Successful amblyopia therapy initiated after age 7 years - Compliance curves

Objective: To report successful therapy for anisometropic and strabismic am blyopia initiated after age 7 years. Methods: A consecutive series of 36 compliant children older than 7 years ( range, 7.0 to 10.3 years; mean, 8.2 years) at initiation of amblyopia thera py for anisometropic (19 patients; mean age, 8.3 years), strabismic (9 pati ents; mean age, 8.0 years), or anisometropic and strabismic (8 patients; me an age, 8.0 years) amblyopia was studied. Initial (worst) visual acuities w ere between 20/50 and 20/400 (log geometric mean, -0.83 [antilog, 20/134] f or all patients; -0.88 [antilog, 20/151] for anisometropic patients; -0.70 [antilog, 20/100] for strabismic patients; and -0.88 [antilog, 20/151] for anisometropic and strabismic patients). Initial (worst) binocularity was ab sent or reduced in all cases. Therapy consisted of (1) full-time standard o cclusion (21 patients; mean age, 8.0 years), (2) total penalization (7 pati ents; mean age, 7.8 years), or (3) full-time occlusive contact lenses (8 pa tients; mean age, 8.8 years). Results: Final (best) visual acuities were between 20/20 and 20/30 for all 36 patients. Final (best) binocularity was maintained or improved for 22 (6 1%) of 36 patients, including 16 anisometropic patients (84%), 2 strabismic patients (22%), and 4 anisometropic and strabismic patients (50%). Conclusion: Given compliance, therapy for anisometropic and strabismic ambl yopia can be successful even if initiated after age 7 years.