Amblyopia Tx: 2 Flashcards
What is the most common type of occlusion used ? Which eye is occluded?
Direct occlusion
- non-amblyopic eye
This describes occluding the amblyopic eye. When do we use this?
Inverse occlusion
- to tx steady eccentric fixation
This is complete occlusion, no form perception.
Total occlusion
This is blurred form perception. What can we use to make this happen?
- partial occlusion
- use atropine
What are the 2 ways we can do total occlusion?
- Patches (Adhesive, Slip-on)
2. Occluding lenses (CLs)
What are 3 ways we can do partial occlusion?
- Occlusion lenses (overplus non amblyopic eye)
- Occlusion filters
- Atropine Penalization
How much patching is needed for moderate amblyopia? severe amblyopia?
- 2 hours with 1 hr of near work
- 6 hrs with 1 hr of near work
Are near activities beneficial while patching?
No huge difference when patient does near activities vs. distance activities
Will increased patching improve acuity in residual amblyopia?
Yes!
- if px is doing 2 hrs, increase to 6 hrs
How does atropine compare to patching?
- improvement in VA was similar to magnitude between the two tx groups
- compliance was better in atropine group
Does the VA improve faster with patching or atropine?
Patching
- but equal at 6 months
How frequent should atropine be put in the patient’s eyes?
Weekend atropine (one drop saturday and one drop sunday)
Does atopine + optical penalization (with specs) increase VA in amblyope?
no
What’s the best way to treat amblyopia in older patients (7-17)?
Treat with patching or atropine
- both showed similar improvement
Risk of amblyopia recurrence after cessation of treatment is 4x more common when __?
Patching of 6-8hours was stopped abruptly
- must ween off
What is better, bangerter filter or patching?
- Comparable
- filter is a reasonable option for initial therapy for moderate amblyopia
How did dichoptic stimulus vs. patching compare when treating amblyopia?
- VA improved w/ both tx
- but iPad tx is not as good as patching
Levodopa ATS 17 concluded whata?
Not recommend, no clinically significant change
Once the patient reaches their maximum acuity, how should we stop the tx?
Taper tx and monitor
How do you taper patching?
2hrs –> 1 hr/day x 6 wks –> every other day x wks –> stop
How do you taper atropine?
2 drops/wk –> 1 drop/wk –> stop
What 3 groups do we tx with VT?
- Older patients with amblyopia
- Younger patients w that plateau w/ patching
- Px with EF
What 3 ways can we tx EF?
- Haidinger’s brushes
- AI transfer (NRC)
- Fast Pointing
