RT Journal Article SR Electronic T1 Refractive adaptation in amblyopia: quantification of effect and implications for practice JF British Journal of Ophthalmology JO Br J Ophthalmol FD BMJ Publishing Group Ltd. SP 1552 OP 1556 DO 10.1136/bjo.2004.044214 VO 88 IS 12 A1 Stewart, C E A1 Moseley, M J A1 Fielder, A R A1 Stephens, D A YR 2004 UL http://bjo.bmj.com/content/88/12/1552.abstract AB Aim: To describe the visual response to spectacle correction (“refractive adaptation”) for children with unilateral amblyopia as a function of age, type of amblyopia, and category of refractive error. Method: Measurement of corrected amblyopic and fellow eye logMAR visual acuity in newly diagnosed children. Measurements repeated at 6 weekly intervals for a total 18 weeks. Results: Data were collected from 65 children of mean (SD) age 5.1 (1.4) years with previously untreated amblyopia and significant refractive error. Amblyopia was associated with anisometropia in 18 (5.5 (1.4) years), strabismus in 16 (4.2 (0.98) years), and mixed in 31 (5.2 (1.5) years) of the study participants. Mean (SD) corrected visual acuity of amblyopic eyes improved significantly (p<0.001) from 0.67 (0.38) to 0.43 (0.37) logMAR: a mean improvement of 0.24 (0.18), range 0.0–0.6 log units. Change in logMAR visual acuity did not significantly differ as a function of amblyopia type (p = 0.29) (anisometropia 0.22 (0.13); mixed 0.18 (0.14); strabismic 0.30 (0.24)) or for age (p = 0.38) (“under 4 years” 0.23 (0.18); “4–6 years” 0.24 (0.20); “over 6 years” 0.16 (0.23)). Conclusion: Refractive adaptation is a distinct component of amblyopia treatment. To appropriately evaluate mainstream therapies such as occlusion and penalisation, the beneficial effects of refractive adaptation need to be fully differentiated. A consequence for clinical practice is that children may start occlusion with improved visual acuity, possibly enhancing compliance, and in some cases unnecessary patching will be avoided.