BMJ  2004;328:348 (7 February), doi:10.1136/bmj.328.7435.348-a

Letter

Treatment of unilateral visual impairment on preschool vision screening

Study leaves questions unanswered

The first 150 words of the full text of this article appear below.

EDITOR—Clarke et al provide evidence that deferring treatment for amblyopia from age 4 to 5 is not harmful as visual acuity remains the same after treatment.1 Deferring makes it easier to target the population, mobilise resources, and motivate children to wear glasses and patches. They also recommend that fewer children need patching. Hence, it is an important article that could change current practice.

The efficacy of patching, however, depends on several variables such as total duration of patching, severity of amblyopia, initial visual acuity, the cause of amblyopia, and compliance.2 3

Although two thirds of the children for whom patching was advised wore patches for a mean of 20 weeks, the paper is not clear about the number of hours advised daily and the compliance. Cleary showed that maximal improvement occurs in response to 400 hours of occlusion wear or less, and to full time occlusion.3 She defines full . . . [Full text of this article]

Hirekatur V Srinivas, ophthalmologist

Aditya Eye Clinic, Bangalore 560 050, India srinivashv@excite.com


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