed an increase in best corrected visual acuity (BCVA) from 0.41 ± 0.24 to 0.68 ± 0.27 (33.9 %), the photosensitivity of the retina in the fovea increased from 27.07 ± 3.90 to 29.8 ± 3.3 dB (10 %), fixation density in the central region from 59.80 ± 31.08 to 72.05 ± 34.5 %(20.4 %) with its amplitude decreased by more than two times. After treatment, unstable central fixation changed to stable central fixation in all cases. With eccentric fixation, the fixation point shifted closer to the central region, and fixation characteristics improved in 75 % of cases. The obtained results retained throughout the observation period which lasted up to 3 months. Conclusion. The proposed new treatment method of amblyopia with impaired fixation of various degrees proved to be effective and safe and can be recommended for use in pediatric patients.

Observation on Effect and Clinical Application of Psychological Nursing on Amblyopia Treatment in Children

Observation on Effect and Clinical Application of Psychological Nursing on Amblyopia Treatment in Children

A Randomized Trial of Binocular Dig Rush Game Treatment for Amblyopia in Children Aged 4 to 6 Years.

Binocular treatment for unilateral amblyopia is an emerging treatment that requires evaluation through a randomized clinical trial. This study aimed to compare change in amblyopic-eye visual acuity (VA) in children aged 4 to 6 years treated with the dichoptic binocular iPad (Apple, Cupertino, CA) game, Dig Rush (not yet commercially available; Ubisoft, Montreal, Canada), plus continued spectacle correction versus continued spectacle correction alone. Children (mean age, 5.7 years) were randomly assigned to home treatment for 8 weeks with the iPad game (prescribed 1 h/d, 5 d/wk [n = 92], or continued spectacle correction alone [n = 90]) in a multicenter randomized clinical trial. Before enrollment, children wearing spectacles were required to have at least 16 weeks of wear or no improvement in amblyopic-eye VA (<0.1 logMAR) for at least 8 weeks. Outcome was change in amblyopic-eye VA from baseline to 4 weeks (primary) and 8 weeks (secondary) assessed by masked examiner. A total of 182 children with anisometropic (63%), strabismic (16%; <5∆ near, simultaneous prism and cover test), or combined-mechanism (20%) amblyopia (20/40 to 20/200; mean, 20/63) were enrolled. After 4 weeks, mean amblyopic VA improved by 1.1 logMAR lines with binocular treatment and 0.6 logMAR lines with spectacles alone (adjusted difference, 0.5 lines; 95.1% confidence interval [CI], 0.1 to 0.9). After 8 weeks, results (binocular treatment: mean amblyopic-eye VA improvement, 1.3 vs. 1.0 logMAR lines with spectacles alone; adjusted difference, 0.3 lines; 98.4% CI, -0.2 to 0.8 lines) were inconclusive because the CI included both zero and the pre-defined difference in mean VA change of 0.75 logMAR lines. In 4- to 6-year-old children with amblyopia, binocular Dig Rush treatment resulted in greater improvement in amblyopic-eye VA for 4 weeks but not 8 weeks. Future work is required to determine if modifications to the contrast increment algorithm or other aspects of the game or its implementation could enhance the treatment effect.

Visual Acuity Outcomes and Loss to Follow-up in the Treatment of Amblyopia in Children From Lower Socioeconomic Backgrounds.

Purpose:To compare visual acuity outcomes and loss to follow-up after initiation of treatment for unilateral amblyopia in children from different socioeconomic backgrounds.Methods:Medical records of children diagnosed as having unilateral amblyopia at an initial encounter between 2015 and 2018 were reviewed. Medicaid and private insurance were used as proxies for socioeconomic status (SES). Data points were collected at the patients’ initial, follow-up, and final visits. Visual acuity improvement was the primary outcome variable in patients with at least one follow-up appointment. In a separate analysis, failure to attend a single follow-up appointment was examined for associations with SES, race, sex, and distance traveled to appointments.Results:Seventy-three patients met the inclusion criteria; of these, 28 had Medicaid and 45 had private insurance. Visual acuity improved by 2.86 lines in the Medicaid group and 2.98 lines in the private insurance group (P = .84). Number of missed appointments and distance traveled did not correlate with visual acuity improvement. In the loss to follow-up subanalysis, 40 of 141 (28.4%) patients with Medicaid and 11 of 107 (10.3%) patients with private insurance failed to attend a single follow-up visit (P = .001). No association was found between loss to follow-up and race, sex, or distance traveled.Conclusions:Visual acuity outcomes of treatment for amblyopia did not differ between patients with Medicaid and patients with private insurance who followed up. However, patients with Medicaid were much more likely to be immediately lost to follow-up. Measures should be taken by eye care providers and pediatricians to increase follow-up in patients from low SES populations.

