Comments on: Comparison of the effectiveness of amblyopia treatment with eye-patch and binocular Occlu-tab for the same treatment duration

Dear Editor, With great interest, we read an article entitled “Comparison of the effectiveness of amblyopia treatment with eye-patch and binocular Occlu-tab for the same treatment duration” by Handa et al.[1] regarding comparison of the effectiveness of amblyopia treatment with conventional patching therapy and Occlu-tab, a binocular open-type amblyopia training device. We would like to congratulate the authors and also like to make some contributions. Reduced monocular visual acuity (VA) in children is most frequently caused by amblyopia, which is also linked to problems with accommodation, fixation, binocularity, vergence, reading speed, contrast sensitivity, and fine motor abilities.[2] Similar research on the use of partial occlusion therapy and occlude-pad therapy in children with refractive anisometropic amblyopia was conducted in India. Over a 3-month period, the authors had predicted a noticeable improvement in VA. Contrary to binocularity, it has not yet been established how binocularity stimulation therapy affects kids with persistent amblyopia.[3] However, they included a group of people who had failed patching therapy in their study because it was a key consideration. The authors should contemplate evaluating functional vision following the use of Occlu-pad therapy in residual amblyopia and during the course. It will help people comprehend eye care much better in view of amblyopia management. In the current study, VA was the only parameter assessed and compared between the two management approaches. One of the studies has reported that occlusion therapy for amblyopia (due to anisometropia, small-angle or intermittent strabismus, or a combination) showed a significant linear relationship between VA and stereoacuity.[4] Amblyopia is a common visual disorder among children that affects VA, stereoacuity, visual field, and contrast sensitivity. Concerning the above findings,[2–4] we think that the present study would have been of greater impact if the above-mentioned parameters (contrast sensitivity and stereoacuity) had also been evaluated and compared. Additionally, previous literature has reported deterioration of VA on cessation of amblyopia therapy after 1 year.[5] Similarly, Levartovsky et al.[6] found that deterioration of VA occurred in 46%, 79%, and 36% of patients in these three groups (strabismic, strabismic anisometropic, and anisometropic), respectively. VA was recorded in the study for 8 weeks (2 months); so, the study was also limited by the fact that it is not known if there will be deterioration of VA once the training is called off. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.