Considerations in the routine assessment and treatment of anisometropic amblyopia

Anisometropic amblyopia has traditionally been treated by direct occlusion with or without refractive correction of the anisometropia. This treatment has generally been considered so successful that practitioners prescribe occlusion for a time and consider treatment complete when visual acuity is no longer improving. The aetiology of anisometropic amblyopia, addressing the functional deficits of the amblyopic system and patient compliance issues, are important to the success of amblyopia treatment in anisometropia and are briefly reviewed in this paper. We propose that, while each case of anisometropic amblyopia may have slightly different attributes, initially they should all be treated with occlusion and full-time spectacle correction. Some presentations may be responsive to individual treatment strategies to correct binocular functions such as stereopsis, accommodative response and fusional vergences.