Search

One hundred and two patients with anisohypermetropic amblyopia without strabismus were studied. Microstrabismus was excluded by detailed orthoptic examinations including visuscopy and Cüppers' bifoveal correspondence test. Treatment consisted in wearing correcting glasses and part-time or full-time patching of the nonamblyopic eye. In patients with dense amblyopia patching of the amblyopic eye was done and Cüppers' after-image method of pleoptic therapy was instituted as the initial procedure. When visual acuity improved sufficiently by this therapy, patching was used on the nonamblyopic eye. Sixty-five (63.7%) patients showed 2 lines or more improvement on the Snellen chart. Though young children (6 to 12 years) improved their visual acuity more often than those aged 13 to 20 years, a considerable number of patients (50.0%) in the older age group improved their visual acuity after therapy. The improvement in visual acuity was accompanied by improved stereoacuity in 49.0% of the patients. It is therefore suggested that every effort should be made to treat these patients even after the age of 12 years.

One hundred seventy-two consecutive cases of pure anisometropic amblyopia have been studied. Of them 167 were anisohypermetropic and five of them were anisomyopic. The majority of the cases (65.1%) were teenagers. A difference of 1 to 2 diopters between the two eyes formed the single largest group comprising 28.5% cases. Amblyopia was dense and the fixation was foveal in majority of the cases. Statistical analysis of the data revealed that the age at presentation has no relationship to the degree of anisometropia. The higher the age at presentation the greater is the depth of amblyopia. A higher degree of anisometropia is associated with a more severe degree of amblyopia. Persons with a lesser degree of anisometropia are more likely to have fixation at or near the fovea than persons with higher degree of anisometropia. There is a significant association between the age at presentation and the eccentricity of fixation. The farther the fixation is from the fovea the greater is the loss of vision.

Fifty-five patients with amblyopia in unilateral high myopia without strabismus were treated. Thirty-two (58%) had a visual improvement by two lines or more on the Snellen chart and 17 (31%) attained a final visual acuity of 6/12 or better. In patients with pretreatment corrected vision of 6/60 or better in the amblyopic eye treatment consisted of full-time occlusion of the good eye, in some cases supplemented by the after-image method of pleoptic exercises in the amblyopic eye. Overall improvement of vision in this group was 72.7%. Occlusion of the good eye combined with pleoptic exercises in the amblyopic eye had no advantage over simple occlusion of the good eye. In patients with pretreatment corrected vision worse than 6/60 in the amblyopic eye occlusion of the amblyopic eye was done and the after-image method of pleoptic exercises was instituted. Improvement of vision in this group was 36.3%. The study showed that it is worth the trouble to treat this disorder even after the age of 14 years and stresses the utility of pleoptic therapy in older patients with severe amblyopia.