Successful amblyopia therapy initiated after age 7 years: compliance cures.
OBJECTIVE
To report successful therapy for anisometropic and strabismic amblyopia initiated after age 7 years.


METHODS
A consecutive series of 36 compliant children older than 7 years (range, 7.0 to 10.3 years; mean, 8.2 years) at initiation of amblyopia therapy for anisometropic (19 patients; mean age, 8.3 years), strabismic (9 patients; mean age, 8.0 years), or anisometropic and strabismic (8 patients; mean age, 8.0 years) amblyopia was studied. Initial (worst) visual acuities were between 20/50 and 20/400 (log geometric mean, -0.83 [antilog, 20/134] for all patients; -0.88 [antilog, 20/151] for anisometropic patients; -0.70 [antilog, 20/100] for strabismic patients; and -0.88 [antilog, 20/151] for anisometropic and strabismic patients). Initial (worst) binocularity was absent or reduced in all cases. Therapy consisted of (1) full-time standard occlusion (21 patients; mean age, 8.0 years), (2) total penalization (7 patients; mean age, 7.8 years), or (3) full-time occlusive contact lenses (8 patients; mean age, 8.8 years).


RESULTS
Final (best) visual acuities were between 20/20 and 20/30 for all 36 patients. Final (best) binocularity was maintained or improved for 22 (61%) of 36 patients, including 16 anisometropic patients (84%), 2 strabismic patients (22%), and 4 anisometropic and strabismic patients (50%).


CONCLUSIONS
Given compliance, therapy for anisometropic and strabismic amblyopia can be successful even if initiated after age 7 years. Arch Ophthalmol. 2000;118:1535-1541
Mintz-Hittner
H A
HA
Department of Opthalmology and Visual Science, University of Texas Houston Medical School, USA. Helen.A.Mintz-Hittner@uth.tmc.edu.
Fernandez
K M
KM
D000550:Amblyopia / Q000209:etiology / Q000628:therapy*; D015858:Anisometropia / Q000150:complications / Q000628:therapy; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance; D012189:Retrospective Studies; D012683:Sensory Deprivation; D013285:Strabismus / Q000150:complications / Q000628:therapy; D016896:Treatment Outcome; D015348:Vision, Binocular; D014792:Visual Acuity