Assessing interventions to increase adherence to patching treatment in children with amblyopia: a systematic review

Abstract

Background: Amblyopia or “lazy-eye†is the most common disease affecting visual acuity in childhood. It is a serious condition leading to increased risk of blindness and left untreated it will not resolve itself. Occluding the good eye with a patch is a highly effective treatment if carried out before age 7 but adherence is a major problem. This systematic review addresses the question: How effective are existing interventions at increasing adherence to patching treatment in amblyopic children? Methods: Electronic searches were carried out in June 2014 to identify studies that reported primary data on an intervention to increase patching adherence. Data screening, extraction and quality ratings were performed independently by two researchers. Findings: Nine papers were included in the review. Interventions including an educational element (5) increased patching adherence and had higher quality ratings than interventions that changed aspects of the patching regime (3) or involved supervised occlusion (1). Discussion: Interventions to increase patching should include educational elements. Future research should assess additional behaviour change strategies and qualitative research is needed to understand patching from the child’s perspective.