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Purpose:   To compare spectacles plus alternate-day patching for 8 hr or more with spectacles plus patching for 8 hr or more 6 days weekly to treat strabismic amblyopia 1 year after a 1-year randomized trial., Methods: Forty children (mean age, 4.3 years) participated. Refractive correction was provided. The children were assigned to alternate-day patching for 8 hr or more or patching for 8 hr or more daily 6 days weekly. VA, binocular function, and refractive errors were measured after 2 years. The main outcome measure was the median VA change in the amblyopic eye after 2 years., Results: The median VA change in the amblyopic eye at the 2-year visit was significantly (p = 0.0453) greater with alternate-day patching (0.8 log unit) versus patching daily 6 days weekly (0.6 log unit). The final median VA in the amblyopic eyes was 0.0 logMAR in the alternate-day patching group and 0.1 logMAR in the daily patching group. Binocular function improved with both treatments. The median spherical equivalent (SE) refractive error increased in the fellow eyes (alternate-day patching, p < 0.0001; patching daily 6 days weekly, p = 0.0033); no change was found in the amblyopic eyes in either group., Conclusions: The magnitude of the VA change 2 years after treatment with spectacles plus alternate-day patching for 8 hr or more was significantly greater than with spectacles plus daily patching for 8 hr or more 6 days weekly for strabismic amblyopia. However, the final median VA did not differ significantly between the two treatments., (© 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.)

Purpose: To describe the refractive and visual outcomes after surgery for congenital or developmental cataract in the Ukraine., Methods: Cataract surgery was performed in 65 children aged 3-15 years. The cataracts were bilateral in 44 children and unilateral in 21. Examinations, including visual acuity (VA) and objective refraction using retinoscopy, were performed preoperatively and at 1 day, 6 months and 2 years postoperatively. Neither occlusion therapy nor spectacles were prescribed., Results: Almost all children (96%) gained in VA. In all, 40% of the bilateral cases achieved a corrected Snellen VA > or = 0.5 and 44% of the unilateral cases obtained a corrected VA > or = 0.2. The difference between VA (logMAR) preoperatively and 2 years postoperatively was statistically significant (p < 0.05). The bilateral cases showed a postoperative reduction in mean astigmatism from 3.9 D (1 day postoperatively) to 0.6 D (2 years postoperatively) (p < 0.001), while the unilateral cases showed a reduction from 4.2 D (1 day postoperatively) to 0.4 D (2 years postoperatively) (p < 0.001)., Conclusion: Good postoperative VA was achieved in the group with bilateral cataract. Surprisingly, even in the group with unilateral cataract, an increase in VA was obtained, despite the lack of postoperative correction with glasses or occlusion therapy.

Background/aims: Prematurely born infants are known to have an increased rate of ophthalmological morbidity. The aim of the present study was to investigate visual acuity and ocular alignment in a population of preterm infants in a geographical area, in infants with and without retinopathy of prematurity (ROP)., Methods: A prospective population based study of ophthalmological status of preterm infants with a birth weight of 1500 g or less was performed during 3.5 years, with examinations at 6, 18, 30, and 42 months of corrected age. Visual acuity was tested using linear optotypes. Multiple regression analyses were used to analyse independent risk factors for poor vision and strabismus., Results: Poor vision (< 0.3) was detected in 2.5% (6/237) of the children. Of these, only two (0.8%) had a severe visual impairment (< 0.1). Strabismus occurred in 13.5% (31/229). Children with cryotreated ROP and neurological complications ran the highest risk of poor vision and strabismus, according to multiple regression analysis. Among children without a history of ROP or neurological complications, 34% had a visual acuity < 0.7 and 5.9% had strabismus, compared with 61% and 22%, respectively, among the children with ROP or neurological complications., Conclusions: The overall incidence of subnormal vision and strabismus in children born prematurely was higher than in a full term population of the same age. On the basis of this study, follow up of all preterm infants screened for ROP is recommended and general guidelines are suggested.

Several studies have indicated that operation during the first months of life in children with dense congenital cataract improves the final visual acuity. In the current study seven otherwise healthy children operated on before the age of fifty-six days are compared with seven children operated on after the age of three months. The patients were followed by a team consisting of a paediatric ophthalmologist, a contact lens optician and an orthoptist. They were treated with contact lenses, spectacles with near addition and occlusion therapy when needed. Visual acuity was initially tested with preferential looking technique and later with Snellen optotypes. In the early treated group the visual development was almost normal with a final visual acuity of 20/20, while in the late treated group no patient obtained better visual acuity than 20/100. The findings indicate that dense congenital cataract should be treated before the age of three months.