Defining and measuring treatment outcome in unilateral amblyopia

Abstract

Aim: To offer a critique of current methods of defining amblyopia treatment outcome and to examine alternative approaches. Method: Literature appraisal and descriptive case presentations. Results: Currently, the outcome of amblyopia treatment is expressed as the number of acuity chart lines gained or, alternatively, achievement of an arbitrarily adopted level of visual acuity. As binocular vision is optimised with equal visual input from each eye the authors propose that the optimum outcome of amblyopia therapy is to achieve a visual acuity in the amblyopic eye equal to that of its fellow. In addition, improvement should be graded as the proportion of change in visual acuity with respect to the absolute potential for improvement (that is, that pertaining in the fellow eye at end of treatment). Conclusions: There are two methods of appropriately describing the outcome of amblyopia treatment: firstly, by the difference in final visual acuity of amblyopic and fellow eye (residual amblyopia); secondly, the proportion of the deficit corrected.