Childhood amblyopia breakthrough claimed

Wed 6th February 2008

New research has claimed that the length of time an eye patch is worn to combat childhood amblyopia can be significantly reduced without compromising the outcome of the treatment.

The study, published in the British Medical Journal (September 14), is the work of a group of researchers at City University, London, and was funded by the charity, Fight for Sight. City’s investigators consider the finding to be a breakthrough in the treatment of the condition, commonly known as ‘lazy eye’.

To date, amblyopia patients wear an eye patch on the good eye to make the affected eye work harder but the optimal time needed for this treatment has not been known. This has resulted in many children wearing a patch for up to 12 hours a day, in some cases for several years.

This new research discovered that current treatment can be reduced; most children only need to wear an eye patch for just three to four hours a day for 12 weeks to produce the desired improvement in vision.  Longer and more intense doses were shown not to confer additional benefit, the research team, which is based at the university’s Department of Optometry & Visual Science, discovered.

Using an occlusion dose monitor (ODM, ‘intelligent’ eye patch) researchers were able to record how many hours the patch was actually worn by the child. These findings are significant because children often do not like wearing patches so compliance with the prescribed dose is a major problem.

Michele Acton, chief executive of Fight for Sight, said: “This is great news for children with amblyopia and their parents.  Wearing eye patches can be stressful and anything that reduces the time they need to be worn whilst still being effective is to be welcomed.

“We are delighted to have been able to fund this research, which will make a real difference to the lives of children affected by amblyopia.”
Dr Catherine Stewart, research fellow at City University’s Department of Optometry & Visual Science who led the research, said: “Children and their parents may now have a more realistic expectation of how long treatment may take. We’re already seeing the impact of these findings on the treatment of amblyopia in the clinic.”

Amblyopia affects 2-3% of children in the western world and is characterised by poor vision and a squint, usually in one eye.  If the condition is left untreated there is a greater risk of blindness later in life.

The research project started in February 2002. It involved 80 patients recruited from St Mary’s Hospital, Paddington and Hillingdon Hospital, Middlesex, split equally into two randomised groups. One group was prescribed six hours of treatment a day; the other was prescribed 12 hours a day. Actual dosage, using the occlusion dose monitor ODM, was recorded to the nearest minute. The ODM consists of an eye patch which is fitted with two electrodes and is connected to a battery powered data logger that records the length of time the patch is fitted. This device was previously developed by the research team.
 

The team of researchers consisted of Dr Catherine Stewart, Professor Alistair Fielder and Dr Merrick Moseley from City University and Dr David Stephens from McGill University, Canada.

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