In a 3-year-old child with amblyopia treated by occlusion therapy (patching), what is the recommended maximum hours per day of patching for severe amblyopia (visual acuity 6/60 or worse)?

• A 2 hours per day
• B 4 hours per day
• C 6 hours per day ✓
• D 10 hours per day

Explanation

The Pediatric Eye Disease Investigator Group (PEDIG) amblyopia studies established that for severe amblyopia (20/100 to 20/400, equivalent to 6/30 to 6/120), patching 6 hours per day is as effective as full-time patching. The PEDIG Amblyopia Treatment Studies showed 6 hours of prescribed patching produces improvement comparable to more intensive regimens for severe amblyopia in children under 7 years. This is the standard evidence-based recommendation.

Reference: Pediatric Eye Disease Investigator Group Trials, cited in Kanski, 9th ed.

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