Abstract
Purpose :
Children born with a unilateral congenital cataract (UCC) can achieve good visual acuity with early removal of the cataract, consistent correction of the residual refractive error and extensive patching of the untreated eye. Further, there is evidence that some children can develop stereopsis. We hypothesized that developing these optimal outcomes is most likely when children are patched enough to achieve good vision in the treated eye, but receive enough binocular input to allow the two eyes to work together, so children with good visual acuity and evidence of stereopsis will be patched less than those who have no evidence of stereopsis.
Methods :
We included data from children who participated in the IATS and had a recognition monocular visual acuity of 20/40 or better using the ATS E-ETDRS (n=27) at age 10.5. Stereopsis of 800 arcseconds or better was assessed using the Randot Preschool Stereoacuity test. Every three months, parents reported patching over the previous 48 hours in a telephone interview and once per year in a 7-day prospective patching diary. The daily hours of patching were averaged for 5 ages (<12 months, 1 to <2 years, 2 to <3 years, 3 to <4 years and 4 to <5 years). Two-sample t-tests and mixed model, repeated measures ANOVA were used to evaluate differences in reported patching across time periods by evidence of stereopsis.
Results :
27 of 109 (24.8%) IATS participants had a visual acuity of 20/40. Six (22.2%) of these had evidence of stereopsis. After 12 months of age, the 6 children who had evidence of stereopsis were reported to be patched significantly fewer hours per day than those without stereopsis (Table 1).
Conclusions :
In children treated for UCC, achieving good vision in the treated eye requires extensive occlusion of the fellow eye. However, for children who are able to see well out of their affected eye, patching may limit the development of stereopsis. Therefore, patching recommendations should be individually titrated to maximize visual outcomes and stereopsis.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.