Efficiency of occlusion therapy for management of amblyopia in older children

Brar, Gagandeep S.; Bandyopadhyay, Supratik; Kaushik, Sushmita; Raj, Surishti
December 2006
Indian Journal of Ophthalmology;Dec2006, Vol. 54 Issue 4, p257
Academic Journal
Purpose: To analyze results of full time occlusion therapy for amblyopia in children older than 6 years. Materials and Methods: This was a retrospective consecutive case series analysis of children treated for amblyopia at a tertiary care center. All children received full time occlusion (FTO) for the dominant eye. Results: Eighty-eight children older than 6 years at the time of initiation of therapy were included. Age at initiation of therapy ranged from 6 to 20 years (9.45 ± 3.11 years). Forty-two children (47.7%) had strabismic amblyopia, 37 (42.0%) had anisometropic amblyopia and 9 (10.2%) had a combination of strabismic and anisometropic amblyopia. Eighty out of 88 eyes (90.0%) had improvement in visual acuity following FTO. Visual acuity (VA) improved from 0.82 ± 0.34 at presentation to 0.42 ± 0.34 (P < 0.001) after FTO. In children with strabismic amblyopia, VA improved from 0.81 ± 0.42 to 0.42 ± 0.39 (P < 0.001). In children with anisometropic amblyopia, visual acuity of the amblyopic eye improved from 0.82 ± 0.24 to 0.36 ± 0.29 (P < 0.001) following FTO. Out of 13 children older than 12 years, only 6 children (46.1%) had improvement in VA. Mean follow-up after complete stoppage of occlusion was 8.37 ± 1.78 months. Conclusion: Occlusion therapy yields favorable results in strabismic and/or anisometropic amblyopia, even when initiated for the first time after 6 years of age. After 12 years of age, some children may still respond to occlusion of the dominant eye.


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