Sir,

I read with keen interest, the article titled ‘contact lenses in the management of high anisometropic amblyopia by Roberts and Adams.1 The authors pointed out that high anisometropic amblyopia is challenging to treat, and there is a good chance of improvement in visual acuity using contact lenses and occlusion in anosometropia of 6 diopter.2

In India, social and climatological circumstances make the wearing of contact lenses by children difficult, since most of our patients are from lower socioeconomic strata. These patients are commonly lost to follow-up, and are not available for timely examination of cornea and optical adjustments in contact lens wearing. We are of the opinion that in such cases, clear lens extraction with intraocular lens implantation is appealing, because most ophthalmologists use this procedure and good visual outcome can be achieved. Lyle and Jin2 achieved a visual acuity of more than 6/12 in 89% eyes with clear lens extraction and intraocular lens implantation. We also observed an improvement in visual acuity of more than two lines in 80% patients (unpublished data, JPOS, submitted).