Development of motor fusion in patients with a history of strabismic amblyopia who are treated part-time with Bangerter foils

PurposeTo document the development of motor fusion when patients with a history of strabismic amblyopia are treated part-time with Bangerter foils.MethodsThis was a prospective interventional outcome study of consecutive patients with a history of strabismic amblyopia, horizontal strabismus (only) ≤20∆, visual acuity of 20/60 or better in the nonfixating eye, and no motor fusion (as indicated by the absence of prism vergence) for 1 year before entry into the study. Subjects wore a 0.1 density Bangerter foil for 3-4 hours daily. Data on visual acuity, alignment, and motor fusion status were collected for a minimum of 2 years. Patients with motor fusion were then followed for a minimum of 18 months to assess the stability of their motor fusion status after the Bangerter foil was discontinued.ResultsOf the 46 patients meeting entry criteria (mean age, 5.3 ± 1.7 years) who completed follow-up, 28 (61%) developed motor fusion. Motor fusion was retained in all 17 patients who were followed after their foils were discontinued for a mean of 13.3 months.ConclusionA child's motor fusion status is generally believed to be established during an early formative period of visual development. The development of motor fusion in many of our patients during the course of part-time Bangerter foil treatment suggests that improvements in motor fusion status can occur at a later age than previously believed.