title: A randomized trial to evaluate 2 hours of daily patching for strabismic and anisometropic amblyopia in children.
abstract: 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.
authors.affiliation: Jaeb Center for Health Research, 15310 Amberly Drive, Suite 350, Tampa, FL 33647, USA. pedig@jaeb.org
authors.forename: David K
authors.initials: DK
authors.lastname: Wallace
authors.forename: Allison R
authors.initials: AR
authors.lastname: Edwards
authors.forename: Susan A
authors.initials: SA
authors.lastname: Cotter
authors.forename: Roy W
authors.initials: RW
authors.lastname: Beck
authors.forename: Robert W
authors.initials: RW
authors.lastname: Arnold
authors.forename: William F
authors.initials: WF
authors.lastname: Astle
authors.forename: Carmen N
authors.initials: CN
authors.lastname: Barnhardt
authors.forename: Eileen E
authors.initials: EE
authors.lastname: Birch
authors.forename: Sean P
authors.initials: SP
authors.lastname: Donahue
authors.forename: Donald F
authors.initials: DF
authors.lastname: Everett
authors.forename: Joost
authors.initials: J
authors.lastname: Felius
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Holmes
authors.forename: Raymond T
authors.initials: RT
authors.lastname: Kraker
authors.forename: Michele
authors.initials: M
authors.lastname: Melia
authors.forename: Michael X
authors.initials: MX
authors.lastname: Repka
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Sala
authors.forename: David I
authors.initials: DI
authors.lastname: Silbert
authors.forename: Katherine K
authors.initials: KK
authors.lastname: Weise
mesh_terms: 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