Part-time Versus Minimal-time Patching for Amblyopia (Two v. Six Study)

A Randomized Trial Comparing Part-time Versus Minimal-time Patching for Moderate Amblyopia (Two v. Six)

Occlusion therapy with patching of the better (stronger) eye has been the mainstay of amblyopia treatment. However, opinions vary on the number of hours of daily patching that should be prescribed for moderate amblyopia, ranging from as little as 1 or 2 hours to 24 hours per day. To address this clinical issue, A NEI supported randomized clinical trial was conducted to compare 2 hours vs 6 hours of daily patching for moderate amblyopia (20/40 to 20/80) in children younger than 7 years (Repka MX Arch Ophthalmol 2003;121:603-11).

In addition to the patching, the parent was instructed to have the child spend at least 1 hour of patching time each day doing near visual activities such as crafts, coloring, tracing, cutting out objects, connecting the dots, hidden pictures and word finds, computerized video games, reading, written homework assignments, or other activities requiring eye-hand coordination.

To compare the benefit Two v. Six hour patching, visual acuity in the amblyopic eye was determined after 4 months.

The study found that amblyopia improved with both patching regimens and that there was no demonstrable advantage to the greater number of patching hours, either in the rapidity of improvement or in the magnitude of improvement after 4 months of treatment. The improvement in the visual acuity of the amblyopic eye from baseline to 4 months averaged 2.40 lines in each group.

Study Conclusion: When combined with prescribing 1 hour of near visual activities, 2 hours of daily patching appears to be as effective as 6 hours in treating moderate amblyopia in children aged 3 to 7 years. The shorter duration of patching may ease the implementation of patching therapy and monitoring of compliance for some parents.

Email to contact the study group: pedig@jaeb.org

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