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Updated: Oct 1, 2026

The Measurement and Treatment of Suppression in Amblyopia
Published on: December 14, 2012
Psychosocial and clinical determinants of compliance with occlusion therapy for amblyopic children
1MRC Health Services, Research Collaboration, Department of Social Medicine, University of Bristol, Bristol, UK. A.J.Searle@bristol.ac.uk
Insights
Parental self-efficacy and perceived activity prohibition significantly impact adherence to amblyopia (lazy eye) treatment. Past patching success and perceived treatment effectiveness are key for sustained compliance in children.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Behavioral Science
Background:
- Amblyopia, or lazy eye, affects visual development in children.
- Occlusion therapy (eye patching) is a primary treatment for amblyopia.
- Parental compliance is crucial for successful amblyopia treatment outcomes.
Purpose of the Study:
- To investigate psychosocial and clinical factors influencing parental adherence to eye patching for amblyopia.
- To identify predictors of compliance with occlusion therapy in children.
Main Methods:
- 151 children undergoing occlusion therapy for amblyopia were recruited.
- Parents completed Protection Motivation Theory-based questionnaires.
- Clinical data and self-reported compliance were collected and analyzed using regression.
Main Results:
- Only 54% of parents achieved recommended patching levels.
- Higher self-efficacy and lower perceived activity prohibition correlated positively with compliance.
- Past behavior and perceived treatment efficacy were significant predictors at follow-up.
Conclusions:
- Findings can inform interventions to improve parental compliance with amblyopia treatment.
- Leveraging successful parents' strategies and emphasizing treatment efficacy may enhance adherence.
- Improving self-efficacy and demonstrating visual acuity gains can foster sustained eye patching.
Aims:
The objective of this study was to determine the extent that psychosocial and clinical variables influence parental compliance with occlusion therapy (eye patching) in children with amblyopia.
Methods:
Children (n = 151) receiving occlusion therapy (eye patching) for the treatment of amblyopia were recruited from five orthoptic clinics in Bristol, UK. Parents completed a questionnaire based on Rogers' (1983) Protection Motivation Theory (PMT). The parents (n = 105) were also followed up 2 months later. Clinical data, including measures of visual acuity, were also recorded. Compliance with eye patching was assessed through self-report accounts of parents. Stepwise regression analyses were used to determine the factors predictive of compliance with eye patching.
Results:
Self-reported compliance with eye patching at study entry revealed that only 54% of parents were achieving orthoptists' recommendations to patch their child. Perceived self-efficacy was positively associated with compliance and perceived prohibition of the child's activities were negatively associated with compliance. At follow-up, past behaviour accounted for the largest proportion of explained variance in patching behaviour followed by response efficacy, and prohibition of the child's activities.
Conclusion:
The present findings may serve to inform interventions aimed at enhancing current orthoptic practice to improve compliance in amblyopic children. The importance of 'self-efficacy' and past behaviour suggests that consultations with parents exhibiting higher levels of success with patching may elicit strategies that could be shared with parents experiencing difficulties with patching their children. In addition, it is possible that the perceived efficacy of the treatment could be enhanced if orthoptists emphasised evidence of improvements in visual acuity which may, in turn, foster the maintenance of eye patching.
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