Abstract
Purpose: :
To describe children with amblyopia treatment failure at an ordinary orthoptic clinic and to review the records six months after the study for BCVA registration.
Methods: :
Thirty three children, 16 girls and 17 boys (mean age 6.8 years) without increase in BCVA though ongoing treatment during at least 6 months, underwent an orthoptic investigation including; BCVA, cycloplegic refraction, binocular functions and cover test. 24 age-matched healthy children served as controls.
Results: :
All but four had heterotropia. Microtropia, diagnosed with 4PD test, was seen in 18/29. Simultaneous perception with Bagolini was more common than total suppression 21/30 vs. 9/30 (p=0.04). With the Titmus test, 10/31 could see the fly and an additional nine had median stereo acuity of 100". High hyperopia (>4D SE) n=18 and astigmatism (>1,5D) n=8 were more frequently seen in the study group compared to controls 0/24 vs. 0/24 (p= 0.001 and 0.016). Three children had myopia (>0.5D SE) and 10 had anisometropia compared to no one among controls (p=0.26 respectively p=0.0032). Low BCVA (>1.0 log MAR) at treatment start was noted in 9 children and three children had treatment start > 6 years of age. Eight of 33 children had an increase in BCVA 6 months after they had participated in the study and three of these eight had no longer amblyopia (9%).
Conclusions: :
Small deviations with gross binocularity, high hyperopia, astigmatism, and low initial BCVA are common in children with amblyopia treatment failure at an ordinary orthoptic clinic. In addition, in at least 9% bad compliance may be the cause.
Keywords: amblyopia • visual acuity • refraction