Amblyopia in 4-year-old children treated with grating stimulation and full-time occlusion; a comparative study

We have compared the effects on visual acuity and binocular functions of grating stimulation (CAM therapy) and full-time occlusion in 38 4-year-old, previously untreated amblyopic children. The patients were divided into subgroups with regard to amblyopia type and fixation pattern. We found that grating stimulation was slightly better than occlusion in improving visual acuity of anisometropic amblyopes with central fixation, but that both types of therapy were equally effective in strabismic amblyopia with central fixation and in amblyopia with eccentric fixation. However, maximal treatment effects were not reached with grating stimulation alone, as shown at follow-up after continued conventional therapy. Grating stimulation may be regarded as a valuable method at the initiation of treatment, particularly in anisometropic amblyopia, but it has to be supplemented with occlusion, which still must be regarded as the prime form of amblyopia therapy.