Evaluation of Spectacles Together with Every, or Every Other Day Occlusion to Treat Amblyopia in 4-year Old Children

1. Ulla Kugelberg¹
2. Maria Kugelberg¹
3. Charlotta Zetterström²
4. Pia Agervi¹

¹St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
²Ullevål University Hospital, University of Oslo, Oslo, Norway

PURPOSE: To compare spectacles plus patching 8 hours daily 6 days a week with spectacles plus patching 8 hours every other day, to treat monocular strabismic amblyopia in children 4 to 5 years of age.

METHODS: A prospective randomized clinical trial of 40 children with a median age of 4.3 years with untreated amblyopia. The median corrected distance visual acuity (CDVA) was 0.9 logMAR (range 0.3-1.5) in the amblyopic eye. Spectacle correction was provided, and the children were randomized to patching 8 hours daily 6 days a week or patching 8 hours every other day. We measured the CDVA, binocular function, and refractive errors repeatedly.

RESULTS: At the follow-up 1 year after start of occlusion therapy, the change in CDVA of the amblyopic eye did not differ significantly between daily or every other day occlusion groups (0.6 log units for daily occlusion; 0.8 log unit for every other day occlusion). The final median CDVA in the amblyopic eyes was 0.1 logMAR in both groups. The binocular functions increased in both groups with no significant difference between the groups.

CONCLUSIONS: There was no difference in the visual results of optical correction and daily occlusion 6 days a week, or alternate day occlusion, which means patching every other day should be sufficient in strabismic amblyopia.