The Psychological Impact of Amblyopia Treatment: A Systematic Literature Review
Haine L., Taylor I., Vaughan M. 2025. British & Irish Orthoptic Journal. DOI:
10.22599/bioj.426

Key FindingsHaine et al. highlight that psychological distress linked to amblyopia treatment is quite
common especially with patching in school-age children, and when strabismus or severe
amblyopia is present. The review suggests some practical, low-cost ways we can tweak our
orthoptic practice: routinely talking about psychosocial risks, offering atropine when
appropriate, using simple screening tools, linking families to school supports, having clear
mental health referral pathways, collecting child-centred outcome measures, and auditing
results. Taking these steps could boost adherence, improve the experience for children and
families, and possibly even enhance visual outcomes.
Strengths and Limitations
Strengths:
The review followed a rigorous systematic approach using PRISMA guidelines.
The literature search was thorough, spanning multiple databases and including
manual reference checks to catch any missed studies.
The quality of included studies was carefully assessed using an adapted Newcastle-
Ottawa Scale, giving a clear picture of the reliability of the evidence.
Limitations / Things to Keep in Mind:

The studies included were quite diverse in design, outcomes, ages, and cultural
context, which makes it hard to combine results quantitatively or generalise findings.

Most studies (16/25) relied on parent or caregiver reports rather than directly asking
children. Proxy reports can sometimes over or underestimate the child’s actual
experience.

The review shows associations between treatment and distress, but we can’t assume
treatment causes long-term psychological harm other factors may contribute.
Clinical Takeaways

In our practice, we already consider psychosocial factors when prescribing occlusion
treatment. Families are given options between patching and atropine when appropriate, and
we discuss likely visual outcomes as well as potential social or emotional impacts.

We routinely use reward charts, decorated patches, and communication with teachers to support
adherence.

One area we could enhance is introducing brief psychosocial screening questions at the first
visit, along with simple written or visual resources to help children and parents anticipate and
manage common reactions like embarrassment or peer attention. Doing this might help us
spot children at risk of distress earlier and provide more targeted support.
How do others approach psychosocial aspects of amblyopia treatment in their clinics? Are
there strategies or tools you’ve found particularly helpful?

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