Occlusion therapy in older children with amblyopia

Background: Occlusion therapy is effective in older children with amblyopia. Objective: To evaluate and compare visual outcomes in older children aged between 9 and 18 years with unilateral refractive amblyopia after treatment with patching and/or optical correction. Settings and Design: Prospective randomized controlled study. Materials and Methods: Sixty children (9-18 years) with unilateral refractive amblyopia (anisometropic/meridional) with best-corrected visual acuity (BCVA) ≤6/12 (0.3 logMAR) in the worse eye were 1:1 randomized into nonocclusion and occlusion group. Both treatment groups underwent 4 weeks refractive adaptation period (RAP) and three follow-up visits at 6 weeks interval. After RAP, the better eye in the occlusion group was patched for 6 h daily, while the nonocclusion group children continued to wear spectacles for 18 weeks. BCVA (logMAR) at each visit was compared with the baseline reading. Statistical Analysis Used: Descriptive and inferential statistical analyses were used. Student′s t-test and Chi-square/Fisher exact test was used to calculate the P value. Results: There was a significant improvement in BCVA from baseline to 18 weeks after RAP within both treatment groups (P < 0.001) and significant higher proportion of children in occlusion group showed three lines of improvement compared with nonocclusion group (P = 0.011). Improvement in BCVA from baseline to 18 weeks was noted irrespective of the severity of amblyopia and age of the participants more so in occlusion group. Conclusion: Occlusion therapy is an effective and better treatment than only spectacle correction in children aged between 9 and18 years, with unilateral refractive amblyopia