Remediation of refractive amblyopia by optical correction alone

Amblyopia--the commonest vision abnormality of childhood--is characterized by a loss of visual acuity usually of one eye only. Treatment aims to promote function of the amblyopic eye and does this by restricting, usually through occlusion, the competitive advantage of the fellow eye. Recent experimental evidence demonstrates that the recovery of vision following early deprivation is facilitated by increasing visually evoked activity. An analogous approach in humans is to minimise image blur by correcting refractive error prior to treatment--a practice which may account for the poorly quantified improvements in visual acuity sometimes attributed to 'spectacle adaptation'. Here we describe clinically significant gains in visual acuity obtained over a period of 4-24 weeks in a group of amblyopic children arising solely in response to the correction of refractive error. Consequences for the clinical management of refractive amblyopia are discussed.