Purpose:
Compliance with occlusion therapy is variable and often problematic. Tjiam et al (2013) reported an educational cartoon had significantly improved compliance with patching. However, this black-white cartoon is not commercially available. We created a 4-minute educational color cartoon video to explain the importance of wearing the eye patch to children. This study investigated the feasibility of using our educational cartoon video to improve compliance with patching in amblyopic children and to report pilot data. .
Methods:
Children who were prescribed patching for treatment of unilateral amblyopia (3 to 10 years-old) were enrolled. In addition to patches, the child was provided with an EPA (Eye Patch Assistant), which contains a microsensor to objectively measure daily compliance with patching (Wang et al , 2019). The story of the cartoon was written under supervision of a speech specialist to ensure that children aged 3 to 10 years-old could understand it. A child voice was used to narrate the scenes of the story. Children were asked to wear the eye patch according to the prescribed number of hours by their eye doctor for 4-weeks. After 4 weeks, subjects returned (baseline visit) to measure compliance. Subjects who had compliance ≤ 50% were assigned to watch the 4-minute cartoon-video once at our clinic. A week later, children who watched the video returned (study post-video visit) to measure compliance. We calculated daily compliance and general compliance. compared compliance at the baseline versus the post-video visit.
Results:
The mean age was 6.84 years. Mean objectively measured compliance with patching at the baseline visit was 28.13 % (SD 18.71 %) versus 62.84 % (SD 24.93 %) at the post-video visit (Figure 1). Mean daily hours of wearing the eye patch at the baseline visit was 1.62 h (SD 2.31 h) versus 3.08 h (SD 2.83 h) at the post-video visit. All children reported enjoying watching this video.
Conclusions:
Our educational cartoon video is feasible for use in a clinical setting and our pilot results showed a trend of improvement in compliance with patching after children watched the video. We are continuing collecting data from a larger cohort.

Saeed Aljohani: Commercial Relationship: Code N (No Commercial Relationship) | JoAnn Bailey: Commercial Relationship: Code N (No Commercial Relationship) | Lindsey Perno: Commercial Relationship: Code N (No Commercial Relationship) | Mitchell Scheiman: Commercial Relationship: Code N (No Commercial Relationship) | Eileen Birch: Commercial Relationship: Code N (No Commercial Relationship) | Xu Hongxin: Commercial Relationship: Code N (No Commercial Relationship) | Jingyun Wang: Commercial Relationship: Code N (No Commercial Relationship)