Combined Vision Therapy, Conventional Treatment Effectively Treats Pediatric Unilateral Refractive Amblyopia

A little boy wearing glasses and an eye patch.
A little boy wearing glasses and an eye patch (plaster, occluder). Apes or grimaces. He undergoes vision treatment to prevent amblyopia and strabismus (squint, lazy eye). Child congenital vision disease problem.
Clinicians have traditionally believed that children older than age 7 are significantly less responsive to amblyopia treatment, according to a report.

Combining vision therapy with conventional treatment results in greater visual improvement and shorter duration of treatment compared with conventional treatment alone in children aged 7 to10 years with unilateral refractive amblyopia, according to a study published in BMC Ophthalmology.

Researchers conducted a retrospective study that included 36 children with unilateral amblyopia. They assigned patients to a case group (n=19), which received both vision therapy and conventional treatment, or a control group (n=17), which received conventional treatment. Conventional treatment consisted of corrective spectacle lenses and part-time patching of the weaker eye. Researchers measured visual acuity (VA) at baseline and at 3-month, 6-month, and 9-month visits. They assessed VA 3 months after cessation of treatment and administered follow-up exams within 6 to 12 months.

Mean VAs improved in both the case and control groups (0.39±0.24 logMAR to 0.10±0.23 logMAR, P =.001; 0.64±0.30 logMAR to 0.52±0.27 logMAR, P =.015, respectively), with a significantly greater improvement in the case group (P =.006). They detected no regression of VA in the case group 3 months after cessation of vision therapy. They did note, however, that combining vision therapy with conventional methods was not particularly useful in children with anisometropia greater than -10.0 D.

Investigators acknowledge that a particular challenge of employing this combined approach is that their pediatric patients “get tired and bored more frequently than adults. The scheduled training course might be interrupted unexpectedly. Moreover, vision therapy is similar to other types of therapy that involve learning and education. Motivation and interest influence the effect.”

Study limitations include a retrospective design, lack of randomization, and small sample size. 


Hsieh Y-C, Liao W-L, Tsai Y-Y, Lin H-J. Efficacy of vision therapy for unilateral refractive amblyopia in children aged 7-10 years. BMC Ophthalmol. 2022;22(1):44. doi:10.1186/s12886-022-02246-9