Anisometropic and strabismic amblyopia in the age group 2 years and above: a prospective study of the results of treatment.

Abstract

Forty-four children aged 2-9 years with strabismic and anisometropic amblyopia were prospectively followed up during amblyopia treatment. The efficacy ofoptimised treatment in terms of number of cured children, time to achieve cure, and rate of initial improvement ofvisual acuity was evaluated in relation to age at start of treatment, type and initial degree of amblyopia, and adherence to treatment regimen. Compliance with treatment was the most critical factor predicting a successful outcome. Among the compliant children 35 out of 36 were cured (visual acuity difference between amblyopic and non-amblyopic eyes not more than one line) within five months regardless of age, treatment regimen, and type or initial degree of amblyopia as compared with none in the group with low compliance. Most of these compliant children were cured within three months, with shorter treatment times on average for the younger children. The initial improvement of visual acuity was also faster at 2 years than at 4 years of age. Anisometropes with moderate amblyopia at the start of treatment were over-represented in the group with low compliance. We conclude that early diagnosis of strabismus in combination with general population screening at the age of 4 to detect amblyopia caused by anisometropia or microstrabismus seems to be efficacious for the cure of most cases. The major factor in treatment failure was found to be inadequate adherence to the treatment reginen.

Prevalence of amblyopia with anisometropia or strabismus among schoolchildren in the Sultanate of Oman

“…In most cases the treatment of amblyopia is cheap and successful if detected early and compliance is obtained (Lithander & Sjö strand 1991). The number of severe eye injuries among the Omani children is relatively high (Lithander, in preparation) and the risk of losing the healthy eye is increased compared to the risk of losing the amblyopic eye in an accident, as shown by Tommila & Tarkkanen in 1981.…”

Efficacy of amblyopia therapy initiated after 9 years of age

“…The same result could be found in other studies for amblyopes in other age groups. 5,19,20 Thus given compliance, the response of occlusion therapy for the initial 3 months could be invaluable for predicting the prognosis of the amblyopia.…”

Reversal of myopic <i>Anisometropic amblyopia</i> with occlusion therapy in a 25 year old

“…[4][5][6] Amblyogenic period during which an eye is susceptible to amblyopia is what has been a subject of controversy. Even more controversial is the age limit to stop occlusion as a treatment modality.…”