Shared Amblyopia Treatment Decision Making May Better Inform Caretakers

Shared amblyopia treatment decision making may enable caretakers of children with the disorder to guide clinicians with selecting the most appropriate treatment option, according to a qualitative study of parent perspectives published in Ophthalmic and Physiological Optics. The 2 treatment options discussed in the report, patching and dichoptic action video gaming, each possess distinct advantages and disadvantages, and parental involvement may determine which therapy is better suited for their child.

Researchers sourced data from the Patching or Gaming as Amblyopia Treatment randomized controlled trial (ClinicalTrials.gov Identifier: NCT03767985), which included children with amblyopia who were recruited from 5 clinics between 2017 and 2020. The team randomly assigned participants to patching for 2 hours per day, 7 days a week or dichoptic action video gaming for 1 hour per week for 24 weeks. A subset of parents from trial participated in semi-structured interviews detailing their experiences with patching (n=7) or dichoptic gaming (n=3).

The caretakers stressed the importance of shared amblyopia treatment decision making and reported that creating a routine was important for maintaining good compliance with both interventions. For patching, the parents endorsed selecting a specific time of day to wear the patch and for the gaming group, selecting a specific day of the week.

Each amblyopia therapy was associated with specific burdens, according to the report. The parents of children treated with patching reported a burden of enforcing treatment, since they performed this therapy outside of a clinical setting. Children who were treated with dichoptic gaming received this therapy in a clinical setting, alleviating this treatment-associated burden among their caretakers. However, the parents of children undergoing this therapy reported a burden of lengthy gaming sessions, which led to their child’s hesitation to undergo treatment.

Many parents reported that shared amblyopia treatment decision making would help them to select the best treatment for their child and alleviate misunderstandings concerning the role of refractive error in amblyopia and long-term outcomes of interventions. Some caretakers were unaware that their child would continue to wear glasses following treatment completion. The report shows that caretakers preferred more discussions with clinicians pertaining to treatment effects and effectiveness in order to better inform their treatment decision making.

“Parents reported the effect and efficiency of the treatment as the most important considerations when deciding on the type of amblyopia management for their children,” according to the researchers. “In addition, if parents were able to decide on the type
of amblyopia treatment, they would make their choice based on organizational aspects and their child’s traits. Overall, they wish to come to a shared decision with their
healthcare professional.”

Study limitations include a small sample size, particularly among individuals undergoing dichoptic video gaming therapy.