Failed Amblyopia Treatment: Factors Affecting Outcome

Abstract

Abstract: : Purpose: Factors affecting outcome of amblyopia treatment are not well understood. The aim of this study was to determine factors affecting the outcome in a defined subset of amblyopes who failed to improve at the end of occlusion treatment inspite of good compliance. Methods: 61 children with failed amblyopia treatment were included in this study. Correlation between depth of anisometropic amblyopia and diferrence in refraction, correlation between age of presentation and the type of amblyopia on the final outcome were studied in this subset. Results:There was a strong correlation between depth of anisometropic amblyopia and the degree of anisometropia. The association is highly significant for the hypermetropic group (p<0.001), and significant for the smaller group of myopes (p=0.022). There is a clear trend to improvement confined to early age of presentation. This is highly significant (p<0.001) in both the anisometropic and strabismic group. Patients with strabismic amblyopia have a more favourable outcome than those with anisometropic amblyopia (p=0.047) Conclusions: Factors like degree of anisometropia and age of presentation have strong positive correlation on the final outcome of patients with failed amblyopia treatment. The outcome is worse for hypermetropes than myopes and for anisometropic amblyopes than strabismic amblyopes. The significance of these findings and its impact on amblyopia management are discussed.

Keywords: ocular motor control • amblyopia • visual development: infancy and childhood