Anisometropic Amblyopia: Analysis of treatment results with patching of dominant eye and refraction with active visual therapy (AVT) in school age children.

Abstract

Objectives: To analyse the results of Active Visual Therapy with patching and refraction in anisometropic amblyopia in school age children from age 7-15 years. Study Design: Analytical study. Setting: Department of Ophthalmology, DHQ KDA Teaching Hospital Kohat. Period: January 2016 to December 2018. Material & Methods: The school age children suffering from anisometropic amblyopia with age range from 7-15 years. Proper documentation proforma was designed for record and follow up of patients. Informed consents were taken from parents of patients and they were specially trained for compliance. Total 41 patients were included comprising 28(68.29%) male and 13(31.70%) female with age range of 7-15 years. Anterior and posterior segments were properly examined. Best corrected visual therapy was recorded. Difference of two or more lines on snellen chart between the two eyes was considered to be anisometropic amblyopia. Before treatment 14(34.14%) patients had BCVA of 6/24, 8(19.51%) patients had 6/36, 10(24.39%) patients had 6/60 and 9(21.95%) patients had CF. Out of 41 patients 29(70.73%) patients were hypermetropic while 12(29.26%) were myopic. The refractive error of amblyopic eyes in spherical equivalent was from + 7 to – 5 diopters. Proper refractive correction was done. Patching of the normal eye was advised for three hours per day at the dose of one week per year of age. The amblyopic eye was exposed to active visual therapy with video games with computer and smart phones. The patients were examined after each three months and improvement in visual acuity and change in refraction was addressed. Results were analysed on the basis of pretreatment and post treatment visual acuity. Finally T-test for regression and co-relation was applied on the post treatment status of visual acuity of 6/24, 6/36, 6/60 and Counting finger with pretreatment status of visual acuity of 6/24, 6/36, 6/60 and Counting finger showing P = 0.005 which is less than 0.05 and is statistically significant. Results: Cumulatively after treatment out of 41 patients 10(24.39%) had best corrected visual acuity 6/6, 6(14.63%) had 6/9, 7(17.07%) had 6/12, 7(17.07%) had 6/18, 4(9.75%) had 6/24, 5(12.19%) had 6/60 and 2(4.87%) had best corrected visual acuity of CF. Conclusion: Patching of dominant eye and refraction with Active Visual Therapy of amblyopic eye is effective in treatment of anisometropic amblyopia.