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Amblyopia Treatment Past, Present and Future
Anne Southgate Sylvie Cringle
Orthoptic Department, HEFT
Amblyopia – what is it?
• Definition:– Defective visual acuity which persists after
correction of any refractive error and removal of any pathological obstacle to vision.
Also termed ‘lazy eye’
• Types
Amblyopia Treatment
• Removal of obstacle to vision• Glasses• Occlusion (patching)– Conventional– Inverse
• Stimulation• Atropine penalisation• Optical penalisation
Early Amblyopia Treatment
• Total to form and light
• Total to form
• Partial to form
• Atropine
• Timing
• Last resort
Amblyopia Treatment
Amblyopia Treatment
• Then
Amblyopia Treatment
• Now
Amblyopia Treatment
• Then
Amblyopia Treatment
• Now
Amblyopia Treatment
• Then and now
Amblyopia Treatment
Age group: Up to 2 ½ years of age (and/or when vision test cannot be relied on):
Fixation pattern Amount of occlusion Review timeAlternating squint or
Holding fixation}No occlusion indicated Review 6 – 12 weeks
Taking up fixation quickly Observe Review 6-12 weeksTaking up fixation slowly Consider 2 hours occlusion daily Review 4-6 weeks
Not taking up fixation Consider inverse occlusion See separate guidelines (section 10.3)
Age group: 2 ½ years to 5 ½ years of age:
VA Amount of occlusion Review timeVA better than 0.6 LogMAR 2-4 hours Review 6-8 weeks
VA less than 0.6 LogMAR 4-6 hours Review 4-6 weeks
Age group: 5 ½ years of age and upwards:
VA Amount of occlusion Review timeVA better than 0.6 LogMAR 2-4 hours Review 6 weeks
VA less than 0.6 LogMAR Consider up to 6 hours occlusion per day dependant on other clinical
considerations i.e. density of suppression, area of fixation,
behaviour of child, parental views etc
Review 2 weeks
Amblyopia Treatment
• Atropine
Amblyopia TreatmentVisit Date VA Test
UsedPrescribed
Daily Occlusion from Last
Visit
Average Actual Daily Occlusion
Total Actual Hours of
Occlusion Since Last
Visit
Prescribed Daily
Occlusion
Reason Occlusion Stopped
Orthoptist
R L
1
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4
5
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8
Thank you