Visual acuity outcomes and loss to follow-up in the treatment of amblyopia in children of lower socioeconomic backgrounds

We compared visual acuity outcomes and loss to follow-up after initiation of treatment for unilateral amblyopia in children from different socioeconomic backgrounds.

Expert consensus on prevention and treatment of amblyopia in children

Amblyopia is caused by vision deprivation and/or abnormal binocular interaction during visual immaturity. According to different etiologies, it is divided into strabismic, ametropic, anisometropic and visual deprivation amblyopia. The key to the treatment of amblyopia is early screening and timely intervention. The managements include eliminating the factors of visual deprivation, optical correction, patching and penalization. Following the publication of the Expert Consensus on Diagnosis of Amblyopia in 2011, the Chinese Association for Pediatric Ophthalmology and Strabismus organized experts in this field again to discuss and formulate the Expert Consensus on Prevention and Treatment of Amblyopia in Children based on the research results of evidence-based medicine. The purpose is to provide clinical guidance of the diagnosis and treatment of amblyopia for ophthalmologists and to improve clinical service. (Chin J Ophthalmol, 2021, 57: 336-340).

A Randomized Clinical Trial Comparing Eyetronix Flicker Glass and Patching for Treatment of Amblyopia in Children Reveals Similar Improvements in Vision.

PurposeRecently, Eyetronix Flicker Glass (EFG) has been introduced as a novel treatment for amblyopia. It alternatively deprives the visual input of each eye rapidly (e.g., 7 Hz). However, whether it is comparable with standard patching therapy is unclear. In this randomized clinical trial, we evaluate the efficacy of an EFG therapy as treatment for amblyopia in children and compare it to the patching therapy.MethodsWe tested 31 children (aged 4–13 years) with amblyopia. They were assigned into one of the two treatment groups and were treated for 12 weeks. The first group was treated with EFG for 1 h/day (Flicker Group) and the latter with a standard patch (Patching Group) for 2 h/day. We designated changes from baseline in best-corrected visual acuity (BCVA) of the amblyopic eye as our primary outcome. Changes from baseline in other visual outcomes, such as contrast sensitivity, stereopsis, and fusional vergence range were measured as secondary outcome.ResultsBCVA improved significantly at 12 weeks relative to baseline in both the Flicker (0.13 ± 0.11 logMAR; mean ± SD) and Patching Groups (0.21 ± 0.14 logMAR). However, the improvements were not significantly different between groups (p = 0.13). Contrast sensitivity also significantly improved at 3 and 12 cycles/degree between baseline and 12 weeks in both groups (p’s < 0.05). However, stereopsis and fusion range did not improve significantly in both groups.ConclusionAn EFG therapy and patching improved BCVA similarly for children with amblyopia at 12 weeks. Both therapies improved the contrast sensitivity at 3 and 12 cycles per degree (cpd); however, only patching improved the contrast sensitivity at 6 cpd. Both therapies did not benefit binocular visual functions (stereopsis and fusional vergence range). We believe that EFG can be an additional choice for therapy.Clinical Trial Registrationchictr.org number: ChiCTR2000034436.

