The purpose of this prospective randomised controlled trial was to compare outcomes of simultaneous (group A) vs sequential (group B) refractive correction and patching in the treatment of amblyopia. The trial included 70 patients aged mean 10.27 ±3.31 years overall (not significant between groups); 38 males and 32 females; split equally between groups. Anisometropic amblyopia was present in 40% and strabismic amblyopia in 60% (not significantly different between groups). Severity of mild, moderate and severe amblyopia, level of best corrected visual acuity (BCVA), esotropia/exotropia distribution, and angle of deviation at baseline, were not different between groups. At follow-up, both groups had significant improvement in BCVA – group A improvement of 1.40 Snellen lines and 1.34 for group B. Overall, there was no difference in BCVA outcomes regardless of treatment option with rate of improvement and treatment duration being similar. There was a significant change in stereoacuity between groups at follow-up, being higher attainment in group B (165.74” vs 512.3”). It is possible that brief daily periods of occlusion might interfere with binocular vision and hinder improvement of stereopsis. The authors suggest that children, who initially lack stereopsis, could benefit from full-time glasses wear without occlusion, as this may promote the recovery of stereopsis through uninterrupted spectacle correction.
