Optical treatment of strabismic amblyopia

McGraw, Paul V.; Barrett, Brendan T.; Ledgeway, Timothy

doi:10.1111/opo.12637

Cited by 4 publications

(3 citation statements)

References 26 publications

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“…Strabismus surgery was needed in 878 cases (51.6%) who had large angle strabismus (pure strabismic or mixed amblyopia). This has been demonstrated in other studies as well [43,44].…”

Section: Discussionsupporting

confidence: 84%

Can Amblyopia of Any Severity be Treated Successfully Irrespective of a Patient’s Age?

Irfan,

Aadil,

Saqib

2023

Preprint

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Introduction: To find out whether full visual recovery is possible in amblyopia at any age? Materials & methods: In a prospective interventional study, 1701 consecutive cases with poor vision were included irrespective of a patient’s age. After wearing refractive correction for 8-12 weeks and no further improvement in the BCVA, amblyopia therapy was started comprising of full-time patching of good eye along with active use of amblyopic eye by reading and writing 6 hours daily. Regular two weekly follow-ups were conducted. The endpoint of therapy was achieving a BCVA equal to that of the good eye. A regular post-patching follow-up was conducted for 1-3 years. Statistical analysis comparing the visual acuity at the start and the end of therapy was performed by a paired t-test for each group. Results: There were 896 males and 805 female cases. 1383 cases (81.3%) had previously failed amblyopia therapy. 49 cases (2.9%) dropped out of the study due to poor compliance to therapy or an incomplete follow-up. For a simplified analysis of results, the 1701 cases were divided into three age groups: Group A: age 4-7 years (473 cases), Group B: age 8-12 years (618 cases) and Group C: age 13-46 years (610 cases). The overall success in Group A and B cases was 98% and 96.9% in Group C cases. Conclusion: Full visual recovery is possible in amblyopia of any severity and at any age. Age of a patient at presentation should not preclude therapy. Registry Platform: The study was registered in the WHO International Clinical Trials Trial Registration Number: NCT02113709

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“…Strabismus surgery was needed in 878 cases (51.6%) who had large angle strabismus (pure strabismic or mixed amblyopia). This has been demonstrated in other studies as well [43,44].…”

Section: Discussionsupporting

confidence: 84%

Can Amblyopia of Any Severity be Treated Successfully Irrespective of a Patient’s Age?

Irfan,

Aadil,

Saqib

2023

Preprint

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“…Treatment for strabismic amblyopia 30 is currently split into two types of passive therapy: full cycloplegic refraction followed by a prolonged period of spectacle wear, and subsequently by occlusion therapy to improve visual acuity outcomes 10 . Cotter et al 31 demonstrated that optical treatment alone produced substantial therapeutic effects in many children with amblyopia (amblyopia was resolved in 34 per cent of the sample).…”

Section: Discussionmentioning

confidence: 99%

Combined passive and active treatment in strabismic amblyopia with accommodative component

Molina‐Martín

Martín-González

Illarramendi-Mendicute

et al. 2020

Clinical and Experimental Optometry

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Background: Treatment of amblyopia in esotropic subjects with accommodative component currently consists of optical correction and subsequent occlusion, or penalisation, of the dominant eye. This treatment obtains a good outcome in visual acuity but poor outcomes in binocular vision. An intervention protocol that could improve the outcome of conventional treatment is presented. Methods: A retrospective study in subjects with amblyopia associated with both fully accommodative and partially accommodative esotropia is presented. Subjects were refracted under cycloplegia and treated with occlusion (passive therapy). Subjects who did not achieve orthotropia through optical correction (partially accommodative esotropia) performed an active therapy (full-time prismatic correction and subsequent fusional vergence therapy or surgery in larger angles > 12 prism dioptres). After treatment, the subjects were examined by a masked optometrist in an external ophthalmology clinic. Results: Twenty-six subjects (12 males and 14 females) aged from six to 13 years (median 8.50; interquartile range [IQR] 3) were included. Median age of detection was three years (IQR 1). All the subjects were hyperopic. In the baseline, median best-corrected visual acuity of the amblyopic eye was 0.40 logMAR (IQR 0.30) and 0.00 logMAR (IQR 0.01) in the dominant eye. After the treatment, the median best-corrected visual acuity in the amblyopic eye was 0.06 logMAR (IQR 0.08). These differences were statistically significant (p < 0.001). All subjects acquired stereoacuity equal or better than 800 00 with the Randot Preschool Stereoacuity Test. Conclusions: The proposed treatment highlights the management of amblyopia in esotropic subjects with accommodative component. This intervention protocol could help to determine if the treatment has to be passive (in fully accommodative esotropia) or a combination of passive and active therapies (in partially accommodative esotropia).

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“…This has been demonstrated in other studies. 43,44 Q. 8: Did diplopia occur in any case following visual improvement?…”

Section: Q 2: How Long Should the Full-time Occlusion Therapy In Ambl...mentioning

confidence: 99%

Is amblyopia of any severity fully treatable, irrespective of a patient’s age?

Irfan,

Aadil,

Maurya

et al. 2024

IJCEO

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: : To find out the level of visual improvement and the time it takes in amblyopia of any severity. : To find out whether the level of visual improvement is influenced by a patient's age at presentation. : To note whether the level of visual recovery is influenced by previous amblyopia therapy. To note any regression of visual acuity with time after initial improvement by therapy. To note complications of full-time occlusion therapy, especially occlusion amblyopia.: In a prospective interventional study, 1701 consecutive cases with poor vision were included irrespective of a patient’s age. After wearing refractive correction for 8-12 weeks and no further improvement in the BCVA, amblyopia therapy was started comprising of full-time patching of the good eye along with active use of the amblyopic eye by reading and writing at least 6 hours daily. Regular two weekly follow-ups were conducted. The endpoint of therapy was achieving a BCVA equal to that of the good eye. A regular post-patching follow-up was conducted for 1-3 years. Statistical analysis comparing the visual acuity at the start and the end of therapy was performed by a paired t-test for each group. : There were 896 male and 805 female cases. 1383 cases (81.3%) had previously failed amblyopia therapy. 49 cases (2.9%) dropped out of the study due to poor compliance with therapy or an incomplete follow-up. For a simplified analysis of results, the 1701 cases were divided into three age groups: Group A: age 4-7 years (473 cases), Group B: age 8-12 years (618 cases) and Group C: age 13-46 years (610 cases). The overall success in Group A and B cases was 98% and 96.9% in Group C cases. Full visual recovery is possible in amblyopia of any severity and age. The age of a patient at presentation should not preclude therapy.

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Optical treatment of strabismic amblyopia

Cited by 4 publications

References 26 publications

Can Amblyopia of Any Severity be Treated Successfully Irrespective of a Patient’s Age?

Can Amblyopia of Any Severity be Treated Successfully Irrespective of a Patient’s Age?

Combined passive and active treatment in strabismic amblyopia with accommodative component

Is amblyopia of any severity fully treatable, irrespective of a patient’s age?

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