A comparative study on combination therapy of occlusion and h.b.stimulation v/s occlusion alone in management of amblyopia in 5 to 16 years children of kamrup(metro) district of assam, a north-eastern state of india

Introduction: Amblyopia is one of the most common causes of visual impairment in children.Conventional treatment of amblyopia by patching of sound eye fails due to poor patient compliance. Hence, Alternative technique of minimal occlusion with H.B.stimulation of amblyopic eye has been studied.
Aims And Objectives: To compare efficacy of combination therapy of occlusion in good eye andH.B.stimulation in amblyopic eye v/s occlusion therapy alone in 51 patients in the age group of 5 to 16 years of Kamrup(Metro) district of Assam.
Materials And Methods: A prospective study of 51 amblyopic children in the age group of 5 to 16 years collected from a cross sectional study, carried out in Government and private schools of Kamrup (Metro) district of Assam, during the academic session 2013-15 from the period September, 2013 to August, 2015 who were treated and followed up in a tertiary care hospital in Guwahati were divided into2groups.1group received patching of the good eye,H.B.stimulation of the amblyopic eye with synoptophore,and the other group received patching of good eye alone.The Va of B/E recorded each time. All children were regularly examined every3months by the same ophthalmologist. The compliance of each patient was reassessed and adjusted. At the end of the schedule, Va of the amblyopic and the good eyes were measured plus the binocularity of B/E was recorded as the main outcome measurement.
Results: Out of 12104 students screened, 845(7.0%) had refractive errors. Prevalence of amblyopia was found to be 98(0.81%). However, only 51 had undergone treatment and could be followed up for the said period(duration of the study was 2yrs). Final BCVA were between6/6and6/12for 44 cases of 51cases (90%). Final best binocularity was maintained in 38 of 51 patients (60%), including20 anisometropic patients,7 pseudophakic patients,13strabismic patients and11combined group patients.
Conclusion: Combination therapy of minimal occlusion in good eye and H.B.stimulation of the amblyopic eye was better than occlusion of the good eye alone, based on visual acuity and compliance of the patient.