Full-time occlusion compared to part-time occlusion for the treatment of amblyopia

Occlusion of the better-seeing eye as a method of treatment for amblyopia has long been a standard of care. A difference exists between practitioners on using either full-time occlusion or part-time occlusion.

A retrospective review of pediatric patients (ages 3 to 7 years) with amblyopia was performed. The patients were prescribed either full-time occlusion or part-time occlusion for the primary treatment of their amblyopia. Exclusions were made for patients with an organic or structural component of their amblyopia. Twenty-one patients were included in the full-time occlusion group and 24 patients were included in the part-time occlusion group.

Seventy-six percent of patients who completed full-time occlusion achieved 20/40 acuity or better and 67% achieved 20/30 or better, with an average treatment time of six weeks. Fifty-eight percent of patients who completed part-time occlusion achieved 20/40 acuity or better and only 46% achieved 20/30 or better, with an average treatment time of 26 weeks. For patients with 20/80 or worse amblyopia, 82% achieved 20/40 or better with full-time occlusion. Only 40% of part-time occluders with 20/80 or worse achieved 20/40. Occlusion amblyopia did not develop in any patient.

A higher percentage of amblyopic patients treated with full-time occlusion achieved 20/30 acuity in the amblyopic eye over a shorter duration of treatment.