The importance of compliance

The importance of compliance
The importance of compliance

Probably most of the parents, if not all, who have a child diagnosed with amblyopia are facing or have been facing an important issue when it comes to amblyopia treatment. In the professional terminology it is referred to as ‘compliance’ of ‘adherence’ to the prescribed treatment.

Think of it as your kid were suffering from strep throat for instance. What would you do in this case? Normally, your doctor would prescribe an antibiotic which they would take every 12 hours for the next 7 days or so. And what you were going to do is to comply completely to the prescribed treatment. You would probably not even think of skipping a dose just for no reason. You would be afraid too much that the infection would spread to the middle ear or that an abscess would form in the throat.

Things are no different when it comes to adherence to the prescribed treatment in case of amblyopia. Or at least they should not be. Conversely, this is rarely the case. Indeed, many studies have shown that compliance to physicians’ prescribed treatment in case of amblyopia rarely exceeds 50%. Possibly, it has got to do with the fact that well majority of those kids function normally and so they, along with their parents do not feel the need to comply 100% to the prescribed therapy. The reasons for poor compliance also include uncertainty about the benefits of treatment, the child’s distress with the therapy, social aspects of eyepatch and the weak parental understanding of the condition, especially among those with low level of education and low income. Physicians as well as eye care providers should therefore raise the awareness of the amblyopia in general and particularly the importance of compliance to its treatment.

Whilst proper refractive correction is crucial in amblyopia treatment, and kids should strictly adhere to the use of corrective spectacles prescribed by physicians, the duration of occlusion (patching) that gives best results is less straightforward. Newer studies show that similar final outcomes can be achieved with less patching than previously thought and the dose-response relationship seems to plateau around 4 hours per day. Therefore, the physicians nowadays seldom prescribe patching for longer than several hours per day. Nonetheless, it does not mean that one should patch less that their doctor prescribes, as the ideal patching duration also depends upon patient’s age and amblyopia etiology. Generally, younger children will require less patching, and those that squint will need more, although these are general rules and may not apply to everyone. Your child’s physician will, according to their experience certainly know that is best for your kid.

Perhaps the most important aspect of amblyopia treatment then, is to stick to the prescribed treatment regime exactly the way you would stick to the antibiotic treatment in case of aforementioned strep throat infection. Strong compliance to the prescribed refractive correction and daily patching combined with active treatment options should bring the best results for your child.

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