A randomized trial to evaluate 2 hours of daily patching for strabismic and anisometropic amblyopia in children.
OBJECTIVE
To compare 2 hours of daily patching (combined with 1 hour of concurrent near visual activities) with a control group of spectacle wear alone (if needed) for treatment of moderate to severe amblyopia in children 3 to 7 years old.


METHODS
Prospective randomized multicenter clinical trial (46 sites).


METHODS
One hundred eighty children 3 to 7 years old with best-corrected amblyopic-eye visual acuity (VA) of 20/40 to 20/400 associated with strabismus, anisometropia, or both who had worn optimal refractive correction (if needed) for at least 16 weeks or for 2 consecutive visits without improvement.


METHODS
Randomization either to 2 hours of daily patching with 1 hour of near visual activities or to spectacles alone (if needed). Patients were continued on the randomized treatment (or no treatment) until no further improvement was noted.


METHODS
Best-corrected VA in the amblyopic eye after 5 weeks.


RESULTS
Improvement in VA of the amblyopic eye from baseline to 5 weeks averaged 1.1 lines in the patching group and 0.5 lines in the control group (P = 0.006), and improvement from baseline to best measured VA at any visit averaged 2.2 lines in the patching group and 1.3 lines in the control group (P<0.001).


CONCLUSIONS
After a period of treatment with spectacles, 2 hours of daily patching combined with 1 hour of near visual activities modestly improves moderate to severe amblyopia in children 3 to 7 years old.
Wallace
David K
DK
Jaeb Center for Health Research, 15310 Amberly Drive, Suite 350, Tampa, FL 33647, USA. pedig@jaeb.org
Edwards
Allison R
AR
Cotter
Susan A
SA
Beck
Roy W
RW
Arnold
Robert W
RW
Astle
William F
WF
Barnhardt
Carmen N
CN
Birch
Eileen E
EE
Donahue
Sean P
SP
Everett
Donald F
DF
Felius
Joost
J
Holmes
Jonathan M
JM
Kraker
Raymond T
RT
Melia
Michele
M
Repka
Michael X
MX
Sala
Nicholas A
NA
Silbert
David I
DI
Weise
Katherine K
KK
D000550:Amblyopia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D015858:Anisometropia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005139:Eyeglasses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012683:Sensory Deprivation; D013285:Strabismus / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology