Abstract
Purpose :
For children aged < 7 years with amblyopia, 80% of visual acuity (VA) improvement with patching occurs during the first 6-12 weeks of treatment. After these initial weeks, complete recovery may require additional months to years of patching. Prolonged patching treatment may have an impact on family life, daily activities, and the child’s well-being and behavior. We investigated whether the prolonged treatment required to convert from mild residual amblyopia to normal VA is of benefit to the amblyopic child.
Methods :
Children aged 5-12 years with treated anisometropia, treated esotropia, or both were enrolled into groups by VA status:
● NEVER: normal VA and no history of amblyopia (N= 120)
● RECOVERED: successfully treated amblyopia (VA≤0.1 logMAR; IOD≤0.1 logMAR; N=169)
● MILD: mild residual amblyopia (0.1≤VA≤0.2 logMAR; >0.2 logMAR IOD, N=238)
Outcomes:
● Reading speed for silent reading of grade-appropriate paragraphs viewed binocularly (Readalyzer)
● Motor skills (manual dexterity, aiming & catching, & balance MABC-2 standard scores)
● Self-Perception assessed by the Self-perception Profile for Children
● Eye-Related quality of life (ER-QOL) for the parent, parent as child-proxy, and child (PedEyeQ)
Results :
There were no significant differences between the RECOVERED and NEVER groups on any outcome, although both scored worse than published norms on some outcomes. Compared to the NEVER group, the MILD amblyopia group performed significantly worse on reading rate (p=.007) and self-perception of scholastic competence (p=.01) and social acceptance (p=.01). For the PedEyeQ, parents of children in the MILD group reported decreased ER-QOL for themselves (worry about the child’s eye condition; p=.02) and, as proxies, decreased ER-QOL for their child (functional vision, bothered by their eyes/vision, frustration/worry, and burden of eye care; .002≤p≤.02). Children in the MILD group self-reported decreased ER-QOL (functional vision, bothered by their eyes and vision, social interactions, and frustration/worry; .004≤p≤.03). There were no significant differences among the 3 groups in motor skills standard scores for manual dexterity, aiming & catching, or balance.
Conclusions :
While the burden of prolonged patching treatment is considerable, the benefits associated with recovery of normal VA compared with mild residual amblyopia are significant.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.