Abstract
Abstract: :
Purpose: Evaluation of patching treatment for amblyopia in a cohort treated 30–35 years ago in Waterland. At that time, vision screening was not routinely done until age 5 or 6. There was one ophthalmologist and 0.4 orthoptist for 70,000 people. Methods: 191 of 470 patients born between 1962–1972 and patched for amblyopia between 1968–1974 were traced and contacted by telephone. 137 of these were re–examined. We identified the characteristics of patients in whom patching had failed, of patients with a drop in visual acuity after termination of patching and of patients with complaints like diplopia. Results: Surprisingly, almost all patients had never consulted an orthoptist or an ophthalmologist after age ten. Patching had started at the age of 64 months (average acuity 0.19) and lasted 25 months, on average. 50 out of 134 patients were unable to read newspaper print; most of these had a current distance acuity of less than 0.5 and had had an initial acuity of 0.16 or less on initiation of patching. Average acuity at termination of patching was 0.49 LogMAR, current average acuity was 0.48 LogMAR. Acuity had increased or remained stable in most cases since termination of patching. In 5 cases acuity had dropped to less than 40% of the acuity at termination of patching: All of these had had increasing anisometropia. 17 Patients occasionally experienced diplopia, in 5 cases sometimes interfering with daily activities. They had toxoplasmosis, microstrabismus decompensated in exotropia, previous strabismus surgery and anisometropia. Conclusions: In this rural setting around 1970, 37% of patching treatments failed, primarily cases with low initial acuity. A severe drop in acuity after termination of patching occurred only in cases that had had increasing anisometropia.
Keywords: amblyopia • strabismus: treatment • infant vision