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March 2004

The Effectiveness of Patching for Amblyopia Should Be Tested With UntreatedControl Subjects—Reply

Arch Ophthalmol. 2004;122(3):423-425. doi:10.1001/archopht.122.3.424

In reply

We thank Drs Lempert, Bloom, and Gottlob and her colleagues for theirinterest in our study. Drs Lempert and Bloom suggest somewhat opposing viewpointsin the interpretation of our results. Dr Lempert suggests that our study wastoo controlled, and Dr Bloom suggests that it was not controlled enough. DrLempert postulates that the observed improvement could be related to the studypatients behaving differently than would patients in the "real world" becauseof, in his words, "an awareness of being observed" and "special attentionreceived." He is implying that compliance with treatment is better in thestudy than in the real world, which results in greater improvement in theamblyopia than would be seen in the real world. Dr Bloom suggests that thelack of a difference could be reflective of poor compliance on the part ofthe 6-hour patching group such that the actual amount of patching receivedby both groups might have been similar. We presume that he is suggesting thestudy design should have included extensive efforts to maximize and monitorcompliance over and above what is done in usual practice.

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