Rafiq M, Ahmad I, Rasool J, Rehman M.
Occlusion Therapy in Older Children with Amblyopia (Efficacy of part-time occlusion vis-�-vis full time occlusion).
Ophthalmol Update Jan ;15(2):82-6.

Aim: To compare the effects of full-time to part-time occlusion therapy in management of amblyopia in children of age 7-12 years. Materials and Methods: It was a prospective interventional case series study. One hundred children seen at ophthalmology outpatient department at Rehman Medical Institute, between 7-12 years of age with anisometropic (57), strabismic (25) and mixed (18) unilateral amblyopia were randomized (simple randomization) into four groups (25 each) to receive two hours, four hours, six hours or full-time occlusion therapy. Children were regularly followed up at six-weekly intervals for a minimum of three visits. Statistical Analysis: Intra group visual improvement was analyzed using paired t-test while intergroup comparisons were done using ANOVA and unpaired t-test. Results: All four groups showed significant visual improvement after 18 weeks of occlusion therapy ( P <0.001). Seventythree (73%) of the total 100 eyes responded to amblyopia therapy with 11 eyes (44%), 17 eyes (68%), 22 eyes (88%) and 23 eyes (92%) being amblyopia responders in the four groups respectively, with the least number of responders in the two hours group. In mild to moderate amblyopia (vision 20/30 to 20/80), there was no significant difference in visual outcome among the four groups ( P =0.083). However, in severe amblyopia (vision 20/100 or worse), six hours ( P =0.048) and fulltime occlusion ( P =0.027) treatment were significantly effective in more than two hours occlusion. Conclusion: All grades of part-time occlusion are comparable to full-time occlusion in effectiveness of treatment for mild to moderate amblyopia in children between 7-12 years of age unlike in severe amblyopia, where six hours and full-time occlusion were more effective than two hours occlusion therapy.

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