Morning Versus Evening Patching in Childhood Amblyopia

To determine whether the time of day at which daily occlusion therapy is administered-morning, with 2 hours of patching completed within 07:00-10:00, versus evening, with 2 hours completed within 17:00-20:00-affects visual-acuity improvement in the amblyopic eye in children with unilateral amblyopia. Rationale: While occlusion therapy remains the mainstay for treatment of childhood amblyopia, existing trials have focused on patching duration, not on the timing of occlusion. Diurnal or chronobiological factors - such as fluctuations in neuroplasticity, attention, compliance, or visual demand during the day - may influence the efficacy of patching. Understanding whether timing matters could help optimize occlusion therapy, improve outcomes, and reduce treatment burden.

Inclusion Criteria: * Age: 4-8 years. * Unilateral amblyopia. * Amblyopic-eye BCVA decimal 0.17-0.67 (≈ 6/36-6/9). * Fellow-eye BCVA ≥ 0.80 decimal (≈ 6/7.5 or better). * Amblyopia type: refractive-dominant or strabismic/mixed. * Parent/guardian consent obtained. Exclusion Criteria: * Bilateral amblyopia. * Sensory-deprivation amblyopia (e.g., due to congenital cataract, ptosis, corneal opacity). * Ocular surgery within the past 6 months, or planned surgery during study. * Likely poor adherence (e.g., due to social, logistic, or family constraints).