Failure to Attend Follow-up Is the Main Reason for Discontinuation of Amblyopia Therapy

Although parents reported good adherence to therapy, a new study published in the Indian Journal of Ophthalmology found that about 69% of pediatric patients had discontinued their amblyopia therapy during the COVID-19 pandemic. A failure to visit the hospital for a scheduled follow-up was found to be the primary reason for discontinuation.

Amblyopia is a “loss of vision in 1 or both eyes caused by conditions that impair the normal visual input during the period of development of vision,” with a prevalence of about 1.44% globally. The success of amblyopia treatment is partially determined by timely detection and early management. This study aimed to estimate the number of children who were lost to follow-up during the COVID-19 pandemic when they were being treated for amblyopia.

A tertiary eye care hospital in India was the setting of the study. Records from 2020 to 2021 of patients with amblyopia were used, with data on best corrected visual acuity, type of treatment, and duration of therapy extracted.

A team was trained to conduct interviews with parents of children with amblyopia by telephone; no one from the team was involved with patient treatment in the clinical practice. Demographics were collected from records and the interviewers asked 15 open-ended questions, with clarifications given as needed. Interviews were approximately 15 minutes long and collected information on adherence to treatment for amblyopia and date of follow-up. Patients lost to follow-up were asked for a reason.

A total of 78 parents who had brought their child to the hospital for amblyopia in 2020 and 2021 agreed to participate in the study. The mean (SD) age of the children with amblyopia was 10.17 (4.24) years and the duration of treatment was 2.20 (2.18) years. Amblyopia was most commonly identified in the left eye (51.2%) but bilateral ametropic amblyopia was also found in 15.3% of patients.

Occlusion therapy was the most common modality of treatment for amyopia, followed by computer vision therapy (23%) and combination therapy (5%). A total of 76% of parents reported adherence to treatment during the therapy period. However, 69% of parents reported that their child was not currently receiving treatment for amblyopia. A failure to follow up with the clinical practitioner was reported by the majority of parents (35%) as the reason that their child discontinued treatment. Children not being with their parents and treatment being hard for a child to follow were also given as reasons for discontinuation.

The researchers concluded that 69% of parents reported discontinuation of therapy for amblyopia during the COVID-19 pandemic, with dependency on regular guidance from follow-up visits hampered by an inability to visit their eye care practitioner.

Reference

Hegde N, C V, Bandamwar K, Murali K, Murthy SR. The impact of COVID-19 on compliance to amblyopia treatment in a tertiary eye care center. Indian J Ophthalmol. 2023;71(5):2105-2108. doi:10.4103/ijo.IJO_2135_22