Part-time occlusion therapy for amblyopia in older children.
OBJECTIVE
To compare the efficacy of part-time versus full-time occlusion for treatment of amblyopia in children aged 7-12 years.


METHODS
Prospective interventional case series. One hundred children between 7-12 years of age with anisometropic (57), strabismic (25) and mixed (18) unilateral amblyopia were randomized (simple randomization) into four groups (25 each) to receive two hours, four hours, six hours or full-time occlusion therapy. Children were regularly followed up at six-weekly intervals for a minimum of three visits.


METHODS
Intragroup visual improvement was analyzed using paired t-test while intergroup comparisons were done using ANOVA and unpaired t-test.


RESULTS
All four groups showed significant visual improvement after 18 weeks of occlusion therapy ( P < 0.001). Seventy-three (73%) of the total 100 eyes responded to amblyopia therapy with 11 eyes (44%), 17 eyes (68%), 22 eyes (88%) and 23 eyes (92%) being amblyopia responders in the four groups respectively, with the least number of responders in the two hours group. In mild to moderate amblyopia (vision 20/30 to 20/80), there was no significant difference in visual outcome among the four groups ( P =0.083). However, in severe amblyopia (vision 20/100 or worse), six hours ( P =0.048) and full-time occlusion ( P =0.027) treatment were significantly more effective than two hours occlusion.


CONCLUSIONS
All grades of part-time occlusion are comparable to full-time occlusion in effectiveness of treatment for mild to moderate amblyopia in children between 7-12 years of age unlike in severe amblyopia, where six hours and full-time occlusion were more effective than two hours occlusion therapy.
Singh
Inderpreet
I
Grewal Eye Institute, Chandigarh-160 009, India.
Sachdev
Nishant
N
Brar
Gagandeep S
GS
Kaushik
Sushmita
S
D000550:Amblyopia / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009779:Occlusive Dressings; D011446:Prospective Studies; D012683:Sensory Deprivation; D013997:Time Factors; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology