Abstract
Purpose :
Use of spectacles in children with amblyopia is crucially important to improvement in vision. We performed a retrospective chart review to assess the relationship between spectacles and change in vision in amblyopic eyes as well as to assess compliance with spectacles and reported barriers to spectacle use.
Methods :
Data from the UC, Irvine Health Pediatric Eyemobile from 2016 to 2018 was retrospectively analyzed. Current program protocol has any eye, seeing 20/50 or worse best corrected (considered amblyopic) on a LEA chart at initial exam, re-measure visual acuity after 3 months of spectacle use. The line change best corrected visual acuity (BCVA) of these in amblyopic eyes was compared to line change in visual acuity for control eyes (BCVA > 20/30). Line change in visual acuity was also compared with the type of spectacle correction and the amblyogenic risk factor present for each eye. Additionally all children prescribed glasses in January and February of 2018 were assessed for parent reported compliance, as well as any reported barriers to compliance.
Results :
Amblyopic eyes improved an average of 1.55 lines and control eyes lost an average of 0.08 lines (p=0.0007, 95% CI=0.72-2.53). Good compliance with spectacles was reported 43.32 % of the time, non-compliance was reported 20.94% of the time, and 35.74% could not be reached. Common reasons for non-compliance were: broken, blurry vision/dizzy, lost, or parent disagreement with glasses. Less common reasons were poor fit or embarrassment. Neither the type of spectacles (p=0.441) nor the amblyogenic risk factor (p=0.252) were significant factors in visual acuity change. Good compliance with glasses was almost always reported for children with amblyopic eyes so we were unable to assess the relationship between compliance and change in visual acuity.
Conclusions :
Eyes seeing 20/50 or worse due to refractive amblyopia showed definite visual improvement after 3 months of spectacle wear alone. The amount of improvement in visual acuity was similar to previously reported studies such as in the Amblyopia Treatment Trials. We also saw no relationship between the type of refractive amblyopia nor the type of spectacle correction in improvement in vision with spectacle wear. A larger sample size and better tracking of actual compliance would allow us to better assess the relationship between spectacle compliance and improvement in vision as well as further assess potential barriers to spectacle use.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.