Adherence to home-based videogame treatment for amblyopia in children and adults

ABSTRACT Clinical relevance: Home-based videogame treatments are increasingly popular for amblyopia treatment. However, at-home treatments tend to be done in short sessions and with frequent disruptions, which may reduce the effectiveness of binocular visual stimulation. These treatment adherence patterns need to be accounted for when considering dose-response relationships and treatment effectiveness. Background: Home-based videogame treatments are increasingly being used for various sensory conditions, including amblyopia (‘lazy eye’), but treatment adherence continues to limit success. To examine detailed behavioural patterns associated with home-based videogame treatment, we analysed in detail the videogame adherence data from the Binocular tReatment of Amblyopia with VideOgames (BRAVO) clinical trial (ACTRN12613001004752). Methods: Children (7-12 years), teenagers (13-17 years) and adults (≥ 18 years) with unilateral amblyopia were loaned iPod Touch devices with either an active treatment or placebo videogame and instructed to play for a total of 1-2 hours/day for six weeks at home. Objectively-recorded adherence data from device software were used to analyse adherence patterns such as session length, daily distribution of gameplay, use of the pause function, and differences between age groups. Objectively-recorded adherence was also compared to subjectively-reported adherence from paper-based diaries. Results: One hundred and five of the 115 randomised participants completed six weeks of videogame training. Average adherence was 65% (SD 37%) of the minimum hours prescribed. Game training was generally performed in short sessions (mean 21.5, SD 11.2 minutes), mostly in the evening, with frequent pauses (median every 4.1 minutes, IQR 6.1). Children played in significantly shorter sessions and paused more frequently than older age groups (p < 0.0001). Participants tended to over-report adherence in subjective diaries compared to objectively-recorded gameplay time. Conclusion: Adherence to home-based videogame treatment was characterised by short sessions interspersed with frequent pauses, suggesting regular disengagement. This complicates dose-response calculations and may interfere with the effectiveness of treatments like binocular treatments for amblyopia, which require sustained visual stimulation.

Мethod of Functional Treatment of Refractive Amblyopia in Children Using Alternating Presentation of Stereo Stimules

The research is devoted to one of the most urgent problems of modern ophthalmology — the search for new approaches to creating effective methods of functional treatment of refractive amblyopia using computer technologies.The purpose of the work is to evaluate the effectiveness of computer technology with consistent use of alternating and non-alternating modes of presentation of stereostimulars in the functional treatment of refractive amblyopia in children.Patients and methods. 105 patients with refractive amblyopia at the age of 7 to 17 (on average 11.45 ± 0.3) years were observed. Refraction was hypermetropic in 31 (29.5 %) children, myopic in 62 (59 %) and mixed astigmatism was detected in 12 (11.5 %) children. The visual acuity of the best-seeing eye was on average 0.76 ± 0.01, that of the worse-seeing eye was 0.68 ± 0.02, and that of the binocular eye was 0.77 ± 0.01. In the study on synoptophore, all children had normal correspondence of the retina with the fusion reserves, which were significantly reduced. The character of vision was binocular in all children, but the presence of stereo vision on the Fly test was detected in 96 (91.4 %) children, and on the Lang test only in 73 (69.5 %) children. Functional treatment was performed using computer programs with sequential use of modes of alternating and non-alternating presentation of stereo stimuli with certain characteristics.Results. As a result of the course of treatment, the number of children with stereo vision increased from 96 (91.4 %) to 105 (100 %) on the Fly test and from 73 (69.52 %) to 97 (92.4 %) on the Lang test. In addition, there was a significant increase in visual acuity (on average, up to 0.96 ± 0.01 for the best-seeing eye, up to 0.9 ± 0.01 for the worse-seeing eye, and up to 0.97 ± 0.01 binocularly). There was also an increase in positive fusion reserves by 1.5 times and negative reserves by 1.3 times.Conclusion. Visual training with computer programs that provide the consistent use of modes of alternating and non-alternating presentation of stereo stimuli with certain characteristics is an effective way of functional treatment of refractive amblyopia in children, allowing to increase monocular and binocular visual acuity, improve the performance of fusion reserves and improve the state of stereo vision.

Active Vision Therapy for Anisometropic Amblyopia in Children: A Systematic Review.

