Alternate-day patching appears as effective as daily patching for treatment of amblyopia

This prospective study randomized 40 children(aged 4 to 5 years) with untreated monocular amblyopia to spectacles plus daily patching of the fellow eye (at least eight hours a day, six days a week; n=20), or spectacles plus fellow-eye patching on alternate days (at least eight hours a day; n=20).

After one year, median best-corrected visual acuity in the amblyopic eye improved from 0.7 to 0.1 logMAR in the daily occlusion group and from 0.9 to 0.1 logMAR in the alternate-day occlusion group and from 0.1 to 0.0 for the fellow eyes in both groups. Binocular function improved in both groups with no significant differences. Median spherical equivalent refractive error did not change significantly for the amblyopic eye in either group but did change significantly for the fellow eyes (from +2.00 to +3.00 for the daily group and from +2.50 to +2.88 for the alternate-day group).

The authors concluded that alternate-day patching might be a way to adjust occlusion treatment, especially in families in which daily occlusion may be problematic. However, because spectacles and patching were prescribed simultaneously without a period of refractive adaptation, the improvement in visual acuity may be, in part, secondary to wearing spectacle rather than patching therapy.