Anisometropic amblyopia: is the patient ever too old to treat?

Optom Vis Sci. 1992 Nov;69(11):866-78. doi: 10.1097/00006324-199211000-00006.


Amblyopia is an example of abnormal visual development that is clinically defined as a reduction of best corrected Snellen acuity to less than 6/9 (20/30) in one eye or a two-line difference between the two eyes, with no visible signs of eye disease. We describe a sequential management program for anisometropic amblyopia that consists of four steps: (1) the full refractive correction, (2) added lenses or prism when needed to improve alignment of the visual axes, (3) 2 to 5 h/day of direct occlusion, and (4) active vision therapy to develop monocular acuity and improve binocular visual function. We examined records of 19 patients over 6 years of age who had been treated using this sequential management philosophy. After 15.2 (+/- 7.7) weeks of treatment the Amblyopia Success Index (ASI) documented an average improvement in visual acuity of 92.1% +/- 8.1 with a range from a low of 75% by a 49-year-old patient to a maximum of 100% achieved by 42.1% of the patients (8 of 19). Patients who had completed therapy 1 or more years ago (N = 4) maintained their acuity improvement. From these results we conclude that following a sequential management plan for treatment of anisometropic amblyopia can yield substantial long-lasting improvement in visual acuity and binocular function for patients of any age.

MeSH terms

  • Adolescent
  • Adult
  • Amblyopia / therapy*
  • Anisometropia / therapy*
  • Child
  • Female
  • Humans
  • Male
  • Middle Aged
  • Optics and Photonics
  • Sensory Deprivation
  • Treatment Outcome
  • Vision, Binocular
  • Visual Acuity