Occlusion and refractive correction are more effective than refractive correction alone in strabismic amblyopia

Clinical question: 
What is the most effective treatment for strabismic amblyopia (lazy eye caused by squint)?
Bottom line: 
Occlusion, while wearing necessary refractive correction, appears to be more effective than refractive correction alone in the treatment of strabismic amblyopia. Combining occlusion and refractive correction with near activities may be more effective than occlusion and refractive correction alone. No adverse events were described in either trial.
Caveat: 
The follow-up periods for the 2 trials were short – 4 and 5 weeks, respectively. The trial showing some additional benefit from carrying out near activities with occlusion and refractive correction was only a pilot, and so included a small number of participants (20). No trials were found that assessed the role of either partial occlusion or optical penalisation with refractive correction for strabismic amblyopia.
Context: 
Amblyopia is reduced visual acuity in one or both eyes in the absence of any demonstrable abnormality of the visual pathway. It is not immediately resolved by the correction of refractive error. Strabismus develops in approximately 5 per cent to 8 per cent of the general population.¹ 1. Rowe F. Clinical Orthoptics. 2nd edn. Oxford: Blackwell Publishing Limited, 2004.
Review CD#: 
CD006461
PEARLS No: 
99
Date: 
September, 2008
Authored by: 
Brian R McAvoy