Date of Award

January 2016

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)



First Advisor

Jennifer A. Galvin


There are limited studies completed in the East African region to assess barriers to adherence with amblyopia treatment and outcomes of this treatment. Our study aims to identify factors which are associated with higher adherence in amblyopia treatment. Institutional Review Board (IRB) approval was obtained and a hospital-based retrospective and prospective observational study was performed at the pediatric ophthalmology clinic of Menelik II Referral Hospital in Addis Ababa, Ethiopia from March 2015 to June 2015. Included in the study were Ethiopian children, between the ages of 4 and 8, with a clinical diagnosis of amblyopia defined as interocular acuity difference of at least 0.2 logMAR. We collected demographic and clinical data from charts. Parents were asked to estimate the number of hours they were able to administer patching in the past week and fill out a brief questionnaire addressing adherence, social stigma, and adverse effects associated with patching. Questions addressing parents’ basic knowledge of amblyopia and its treatment were also included in the questionnaire.

Fifty-three patients (25 male, 28 female) of mean age 6.4 + 1.3 years participated. Forty-one (77.3%) of patients were residents of the capital, Addis Ababa, and 73.6% spoke Amharic, the national language. Amblyopia was associated with strabismus (n=36), anisometropia (n=6) and combined mechanism (n=11). Mean duration of treatment was 19 months. Approximately one-third of the parents (28%) were found to be non-adherent to the amblyopia treatment. Adherence was associated with parental educational level (p= 0.003) and residual amblyopia (p=0.001). Only 23.4% of patients achieved residual amblyopia of 0.19 logMAR units or less. The main factor affecting the outcome of amblyopia treatment in this study was treatment adherence.


This is an Open Access Thesis.