Is amblyopia of any severity fully treatable, irrespective of a patient’s age?

Abstract

Primary Objectives: 1: To find out the level of visual improvement and the time it takes in amblyopia of any severity. 2: To find out whether the level of visual improvement is influenced by a patient’s age at presentation. Secondary Objectives: 1: To note whether the level of visual recovery is influenced by previous amblyopia therapy. 2: To note any regression of visual acuity with time after initial improvement by therapy. 3: To note complications of full-time occlusion therapy, especially occlusion amblyopia. Materials and Methods: In a prospective interventional study, 1701 consecutive cases with poor vision were included irrespective of a patient’s age. After wearing refractive correction for 8-12 weeks and no further improvement in the BCVA, amblyopia therapy was started comprising of full-time patching of the good eye along with active use of the amblyopic eye by reading and writing at least 6 hours daily. Regular two weekly follow-ups were conducted. The endpoint of therapy was achieving a BCVA equal to that of the good eye. A regular post-patching follow-up was conducted for 1-3 years. Statistical analysis comparing the visual acuity at the start and the end of therapy was performed by a paired t-test for each group. Results: There were 896 male and 805 female cases. 1383 cases (81.3%) had previously failed amblyopia therapy. 49 cases (2.9%) dropped out of the study due to poor compliance with therapy or an incomplete follow-up. For a simplified analysis of results, the 1701 cases were divided into three age groups: Group A: age 4-7 years (473 cases), Group B: age 8-12 years (618 cases) and Group C: age 13-46 years (610 cases). The overall success in Group A and B cases was 98% and 96.9% in Group C cases. Conclusion: Full visual recovery is possible in amblyopia of any severity and age. The age of a patient at presentation should not preclude therapy. © 2024 Author(s).