Abstract
AIM—To study the effects of supervised inpatient occlusion treatment for amblyopia in children who had failed to respond to outpatient treatment. METHODS—A retrospective study of 39 children admitted to a paediatric ophthalmic ward for 5 days of supervised intensive occlusion therapy having previously failed to respond to outpatient occlusion. Visual acuity of amblyopic and fellow eyes was recorded at each clinic visit before admission, daily during admission, and at each outpatient visit after discharge. RESULTS—There was no significant overall improvement in visual acuity during a mean of 9 months of attempted outpatient occlusion before admission. During the 5 days of admission 26 children (67%) gained at least one line of acuity in their amblyopic eye and five (13%) gained three or more lines (mean gain 1.03 Snellen lines). The acuities of both the amblyopic and fellow eyes subsequently improved with continuing part time patching as an outpatient, including in nine of the children who did not respond during admission. At the last recorded visit, at a median time of 14 months after discharge, 13 (33%) of the patients had an acuity of at least 6/12 in their amblyopic eye. CONCLUSIONS—The acuity of amblyopic eyes did not improve without effective treatment. Subsequent supervised inpatient occlusion therapy was effective in the majority of the children.
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Figure 1 .
Mean logMAR equivalent acuity for the amblyopic and fellow eyes of 39 children before, during, and after admission for inpatient occlusion. The intervals from first visit to admission and from discharge to final visit are mean values.
Figure 2 .
Distribution of the Snellen acuities of the amblyopic eye of 39 children at admission, discharge, and final visit.
Figure 3 .
Comparison of subsequent improvement in the acuity of the amblyopic eye following discharge in children who did or did not improve during admission. Children who did not improve during admission showed a larger subsequent improvement.
Figure 4 .
Number of Snellen lines of acuity gained by the amblyopic eye between admission and final visit for 39 children.
Selected References
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