To evaluate the effectiveness of combining patching with active vision therapy, compared to patching with placebo training on contrast sensitivity (CS) in pediatric participants with bilateral refractive amblyopia.

In this double-blind, clinical trial, 43 participants aged 5–8 with bilateral refractive amblyopia, unresponsive to spectacles, were randomly assigned to either the experimental group (active vision therapy plus patching) or the control group (placebo treatment with patching) for four months. Active therapy included anti-suppression, accommodative, vergence, and visual memory exercises. CS was measured at baseline and after four months, serving as key outcome measures.

Forty participants (20 in each group) completed the study. The mean age for the experimental group (5 males) was 6.10±0.84y, and 6.50±1.15y for the control group (11 males). CS in the experimental group improved by 0.10 log (right eye), 0.14 log (left eye), and 0.07 log binocularly (P≤0.03). The control group showed no statistically significant enhancements in monocular or binocular CS (P≥0.07). Compared to the control group, the experimental group demonstrated a rate of change in monocular CS of 0.05 during follow-up time.

Active vision therapy leads to significant and accelerates improvements in CS among children with bilateral refractive amblyopia.