Purpose The aim of the study was evaluation of the scientific evidence about the efficacy of vision therapy in children and teenagers with anisometropic amblyopia by performing a systematic literature review. Methods A search was performed using 3 searching strategies in 4 different databases (PubMed, Web of Science, Scopus, and PruQuest). The quality of the included articles was evaluated using two tools for the risk of bias assessment, ROBINS-I for nonrandomized studies of intervention (NRSI), and ROB 2.0 for randomized clinical trials. Results The search showed 1274 references, but only 8 of them passed the inclusion criteria after the complete text review. The articles that were finally included comprised 2 randomized control trials and 6 nonrandomized studies of intervention. These articles provided evidence supporting the efficacy of vision therapy for the treatment of anisometropic amblyopia in children and teenagers. Assessment of the risk of bias showed an appropriate risk of bias for the randomized control trials, but a high risk of bias for nonrandomized studies of intervention (NRSI). A main source of risk of bias for NRSI was the domain related to the measurements of the outcomes, due to a lack of double-blind studies. Conclusion Vision therapy is a promising option for the treatment of anisometropic amblyopia in children and teenagers. However, the level of scientific evidence provided by the studies revised is still limited, and further randomized clinical trials are necessary to confirm the results provided to date and to optimize the vision therapy techniques by knowing the specific neural mechanisms involved.

Comparison of Different Binocular I Pad Games with Patching for Treatment of Amblyopia in Children: Pilot Study

Purpose- The aim of the study is to compare visual functions of children with uncorrected amblyopia treated with different binocular I Pad games and/or patching. Methods- Children with untreated amblyopia were enrolled in this pilot study. Children were divided into three groups: children treated with patching only, children attributed to play binocular snake I Pad game with patching, children attributed to play binocular blocks I Pad game with patching. Visual acuity VA, refraction, stereo acuity test, and ocular alignment tests were performed for all participants in the first visit and 4 weeks after starting treatment. Visual functions were compared between both visits. Results- A total of 18 children with untreated amblyopia participated in this study. Children were divided into three groups: Group 1= 8 children treated with patching only, Group 2= 5 children attributed to play binocular snake I Pad game with patching, and Group 3= 5 children attributed to play binocular blocks I Pad game with patching. There was no significant difference (P > 0.05) in gender and age between the three groups. Children showed good compliance to all patching treatment and I pad games groups. After 4 weeks, Visual acuity was improved in all amblyopic children in the form of one line improvement in patching group, two lines with binocular snake I Pad game and three lines with binocular blocks I Pad game. Moreover, stereoacuity was improved in all groups with greatest advance in blocks games group followed by snake group then patching group. Conclusion- This study demonstrated great effectiveness of both snake, and blocks binocular I Pad games on visual functions improvement for treatment of amblyopia. These games can contribute with patching in achieving better VA and stereoacuity enhancement in a shorter duration than patching alone.

Efficacy of 632.8 nm Low Power He Ne Laser in Comprehensive Treatment of Refractive Amblyopia in Children

AIM: To investigate the clinical effect of low power He Ne laser in the treatment of children's refractive amblyopia, and to analyze the necessary reference for the comprehensive treatment of children's refractive amblyopia. METHODS: 112 cases diagnosed (176 eyes) with refractive amblyopic children according to the visiting sequence were randomly divided into treatment group and control group, control group of children with conventional synthetic amblyopia therapeutic apparatus in the treatment, and treatment group attached children helium neon laser project suffering from ocular irradiation treatment, observation of visual function after record 3-6 months, fundus and electrophysiological changes. RESULTS: in the treatment group, the cure rate of mild, moderate and severe amblyopia after 3 months were 82.2%, 80.6%, 36.4%, the cure rate was 95.6%, 88.9%, 63.6% after 6 months. In the control group, the cure rate was 47.7%, 20% and 0% after 3 months, the cure rate was 54.5%, 30%, 12.5% after 6 months, respectively. Statistical analysis showed that the treatment group was better than the control group in the visual function of children with amblyopia (P<0.05), and shortened the recovery time of the visual function of the children with amblyopia, and there was no abnormal changes in the fundus of the eyes. Conclusion: low power He Ne laser used in the comprehensive treatment of children with refractive amblyopia, improve the cure rate of amblyopia in children, and shorten the treatment of amblyopia treatment recovery, safe and effective.

