[An alternative treatment for amblyopic strabismus: optical penalization]

The aim of this study is to demonstrate the efficacy of the systematic prescription of an overcorrection of +2 to +2.5 D in 89 patients with a persisting pathological dominance of fixation after treatment by prisms and calibrated filters. The second criterion of prescription was the absence of any short term surgical plan. The percentage of compliance was 89% but 93.5% of the patients achieved a visual acuity > or = to 7/10. Besides the visual result, this method improved the motor instability in 68% of strabismic patients with a deviation of 10 to 20 PD. Two cases recovered a normal retinal correspondence and a stereoacuity of 60" measured at the TNO test. The mean age of the optical penalization is 5.2 years (range: 2 to 10.5 y.) and the mean duration 2.3 y. (range: 0.5 to 4.5 y.). The minimal age of evaluation was 7 y. This method is simple and efficient and appears to be the best way to the long term success of strabismic functional amblyopia.