Related Experiment Video
Updated: Jul 1, 2026
Stereoacuity Improvement using Random-Dot Video Games
Published on: January 14, 2020
A randomized trial of near versus distance activities while patching for amblyopia in children aged 3 to less than 7
Insights
Near activities during patching do not improve visual acuity for amblyopia. Two hours of daily patching may still benefit children with severe amblyopia, showing potential for vision improvement.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Vision Science
Background:
- Amblyopia, or 'lazy eye', affects visual development.
- Patching therapy is a common treatment for amblyopia.
- The role of near activities during patching is debated.
Purpose of the Study:
- To investigate if near activities enhance visual acuity improvement during amblyopia patching therapy.
- To compare outcomes between patching with near versus distance activities.
Main Methods:
- Randomized clinical trial involving 425 children (3-7 years) with amblyopia.
- Participants were assigned to 2 hours of daily patching with either near or distance activities.
- Visual acuity was assessed using HOTV optotypes at 2, 5, 8, and 17 weeks.
Main Results:
- No significant difference in visual acuity improvement between near and distance activity groups at 8 weeks (mean difference 0.0 lines).
- Both groups showed similar outcomes at 2, 5, and 17 weeks.
- Children with severe amblyopia achieved a mean improvement of 3.6 lines with 2 hours of patching daily.
Conclusions:
- Incorporating near activities into patching therapy does not enhance visual acuity outcomes for common forms of amblyopia.
- Two hours of daily patching can lead to significant visual acuity gains, particularly in severe amblyopia cases.
Purpose:
To determine whether performing near activities while patching for amblyopia enhances improvement in visual acuity.
Design:
Randomized clinical trial.
Participants:
A total of 425 children, aged 3 to <7 years, with amblyopia (20/40-20/400) that was caused by anisometropia, strabismus, or both, and that persisted after treatment with spectacles.
Methods:
Children were randomized to 2 hours of patching per day with near activities or 2 hours of patching per day with distance activities. Instruction sheets describing common near and distance activities were given to the parents. Study visits were scheduled at 2, 5, 8, and 17 weeks. In weeks without a visit, weekly telephone calls were made to the parent to monitor and encourage compliance during the first 8 weeks.
Main Outcome Measure:
Masked assessment of visual acuity by isolated crowded HOTV optotypes at 8 weeks.
Results:
At 8 weeks, improvement in amblyopic eye visual acuity averaged 2.6 lines in the distance activities group and 2.5 lines in the near activities group (mean difference in acuity between groups, adjusted for baseline acuity, 0.0 lines 95% confidence interval, -0.3 to 0.3). The 2 groups also appeared statistically similar at the 2-, 5-, and 17-week visits. At the 17-week examination, children with severe amblyopia improved a mean of 3.6 lines with 2 hours of daily patching.
Conclusions:
Performing common near activities does not improve visual acuity outcome when treating anisometropic, strabismic, or combined amblyopia with 2 hours of daily patching. Children with severe amblyopia may respond to 2 hours of daily patching.
