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Volume 46, 1996, p. 111117

Occluder Contact Lens Tolerance in Noncompliant Patients with Amblyopia (Abstract)
C. Gail Summers, M.D., and James E. Egbert, M.D.

Amblyopic children who are noncompliant with an occlusive patch are at risk for permanent loss of vision. We studied tolerance with an occluder contact lens as an alternative for amblyopia therapy in children who were resistant to conventional methods of amblyopia management. This retrospective study identified 24 consecutive patients with amblyopia who had been noncompliant with traditional amblyopia therapy, and were fit with black soft contact lenses over their preferred eyes. Tolerance required that the child wore the occluder contact lens as prescribed for at least one month. Thirteen of these amblyopic patients were tolerant of wearing the occluder contact lens for a mean duration of 13 months. No ocular complications occurred. Eleven children were noncompliant with the occluder contact lens due to parental difficulty with insertion and removal and/or patient manipulation of the lens. Noncompliant patients more frequently showed structural abnormalities that limited visual potential (P = .082). The occluder contact lens may be tolerated by a child who is noncompliant with other methods of treatment. This method of penalization has the potential to improve vision in an amblyopic eye when other methods of therapy have failed to produce compliance.