Elbow splinting as a method to increase patching compliance in amblyopia therapy.
PurposeThe purpose of the study was to evaluate the feasibility and acceptability of utilizing elbow splints as a method of increasing amblyopic patching compliance in pediatric ophthalmology patients who fail to comply with prescribed patching regimens.Patients and methodsPatients <6 years of age who were not adhering to pre-specified patching guidelines were prescribed elbow splints in order to increase patching compliance at the discretion of a pediatric ophthalmologist. If the child was non-compliant (patching <50% of specified time or consistently removing patch), parents were asked to try using the elbow splints until patching compliance was achieved. Non-parametric Wilcoxon signed-rank tests were used to compare patching time pre- and post-splints.Results41/48 children who were prescribed elbow splints to increase patching compliance for amblyopia were included for analysis. Seven children were excluded due to patching and splints being prescribed at the outset (n=4), and for not using the splinting intervention (n=3). Median age at being prescribed elbow splints was 37 (12-68) months. Mean daily patching prior to splints was 1.5±1.7 h, whereas mean prescribed daily patching was 4.95±1.5 h. Following splinting, 34/41 (83%) became compliant with patch alone, and visual acuity increased in 39/41 (95%) patients, with no patients developing amblyopia in the fellow eye. Median amount of time splints was required to improve compliance was 7 (1-240) days.ConclusionElbow splinting seems to be a viable alternative method to increase pediatric amblyopic patching compliance when patching alone fails to achieve satisfactory compliance.
Department of Surgery, McMaster Paediatric Eye Research Group, McMaster University, Hamilton, Ontario, Canada.|Department of Surgery, McMaster Pediatric Surgery Research Collaborative, McMaster University, Hamilton, Ontario, Canada.|Ophthalmology Clinic, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada.
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Sabri
Department of Surgery, McMaster Pediatric Surgery Research Collaborative, McMaster University, Hamilton, Ontario, Canada.
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Easterbrook
Department of Pediatric Ophthalmology, Stollery Children's Hospital, Edmonton, Alberta, Canada.|Department of Ophthalmology, University of Alberta, Edmonton, Alberta, Canada.
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Wakeman
Orthoptic Clinic, Department of Ophthalmology, BC Children's Hospital, Vancouver, British Columbia, Canada.
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Mehta
Department of Ophthalmology, University of Alberta, Edmonton, Alberta, Canada.
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Riyaz
D000550:Amblyopia / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004550:Elbow; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012149:Restraint, Physical / Q000379:methods*; D012683:Sensory Deprivation; D013165:Splints; D018709:Statistics, Nonparametric; D014792:Visual Acuity