Amblyopia treatment and quality of life: the child’s perspective on atropine versus patching

ABSTRACTBackground: The impact on children of patching versus atropine treatment for amblyopia was assessed using children’s perspective Health-Related Quality of Life (HRQoL) scores in 5 to 7-year olds.Methods: Forty-six children on the threshold of commencing either patching or atropine treatment for amblyopia were recruited. Treatment was prescribed for uniocular amblyopia of visual acuity (VA) 0.2 logMAR or worse. After four weeks of their chosen treatment, each child completed the Child Amblyopia Treatment Quality-of-Life Questionnaire (CAT-QoL). The Pediatric Quality of Life Inventory (PedsQL™), Young Child (5–7) Self-Report version, was completed before and after four weeks of treatment. Quality of life scores were compared between the two treatment groups.Results: Sixty-one percent (n = 28) of participants were male and 56.5% (n = 26) were white British. The CAT-QoL has a range of 0–16, with 16 being the worst quality of life. No significant difference was found between the patching group (n = 30, mean age 69.7 months) and the atropine group (n = 16, mean age 69.3 months) for CAT-QoL quality of life scores (Patch median = 6.3, Atropine median = 5.6, U = 199, p = .341, 95% CI of the median difference of −2.3 to 0.9). The Young Child (5–7) Self-Report version of the PedsQL™ has a ‘total score’ range of 0–100, with 0 being the worst quality of life. There was also no significant difference in PedsQL™ quality of life total scores (Patch median = 80, Atropine median = 83.33, U = 239.5, p = .991, 95% CI of the median difference −13.33 to 10) after four weeks of treatment.Conclusion: Amblyopic children reported that patching and atropine treatments did not have a significant impact on their quality of life. Patching and atropine should continue to be offered as first-line treatments for amblyopia, as children appear to tolerate both well and do not favor one over the other.

Comparison of the CAT-QoL and PedsQLTM instruments in measuring quality of life in amblyopia treatment: preliminary results

ABSTRACTBackground/Aims: The Child Amblyopia Treatment Questionnaire (CAT-QoL) is a patient-reported outcome measure (PROM), designed to assess the impact of amblyopia treatment. The aim of this study was to compare the psychometric properties of two PROMs; the CAT-QoL instrument and Pediatric Quality of Life Inventory (PedsQLTM), a generic pediatric PROM. This work was part of a wider project to develop a condition-specific PROM for children with amblyopia.Methods: Three hundred and forty-two participants were recruited in a UK multi-center study. Quality of life data was collected using the CAT-QoL and the PedsQLTM instruments. The psychometric performance of the CAT-QoL and PedsQLTM were examined in terms of acceptability, reliability, and validity.Results: Both instruments demonstrated good reliability (CAT-QoL Cronbach’s α = 0.793; PedsQLTM α = 0.872). The convergent validity of the CAT-QoL and PedsQLTM instruments was tested by comparing the instruments to each other. There was a moderate correlation between the PedsQLTM and the CAT-QoL scores, and this relationship was statistically significant (rs = −0.517, p < .000). No statistical significance was found between the level of amblyopia severity and the mean PedsQLTM score (p = .420).Conclusion: It was possible to assess the impact of amblyopia treatment using the CAT-QoL and PedsQLTM instruments. The preliminary findings from this are not conclusive, and it is not possible to advocate the use of one questionnaire over another based upon psychometric performance demonstrated here. This may be due to the sample population, as there were limited numbers of participants with severe amblyopia. Both the CAT-QoL and PedsQLTM instruments were noted to have some issues with ceiling effects at an individual item level. The CAT-QoL and PedsQLTM were reliable (as determined by Cronbach’s alpha). The PedsQLTM instrument was not able to discriminate between amblyopia severity groups (discriminant validity). Further research is required to formally assess the psychometric properties of the CAT-QoL questionnaire.