The importance of compliance for lazy eye treatment

Girl wearing glasses.

Most 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 if your kid was 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 would do is comply completely with 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.

Adherence to treatment

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 the case of amblyopia rarely exceeds 50%. Possibly, it has got to do with the fact that the majority of those kids function normally and so they, along with their parents, do not feel the need to comply 100% with 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 an eyepatch and the weak parental understanding of the condition, especially among those with a low education level and low income. Physicians, as well as eye care providers, should therefore raise awareness of amblyopia in general and particularly the importance of compliance to its treatment.

While 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 the best results is less straightforward.

Corrective spectacles

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, physicians nowadays seldom prescribe patching for longer than several hours per day. Nonetheless, it does not mean that one should patch less than their doctor prescribes, as the ideal patching duration also depends on the 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 what 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 an antibiotic treatment in case of the 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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