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A. M. Roefs, A. M. Tjiam, E. Vukovic, S. E. Loudon, J. Felius, H. J. Simonsz; Qol and Compliance During Occlusion Therapy for Amblyopia in a Prospective, Double Blind Study Comparing Four Brands of Occlusion Patches. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2583.
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Loudon et al. found large differences in physiological and mechanical properties (especially in water permeability, opacity and strength of adhesion to the skin) of eye patches.In spite of these major differences most orthoptists prescribe only one brand and do not prescribe a particularly brand for a specific skin type, season or prescribed occlusion time. We compared four different brands of occlusion patches regarding QoL and compliance.
Primary outcome measure is QoL measured using a questionnaire. Secondary outcome is compliance measured electronically with the Occlusion Dose Monitor.Inclusion criteria: 3-6 years, receiving occlusion therapy for amblyopia as initial treatment, difference of visual acuity of ≥ 2 logMAR lines. Exclusion criteria: refusal, finished patching, not able to contact.All participating children wear four different brands of eye patches (3M: Opticlude boys & girls, Masteraid: Ortopad boys & girls, Lohmann-Rauscher: Pro-Optha, BSN Medical: Coverlet S) each during two days. A questionnaire developed in a focus group consists of six domains (the patching, skin reaction, acceptation by child, acceptation family, acceptation by others and other factors concerning patching) and evaluates each brand every other day (by phone call or house visit). A second questionnaire consisting of the translated ‘CVFQ’ (Felius et al.) and ‘ATI: Patching Questionnaire’ is filled out once during a house visit.
In total 79 children in The Hague and Rotterdam were eligible. Thirteen children already finished the study at this point in time. One child withdrew after only one day because removal of the patch was too painful.The participating children represent the demographic features of The Hague and Rotterdam: 4 Turkish, 1 Surinam, 2 Indian, 4 Moroccan and 7 Dutch children. Ten parents refused to participate. Four children finished patching. Initial preliminary results show one brand to be particularly painful when removing the patch and makes the child’s eye or eyelids red or irritated, especially when the parents found the skin to be dry or sensitive. Two brands seem to stick to the skin too light when the occlusion time is two or more hours. The last brand seems to give few complaints.
In the initial stage we already found major differences in compliance to exist between different brands. When prescribing an eye patch to a child, orthoptists should consider the wide variety in skin type, season and the actually prescribed occlusion time.
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