To investigate the clinical features of patients with decreased visual acuity (VA) of the dominant eye as compared to that of the amblyopic eye during occlusion therapy.

The authors analyzed clinical features of 28 patients with VA reversed between the two eyes during occlusion therapy among 500 patients treated with occlusion therapy under the diagnosis of monocular amblyopia.

Twenty-one patients with strabismic amblyopia (SA), five patients with anisometropic amblyopia (AA) and two patients with combined amblyopia (CA) were enrolled in the present study. Decreased VA of the dominant eye as compared to that of the amblyopic eye occurred 66.75 ± 83.63 weeks after the onset of occlusion therapy. Reversion of VA between both eyes occurred during amblyopia treatment in 17 patients and during maintenance therapy in 11 patients. The reversed VA was recovered in all patients. The mean duration (MD) of reversed VA was 15.00 ± 24.43 weeks, and the number of clinic visits (CV) was 4.68 ± 8.65. In five patients, the MD of reversed VA (59.80 ± 30.14 weeks, p = 0.016) and the number of CVs (18.40 ± 14.48, p < 0.001) were significantly longer than those of the other 23 patients (MD of reversed VA: 5.78 ± 4.04 weeks, number of CV: 1.70 ± 1.22); those five patients had low compliances and SAs.

Visual acuity was recovered in all patients with decreased VA of the dominant eye as compared to that of the amblyopic eye during occlusion therapy, rapid recovery was observed in most patients except in several patients with low compliance.