Occlusion Therapy in Amblyopia With Eccentric Fixation

Abstract

Eccentric fixation was once considered to be a rare complication of long-standing strabismus. The improvement of our diagnostic armamentarium by instruments which permit direct observation of the fundus during fixation has revealed that amblyopic eyes frequently fixate with an extrafoveal area. While the diagnosis of this condition has become easy, its therapy remains the subject of controversy. Since the value of pleoptics as a practical method of completely curing amblyopia with eccentric fixation has yet to be established,¹ a reappraisal of conventional methods of occlusion is needed. Contradictory therapeutic methods advocated by various specialists often make it difficult for the ophthalmologist to decide which eye to occlude in a child with eccentric fixation. One group of authors^2-7 recommend occlusion of the amblyopic eye (inverse occlusion) and claim that occlusion of the sound eye after age 2 is not only useless but dangerous, and, therefore, contraindicated. Others^8-11 report