Jornal de Oftalmologia Clínica e Experimental
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Factors Affecting Compliance to Two-Hour Versus Six-Hour Occlusion Therapy Regimens for Treatment of Strabismic Amblyopia

Attiat M. Mostafa, Rehab R. Kassem and Asser A.E. Abdel-Meguid

Purpose: To compare the effect of daily occlusion of the sound eye for two hours, without and with near vision exercises, versus six hours without near vision exercises, for the management of strabismic amblyopia and to determine the different factors affecting compliance to each treatment regimen.
Methods: Forty five children having unilateral strabismic amblyopia were divided equally into 3 groups. Group A received 2-hour daily occlusion. Group B received 2-hour occlusion combined with near vision exercises. Group C received 6-hour occlusion therapy. Patients were followed up for 6 months.
Results: The mean logMAR improvement was -1.03+/-0.57, -0.63+/-0.66 and -0.65+/-0.66, for groups A, B and C, respectively. The difference in mean logMAR improvement was significant (P < .001) in groups A versus B and A versus C, but was insignificant (P =.748) in group B versus C. Factors affecting compliance to each occlusion regimen were related to age, socioeconomic status, life pattern and season of the year.
Conclusion: The best outcome was achieved when 2-hour daily patching was combined with near vision activities. Higher compliance to two-hour occlusion with near vision exercises was attained in older, educated children. Six-hour occlusion was more suitable in younger and in uneducated children.