International Clinical and Medical Case Reports Journal (ISSN: 2832-5788) | Volume 4, Issue 3 | Research Article | Open Access DOI
Sameera Irfan*
Sameera Irfan1*, Hina Irfan Ahmed2
1Envision Squint & Oculoplastics Centre, 515, K Block, Johar Town, Lahore, Pakistan
2Georgia Institute of Technology, Atlanta, USA
*Correspondence to: Sameera Irfan
Fulltext PDFThis prospective, interventional study was conducted to determine whether full visual recovery and/or shift of retinal fixation locus was possible in severe unilateral amblyopia with eccentric fixation.
Methods: 59 consecutive cases between the ages of 7 and 31 (median 19 years) were included. After wearing refractive correction for 12-16 weeks, further visual improvement stopped, and 16 cases dropped out of the study. 43 cases completed the study and were treated with refractive glasses, full-time occlusion of the good eye during all waking hours, and active stimulation of the amblyopic eye by studying books for 6 hours daily. Once further visual improvement stopped, they were made to study through a pinhole in the center of the eyeglass of the amblyopic eye along with patching of the good eye.
Results: Visual acuity improved from 0.05-0.1 in all cases that strictly complied with full-time occlusion alone with an average statistical gain of 0.54 units (paired t-test). For those who complied with patching and pinhole therapy, the average improvement in visual acuity was 0.71 units with a confidence interval of 95%. Patching alone did not change the retinal fixation locus; however, combined patching and pinhole therapy had a statistically significant association (p-value less than 0.05) with retinal fixation with a confidence interval of 95%.
Conclusion: Pinhole therapy of the amblyopic eye combined with full-time occlusion of the good eye is a simple, economical, and efficient method to treat severe amblyopia with eccentric fixation. However, it solely depends upon good patient compliance, irrespective of a patient's age.
Amblyopia; Eccentric fixation; Pinhole therapy; Occlusion treatment
Sameera Irfan. Hina Irfan Ahmed. How Efficient Is Pinhole Therapy In Treating Severe Unilateral Amblyopia With Eccentric Fixation?. Int Clinc Med Case Rep Jour. 2025;4(3):1-14.