View abstract

This abstract is assigned to session AOB FP

Title

Amblyopia with eccentric fixation: Is inverse occlusion still an option?

Purpose	To present a treatment protocol for patients with amblyopia and eccentric fixation who do not respond to conventional occlusion therapy.
Methods	In this consecutive case series 11 patients were included (age 3.5 to 5.0), all with mixed amblyopia and eccentric fixation, who had only minor improvement of their visual acuity (VA) despite good compliance after 6 hours/day to full-time occlusion of the dominant eye for at least 6 months (VA ranged from 6/120 to 6/15). Total inverse occlusion of the amblyopic eye was done for 4 to 8 weeks to convert the steady eccentric fixation into wandering fixation. No binocular viewing was allowed. Once the fixation became wandering, the dominant eye was occluded day and night and in most patients a red filter was placed before the amblyopic eye to stimulate foveal fixation. In 9 patients the fixation became central and occlusion of the dominant eye was continued without red filter. All children continued full-time occlusion until no further improvement of VA was noticed after 2 consecutive visits despite good compliance.
Results	In 9 children the VA improved to at least 6/9.5 in the amblyopic eye, the VA of the dominant eye did not change.
Conclusion	Inverse occlusion is still a valuable option if conventional occlusion appears to be insufficient to improve VA in amblyopic eyes with eccentric fixation. Full-time inverse occlusion should be done until the eccentric point loses fixation and should be followed again with full-time occlusion of the dominant eye. Placing a red filter before the amblyopic eye may be helpful to stimulate foveal fixation.
Conflict of interest	No

Authors 1

Last name	GODTS
Initials	DJM
Department	Afdeling Oogheelkunde, Universitair Ziekenhuis Antwerpen
City	Edegem