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      Occlusion Therapy for the Treatment of Amblyopia: Letting the Parents Decide

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          Background: Compliance with prescribed occlusion therapy is a significant problem in the treatment of amblyopia. Parental preference for a particular type of occlusion treatment has not been previously addressed. Unless parental views are taken into account when planning therapy, compliance may be poor and treatment may fail. Subjects and Methods: Parents of children with strabismic and/or anisometropic amblyopia who were due to start or had already had occlusion treatment were included in this study. Group A comprised parents of children who had no previous experience of occlusion, and group B comprised parents of children who had previous experience of occlusion therapy. Parental preferences regarding occlusion therapy were investigated by way of a questionnaire, in which they were asked whether they would prefer part-day/full-week occlusion or all-day/part-week occlusion so that the total number of hours of occlusion per week was the same. Results: One hundred parents completed the questionnaire, 47 from group A and 53 from group B. A significant number of parents in group A (95.3%) who had no previous experience with occlusion preferred part-day/full-week occlusion (p < 0.001), whereas there was no such preference among parents who had experience with occlusion, that is only 54.3% of parents in group B showed a preference for part-day/full-week occlusion (p = 0.1). The reasons given by the parents for their preferences varied but were in keeping with their lifestyles so that the type of occlusion regimen chosen by the parents was in accordance with the reasons given for their choice. Conclusion: Parental preferences should be considered when occlusion therapy is planned if compliance is to be improved. For maintenance occlusion, it would be reasonable to prescribe the number of hours of occlusion required per week and allow parents the responsibility to implement the pattern of occlusion according to their circumstances – the implied restriction ensuring that the number of hours of occlusion per week is met. Although parents appeared to have preconceived ideas before the commencement of treatment, their preferences changed once treatment had begun.

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          Most cited references 2

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          Parental non-concordance with occlusion therapy

           D Newsham (2000)
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            Electronic monitoring of treatment compliance in patching for amblyopia.

            We developed a coinsized occlusion dose monitor (ODM) to measure compliance with patch-wearing during the treatment of amblyopia objectively. It measures the temperature difference between the front and back of the ODM every 2-5 minutes by means of two thermistors. The data is stored in EEPROM memory and read out after recording for a week by connecting it to a PC. The ODM measures 35x23x4 mm and weighs 6 g. The back of the ODM is glued to the front of the amblyopia patch with double-sided Scotch tape. When the patch with the ODM is on the eye, the temperature at the back of the ODM is higher than at the front. Compliance is being studied in children taking part in a large amblyopia cohort study. The parents were instructed during home visits every three months to put the ODM on the patch. After a week, the ODM was collected and read out. Although the parents knew that a recording was being made, compliance was mediocre in many cases. Children were patched infrequently, for 5 minutes only, for long periods on the last days of the recording, at night, etc. Diaries detailing patch time were unreliable.

              Author and article information

              S. Karger AG
              December 2002
              10 January 2003
              : 216
              : 6
              : 426-429
              aBirmingham and Midland Eye Centre, City Hospital, Birmingham, bSouthport Eye Unit, Southport, cDepartment of Ophthalmology, Derby Royal Infirmary, Derby, and dDepartment of Ophthalmology, Royal Liverpool Children Hospital, Liverpool, UK
              67541 Ophthalmologica 2002;216:426–429
              © 2002 S. Karger AG, Basel

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              Page count
              Tables: 2, References: 12, Pages: 4
              Original Paper · Travail original · Originalarbeit

              Vision sciences, Ophthalmology & Optometry, Pathology

              Amblyopia, Acceptance, Compliance, Occlusion, Strabismus


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