The emotional impact of amblyopia treatment in preschool children: randomized controlled trial

Ophthalmology. 2004 Aug;111(8):1550-6. doi: 10.1016/j.ophtha.2003.12.059.


Purpose: To investigate the emotional status of children undergoing active treatment for amblyopia.

Design: Postal survey, in the context of a prospective, multicenter, randomized controlled trial.

Participants: Parents of 177 children with a unilateral visual impairment referred from preschool vision screening. The children had been recruited to a randomized controlled trial of treatment for unilateral visual impairment and randomly assigned to receive either glasses with or without patches, glasses alone, or treatment deferred for 1 year.

Methods: A self-completion questionnaire, including a psychometric behavioral scale, was sent to the parents of all children recruited to the trial at age 4 years, to 66 whose deferred treatment began at age 5 years, and finally to 151 remaining in the trial at the end of follow-up.

Main outcome measures: Mean scores per treatment group on the Revised Rutter Parent Scale for Preschool Children. Comparison of parent responses to questions assessing the child's general well-being and difficulties associated with treatment.

Results: Completed questionnaires were returned for 144 of 177 (81%) children at a mean age (standard deviation) of 48 months (5.0), for 45 of 66 (68%) at a mean age of 61 months (5.8), and for 78 of 151 (52%) at a mean age of 67 months (5.0). Most parents reported having difficulty with patching their child regardless of age (77% at age 4 years and 73% at age 5 years), with fewer reporting difficulties with glasses alone (42% and 53%, respectively). Children were significantly more upset by patching than by glasses only (chi-square test, P = 0.03 for age 4 years and P = 0.01 for age 5 years), as were the parents of 4-year-olds (chi-square test, P = 0.01). Most parents thought their children were happy, cooperative, and good tempered, and behavioral scores did not differ between treatment groups.

Conclusions: Treatment for unilateral visual impairment is not easy to implement and is commonly associated with some degree of distress. Despite this, no impact on the child's global well-being or behavior was seen either during or after the treatment period.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Affective Symptoms
  • Amblyopia / psychology*
  • Amblyopia / therapy*
  • Child Behavior / psychology*
  • Child Development
  • Child, Preschool
  • Emotions*
  • Eyeglasses*
  • Family / psychology
  • Female
  • Humans
  • Male
  • Orthoptics / methods
  • Prospective Studies
  • Sensory Deprivation*
  • Stress, Psychological / psychology
  • Surveys and Questionnaires