How can this new information be translated into practice? First, clinicians treating children with visual defects should use LogMAR acuity tests, as these enable more accurate interpretation of results by establishing and applying known normal ranges for different ages of children. Treatment should only be considered for those children who clearly fall outside the normal range for their age group.
If there is any significant refractive error, this should be corrected and the child left in the refractive correction for a period of 16-20 weeks before further treatment is considered. Parents and carers should then be offered an informed choice between occlusion and atropine drops or ointment. Occlusion regimes for strabismic and ani-sometropic types of amblyopia of more than 2 h patching a day, and lasting for more than 6 months,need to be carefully justified.A suggested scheme is shown in the flow diagram (Fig. 3.1).
Acknowledgements. The author would like to thank Sarah Richardson, Jugnoo Rahi and Philip Griffiths for reading drafts of this chapter and for their constructive comments.
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