Author Affiliations: Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou (Drs Zhao, Zhang, and Lam); Department of Ophthalmology and Visual Sciences (Drs Chen, A. H. Fan, Zhao, D. S. P. Fan, and Lam), Institute of Chinese Medicine (Drs Leung and Lam), the Chinese University of Hong Kong, Hong Kong; Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York (Dr Ritch); and the Department of Ophthalmology, New York Medical College, Valhalla (Dr Ritch).
We appreciate Dr Milsky's interest in our article,1 and we agree that there are concerns about the need for frequent visits for acupuncture, and that patching is easier. Patching is the benchmark treatment for amblyopia in older children. However, it has limitations such as issues of compliance, psychological effects, and interference to binocular function. Moreover, treatment results from patching alone are not optimal in some patients. It is therefore desirable to explore alternative treatment modalities for amblyopia. In our study, the results showed that treatment effect of acupuncture was clinically equivalent to, and statistically better than, that of patching.1 Therefore, despite the shortcomings of acupuncture mentioned above, it would still be worth considering if it can bring about good visual improvements, especially for children who have refused patching or for whom it has failed. Nevertheless, it is worth investigating whether less frequent office visits for acupuncture, eg, 5 visits per 2 weeks with 2 treatment sessions performed every visit, has equivalent treatment effects to that of 10 visits per 2 weeks with 1 treatment session per visit. This is being investigated in our follow-up studies.
Chen LJ, Fan AH, Zhao J, Fan DSP, Zhang M, Leung PC, Ritch R, Lam DS. Unfair Comparison of In-Office Acupuncture vs At-Home Patching for Amblyopia—Reply. Arch Ophthalmol. 2011;129(7):963–964. doi:10.1001/archophthalmol.2011.157