Related Experiment Video
Updated: Mar 10, 2026
Comparison of Three Clinical Stereoscopic Methods for Measuring Binocular Visual Function During Amblyopic Treatment in Unilateral Amblyopia
Published on: September 27, 2024
Assessment of Adherence to Visual Correction and Occlusion Therapy in the Infant Aphakia Treatment Study
Carolyn Drews-Botsch1, George Cotsonis2, Marianne Celano3
1Department of Epidemiology, Rollins School of Public Health, Emory University.
Insights
Parental reports via interviews or diaries can effectively track occlusion therapy adherence in young children. These methods offer consistent data for assessing patching compliance when monitors aren
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Clinical Research Methodology
Background:
- Occlusion therapy is a common treatment for deprivation amblyopia in early childhood.
- Rigorous clinical assessment and reliable adherence monitoring tools for long-term occlusion therapy are lacking.
- Unilateral congenital cataract treatment studies provide a context for evaluating adherence assessment methods.
Purpose of the Study:
- To evaluate the efficacy of quarterly 48-hour recall interviews and annual 7-day prospective diaries for assessing occlusion therapy adherence.
- To compare the consistency and completion rates of parental report methods in a pediatric clinical trial.
Main Methods:
- Utilized data from 114 children in the Infant Aphakia Treatment Study (unilateral congenital cataract).
- Assessed reported hours of patching and sleep using recall interviews and prospective diaries over the first five years of life.
- Analyzed data consistency using correlation coefficients and intraclass correlation coefficients.
Main Results:
- Both interview and diary data demonstrated excellent consistency for reported hours of patching (Cronbach's Alpha 0.69–0.88) and sleep (0.60–0.73).
- Caregivers reported higher adherence with prospective diaries compared to retrospective interviews.
- Telephone interviews achieved substantially higher completion rates (over 75% after four years) than diaries (54%).
Conclusions:
- Parental self-report, through recall interviews or prospective diaries, provides a viable quantitative method for assessing occlusion therapy adherence.
- These methods are particularly useful when occlusion dose monitors are impractical, such as for infants or long-term treatment.
- Telephone interviews offer a more practical approach due to higher completion rates for extended adherence monitoring.
Abstract:
Occlusion therapy throughout early childhood is believed to be efficacious in treating deprivation amblyopia but has not been rigorously assessed in clinical trials. Further, tools to assess adherence to such therapy over an extended period of time are lacking. Using data from the Infant Aphakia Treatment Study, a randomized clinical trial of treatment for unilateral congenital cataract, we examined the use of quarterly 48-hour recall interviews and annual 7-day prospective diaries to assess reported hours of patching in 114 children throughout the first 5 years of life. Consistency of data reported was assessed using correlation coefficients and intraclass correlation coefficients. Both interview and diary data showed excellent consistency with Cronbach's Alpha's ranging from 0.69 to 0.88 for hours of patching and 0.60 to 0.73 for hours of sleep. However, caregivers reported somewhat more adherence in prospective diaries than retrospective interviews. Completion rates, on the other hand, were substantially higher for telephone interviews than prospective diaries. For example, after four years of surgery response rates to telephone interviews exceeded 75% versus completion rates of only 54% for diaries. In situations where occlusion dose monitors cannot be used for assessing adherence to occlusion therapy, such as in infants or over an extended period of time, quantitative assessments of occlusion therapy can be obtained by parental report, either as a series of prospective diaries or a series of recall interviews.
