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Comparison of Three Clinical Stereoscopic Methods for Measuring Binocular Visual Function During Amblyopic Treatment in Unilateral Amblyopia
Published on: September 27, 2024
Comparison of novel clinic-based approach (amblyopia school) Vs. home-based occlusion for amblyopia therapy - A
Subhajit Bhattacharya1, Ketaki Subhedar, Madhu Bhadauria
1Department of Paediatric Ophthalmology, Sitapur Eye Hospital and Regional Institute of Ophthalmology, Sitapur, Uttar Pradesh, India.
Insights
Clinic-based amblyopia therapy, including an "amblyopia school," significantly improved vision in children compared to home-based occlusion. This approach may be more effective, especially in rural areas with lower patient compliance.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Vision Science
Background:
- Amblyopia, or
Purpose of the Study:
- To compare the visual outcomes of standard occlusion therapy administered at home versus in a clinic setting for children with amblyopia.
Main Methods:
- A retrospective study analyzed 219 children (<15 years) with strabismic or anisometropic amblyopia treated between Jan 2017-Jan 2020.
- Children were divided into a clinic group (amblyopia school with occlusion and near work) and a home group (part-time occlusion per PEDIG guidelines).
- Visual improvement was measured in Snellen's lines at 1 month and final follow-up.
Main Results:
- The clinic group showed significantly greater visual improvement at 1 month (2.1 lines) compared to the home group (1.1 lines) (P < 0.001).
- At final follow-up (mean 4.1 months), the clinic group's vision improvement (2.9 lines) remained superior to the home group (2.3 lines) (P = 0.05).
- Both groups demonstrated continued visual improvement over time.
Conclusions:
- Clinic-based amblyopia therapy, particularly an
Purpose:
To compare visual outcomes of standard occlusion therapy at home versus clinic in amblyopic children.
Methods:
A retrospective study of case records of children aged <15 years with diagnosis of strabismic or anisometropic amblyopia or both was conducted at a tertiary eye hospital located in rural North India between Jan 2017-Jan 2020. Those with at least 1 follow-up visit were included. Children with ocular co-morbidities were excluded. Treatment in clinic by admission or at home was based on the parents' discretion. Children in clinic group underwent part time occlusion & near work exercises for minimum 1 month, in classroom format which we called amblyopia school. Those in home group underwent part time occlusion as per PEDIG recommendations. Primary outcome measure was improvement in number of Snellen's lines at the end of 1 month & at final follow-up.
Results:
We included 219 children with mean age of 8.8±3.23 years, out of which clinic group had 122 (56%) children. At one-month, visual improvement in clinic group (2.1±1.1 lines) was significantly greater than home group (mean=1.1±0.8 lines) (P < 0.001). Both groups continued to improve vision on follow-up, however the vision in the clinic group (2.9±1.2 lines improvement at mean follow-up of 4.1±1.6 months), continued to be better than home group (2.3±1.1 lines improvement at mean follow-up 5.1±0.9 months) (P = 0.05).
Conclusion:
Clinic based amblyopia therapy in the form of an amblyopia school can help expedite visual rehabilitation. Thus, it may be a better option for rural settings where patients in general tend to be poorly compliant.
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