Amblyopia therapy: Results at the giessen clinic

Abstract

Analysis of this group of 88 amblyopes permitted the following conclusions: (1) A positive family history of strabismus is probably the only historical fact implicated in the outcome of therapy. (2) A visual acuity of 0 1 or better at the start seems to be associated with a better out-come. Care must be taken in interpretation of these results. (3) It appears easier to achieve foveal fixation when fixation was in the region of the macula. Further study of this problem, particularly with regard to the latency of the foveal PVD, is indicated. (4) Amblyopes with high hypermetropia seem to have a poorer prognosis than other refractive groups. (5) Anisometropia in no way affects the outcome. (6) The duration of treatment was remarkably uniform, the mean being about 7-9 weeks regardless of the type of amblyopia. However, those with central inhibition were older and their spread or variance greater. This may have prolonged the duration of therapy in this group. (7) Both uniocular and binocular therapy was usually given. Some patients also had surgery designed to change eccentric fixation to foveal. (8) Success was achieved in 36, 23 regained foveal fixation, and 29 failed to derive any benefit. The problem of amblyopia is common (Downing, 1945; Helveston, 1965) but by no means simple. This survey of the patient population and results of the Giessen Clinic over a 2-year period shows that much time and intensive effort are required to treat amblyopia by pleoptics. The prolonged hospitalization, multiple daily therapy sessions, and combination of surgery with sensory training are departures from typical methods, but 41 per cent. of the patients reviewed achieved full vision and a further 26 per cent. recovered foveal fixation, while 33 per cent. gained no benefit.