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Feasibility of a clinical trial of vision therapy for treatment of amblyopia.


ABSTRACT: We conducted a pilot randomized clinical trial of office-based active vision therapy for the treatment of childhood amblyopia to determine the feasibility of conducting a full-scale randomized clinical trial.A training and certification program and manual of procedures were developed to certify therapists to administer a standardized vision therapy program in ophthalmology and optometry offices consisting of weekly visits for 16 weeks. Nineteen children, aged 7 to less than 13 years, with amblyopia (20/40-20/100) were randomly assigned to receive either 2 hours of daily patching with active vision therapy or 2 hours of daily patching with placebo vision therapy.Therapists in diverse practice settings were successfully trained and certified to perform standardized vision therapy in strict adherence with protocol. Subjects completed 85% of required weekly in-office vision therapy visits. Eligibility criteria based on age, visual acuity, and stereoacuity, designed to identify children able to complete a standardized vision therapy program and judged likely to benefit from this treatment, led to a high proportion of screened subjects being judged ineligible, resulting in insufficient recruitment. There were difficulties in retrieving adherence data for the computerized home therapy procedures.This study demonstrated that a 16-week treatment trial of vision therapy was feasible with respect to maintaining protocol adherence; however, recruitment under the proposed eligibility criteria, necessitated by the standardized approach to vision therapy, was not successful. A randomized clinical trial of in-office vision therapy for the treatment of amblyopia would require broadening of the eligibility criteria and improved methods to gather objective data regarding the home therapy. A more flexible approach that customizes vision therapy based on subject age, visual acuity, and stereopsis might be required to allow enrollment of a broader group of subjects.

SUBMITTER: Lyon DW 

PROVIDER: S-EPMC3662294 | biostudies-literature | 2013 May

REPOSITORIES: biostudies-literature

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Feasibility of a clinical trial of vision therapy for treatment of amblyopia.

Lyon Don W DW   Hopkins Kristine K   Chu Raymond H RH   Tamkins Susanna M SM   Cotter Susan A SA   Melia B Michele BM   Holmes Jonathan M JM   Repka Michael X MX   Wheeler David T DT   Sala Nicholas A NA   Dumas Janette J   Silbert David I DI  

Optometry and vision science : official publication of the American Academy of Optometry 20130501 5


<h4>Purpose</h4>We conducted a pilot randomized clinical trial of office-based active vision therapy for the treatment of childhood amblyopia to determine the feasibility of conducting a full-scale randomized clinical trial.<h4>Methods</h4>A training and certification program and manual of procedures were developed to certify therapists to administer a standardized vision therapy program in ophthalmology and optometry offices consisting of weekly visits for 16 weeks. Nineteen children, aged 7 to  ...[more]

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