Electronic monitoring of treatment compliance in patching for amblyopia

We developed a coinsized occlusion dose monitor (ODM) to measure compliance with patch-wearing during the treatment of amblyopia objectively. It measures the temperature difference between the front and back of the ODM every 2-5 minutes by means of two thermistors. The data is stored in EEPROM memory and read out after recording for a week by connecting it to a PC. The ODM measures 35 × 23 × 4 mm and weighs 6 g. The back of the ODM is glued to the front of the amblyopia patch with double-sided Scotch tape. When the patch with the ODM is on the eye, the temperature at the back of the ODM is higher than at the front. Compliance is being studied in children taking part in a large amblyopia cohort study. The parents were instructed during home visits every three months to put the ODM on the patch. After a week, the ODM was collected and read out. Although the parents knew that a recording was being made, compliance was mediocre in many cases. Children were patched infrequently, for 5 minutes only, for long periods on the last days of the recording, at night, etc. Diaries detailing patch time were unreliable.