Proportion of Non-Compliance and Factors Affecting It in Children Undergoing Occlusion Therapy for Amblyopia

Abstract

BACKGROUND The term amblyopia literally means dullness of vision. It is defined as unilateral or bilateral reduction of visual acuity due to pattern vision deprivation or abnormal binocular interaction for which no ocular causes can be detected by ocular examination and can be reversed by therapeutic measures. The study was undertaken to estimate the proportion of non-compliance and factors affecting it in children undergoing occlusion therapy for amblyopia. METHODS The study was designed as a hospital based cross sectional study. Children aged 5 - 12 years undergoing occlusion therapy for amblyopia due to strabismus, anisometropia or both, who had been prescribed occlusion for a period of minimum 3 months were included in the study. Children with developmental or neurological disorders and other ocular conditions causing visual impairment, whose parents were not willing to participate in the study or follow up, and uncooperative children were also excluded from the study. RESULTS 52.5 % were non-compliant to occlusion therapy, 31.1 % were partially compliant and only 16.4 % were compliant. 38.5 % had final visual acuity in the range of 6 / 60 - 6 / 24 and 6 / 18 – 6 / 12, 20 % had 6 / 9 - 6 / 6. Different variables were assessed against compliance to check for any association. Significant association was found between compliance to occlusion and socioeconomic status (p = .006), visual acuity at presentation (p = .026), type of amblyopia (p = .038) and final visual acuity (p < .01) and association with educational status were found to be borderline (p = .059). CONCLUSIONS Occlusion therapy for amblyopia is a long drawn process which needs strict compliance and regular follow up. Compliance is a major factor affecting final visual outcome. Poor compliance leads to unsuccessful amblyopia therapy which in turn can have negative impact on child’s learning ability and psychosocial wellbeing. For this reason it is critical that care givers leave the clinic with clear knowledge of how and why patching is being recommended and its importance in improving child’s vision. KEYWORDS Amblyopia, Occlusion, Compliance