Impact of patching treatment on quality of life among children with amblyopia in Gaza Strip, Palestine

Abstract Background: Eye patching treatment affects the health-related quality of life of children with amblyopia. However, the extent of this effect in Gazan children with amblyopia remains unknown. This study evaluated the effect of patching on the health-related quality of life in Gazan children with unilateral or bilateral refractive amblyopia. Methods: This cross-sectional study was conducted at Gaza Ophthalmic Hospital, Gaza Strip, Palestine, from September ۲۰۱۹ to October ۲۰۲۰ with adherence to the standard operating procedures of the coronavirus pandemic. Children with refractive amblyopia who completed patching therapy with a successful outcome were recruited. After patching therapy was completed, the parents completed an ۱۸-item parental Amblyopia Treatment Index (ATI) questionnaire via telephone. Results: Twenty-four children having ۳۶ eyes with refractive amblyopia and a mean (standard deviation) age of ۷.۶ (۱.۸) years were included. Children underwent ۲ h or ۲–۶ h of daily patching for ۱۲ or ۱۷ weeks. The mean values for total ATI score, adverse effects subscale, difficulty with compliance subscale, and social stigma subscale were ۲.۶, ۲.۶, ۲.۷, and ۲.۹, respectively, indicating that part-time patching was mostly accepted and had less impact on health-related quality of life. Treatment compliance was high; children complained at the time of patch application but did not pay attention to the patch once it was in place. In most children, the patch caused no adverse effects related to physical activities such as fun activities, learning, writing or drawing, visualizing, or playing with toys. Social stigma due to patch complications or different perceptions was not a concern. However, the perceptions of others were a major concern (n = ۱۹, ۷۹.۲%). No significant association was found between the overall ATI score or the score of any of the subscales (adverse effects, difficulty with compliance subscale, or social stigma) and the child’s age, sex, number of lines improved in visual acuity of the amblyopic eye, severity of amblyopia, laterality, or treatment period (all P > ۰.۰۵). Conclusions: The ATI questionnaire score and its three subscales revealed that the quality of life among Gazan children with refractive amblyopia was less affected by the part-time patching treatment. In the future, the ATI questionnaire could be used with various treatment modalities and types of amblyopia in the same setting to provide more practical guidelines on the management of amblyopia. Keywords: children parent amblyopias health-related quality of life hrqol questionnaire Gaza strip