alexa The emotional impact of amblyopia treatment in preschool children: randomized controlled trial.
Ophthalmology

Ophthalmology

Optometry: Open Access

Author(s): Hrisos S, Clarke MP, Wright CM, Hrisos S, Clarke MP, Wright CM

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Abstract PURPOSE: To investigate the emotional status of children undergoing active treatment for amblyopia. DESIGN: Postal survey, in the context of a prospective, multicenter, randomized controlled trial. PARTICIPANTS: Parents of 177 children with a unilateral visual impairment referred from preschool vision screening. The children had been recruited to a randomized controlled trial of treatment for unilateral visual impairment and randomly assigned to receive either glasses with or without patches, glasses alone, or treatment deferred for 1 year. METHODS: A self-completion questionnaire, including a psychometric behavioral scale, was sent to the parents of all children recruited to the trial at age 4 years, to 66 whose deferred treatment began at age 5 years, and finally to 151 remaining in the trial at the end of follow-up. MAIN OUTCOME MEASURES: Mean scores per treatment group on the Revised Rutter Parent Scale for Preschool Children. Comparison of parent responses to questions assessing the child's general well-being and difficulties associated with treatment. RESULTS: Completed questionnaires were returned for 144 of 177 (81\%) children at a mean age (standard deviation) of 48 months (5.0), for 45 of 66 (68\%) at a mean age of 61 months (5.8), and for 78 of 151 (52\%) at a mean age of 67 months (5.0). Most parents reported having difficulty with patching their child regardless of age (77\% at age 4 years and 73\% at age 5 years), with fewer reporting difficulties with glasses alone (42\% and 53\%, respectively). Children were significantly more upset by patching than by glasses only (chi-square test, P = 0.03 for age 4 years and P = 0.01 for age 5 years), as were the parents of 4-year-olds (chi-square test, P = 0.01). Most parents thought their children were happy, cooperative, and good tempered, and behavioral scores did not differ between treatment groups. CONCLUSIONS: Treatment for unilateral visual impairment is not easy to implement and is commonly associated with some degree of distress. Despite this, no impact on the child's global well-being or behavior was seen either during or after the treatment period. This article was published in Ophthalmology and referenced in Optometry: Open Access

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