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Full-time occlusion for amblyopia has low strabismus risk, study finds

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WASHINGTON — Children who undergo full-time occlusion for amblyopia have minimal risk of developing strabismus, said Scott E. Olitsky, MD, in a presentation here.

“Some ophthalmologists are reluctant to patch full-time in patients with normal alignment because of the perceived risk of inducing strabismus. We have found this risk to be very minimal,” Dr. Olitsky said at the American Association for Pediatric Ophthalmology and Strabismus meeting.

In a retrospective study, researchers reviewed the charts of 701 patients at Children’s Mercy Hospitals of Kansas City, Mo., who received full-time occlusion therapy for anisometropia and amblyopia.

At the time of therapy, 329 children had concurrent strabismus. The remaining 372 patients were followed for subsequent strabismus development. Patients whose deviation rose above 10 PD were considered to have strabismus.

Only five (1.3%) of 372 patients developed strabismus during occlusion therapy. In three of these patients, the strabismus resolved after treatment. Two patients required muscle surgery after large deviations did not improve.

Dr. Olitsky said tailoring treatment to each patient’s needs is essential for effective amblyopia management.