Sir,
I have read with interest the article of KH Park et al1.
It raises several questions:
The title gives the impression that the article is about the usual amblyopia observed in children with convergent strabismus. However, as we read on, we see that instead it deals with anisometropias and a few divergent strabismus, two of which are intermittent.
The discussion seems to imply that all amblyopias are alike, as the authors talk of a ‘critical period’, a term usually referring to the period in which treatment of amblyopia with convergent strabismus may be successful.
In amblyopia with convergent strabismus, early detection and treatment are essential. Our group, PHORD (Forum d'Othopsie Renouvelee et Digitale) is at present experimenting early detection with digital cameras.
While clinical observations are always interesting, I fear that, by suggesting such a high rate of success in late treatment, this article could induce nonspecialists to continue occlusion on children with convergent strabismus longer than the period in which positive results may be obtained, with the risk of creating irreversible psychological damages.
References
Park KH, Hwang JM, Ahn JK . Efficacy of amblyopia therapy initiated after 9 years of age. Eye 2004; 18(6): 571–574.
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Franceschetti, A. Efficacy of amblyopia therapy initiated after 9 years of age. Eye 20, 122 (2006). https://doi.org/10.1038/sj.eye.6701805
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DOI: https://doi.org/10.1038/sj.eye.6701805