It is well known that the younger the age of amblyopia treatment, the better the results. Treatment can be started as early as 1 to 2 years of age. Refractory amblyopia, if treated beyond 6 years of age, is very difficult to treat to 1.0 or higher. Therefore, for those diagnosed with refractory amblyopia, it is even more important to treat early. If the best time is missed, long-term treatment with an intensive compound amblyopia device of the 3rd generation or higher is often required to obtain good results. In my previous article, I have already mentioned that the amblyopia treatment method is summarized in four words – “early mirror and instrument cover”. Since this has already been said, the remaining points are the three main points of treatment for refractory amblyopia. Specifically, reasonable prescription, strict masking, and the use of high generation instruments. (1) All myopia, astigmatism, hyperopia of more than 250 degrees and refractive error of more than 100 degrees should be fitted with glasses. Because it is usually very difficult to improve the vision of refractory and refractory amblyopia, as long as it helps to improve the vision, even if the effect is slight, it should be used as much as possible. Therefore, the first step in the treatment of amblyopia is the prescription of glasses. (2) When high hyperopia is accompanied by adjustable strabismus, the prescription of glasses should be given priority in the process of amblyopia treatment, and the role of glasses in correcting strabismus should be considered second. Try to wear glasses for 2-3 months, if the eye position is normal, you should immediately reduce 200~300 degrees to promote vision increase. If the eye position is still skewed, the prescription should be reduced by about 200 degrees to promote the vision of the better eye first and give up the correction of the skewed eye for the time being. This is because refractory amblyopia is more difficult or even ineffective to treat if you miss a certain age (almost impossible to cure above the age of 7), while strabismus can be corrected at any age with sufficient relaxation of accommodation. Of course, if you can ensure that the improvement of visual acuity is not hindered, while correcting the eye position before the age of 6, it is very important to establish and improve the stereo vision function. (3) The distance between the apex of the glasses worn for high farsightedness or myopia should be as small as possible, that is, the lenses should be as close to the eyes as possible, so as to reduce the tremor caused by the glasses when walking too much tremor and hinder the improvement of vision, by using a hard metal frame, adjusting the nosepiece and shortening the distance between the legs and the ear bend. (4) Horizontal nystagmus: the degree of hyperopia, myopia and hyperopic astigmatism should be appropriately undercorrected, while myopic astigmatism can be adequately corrected. At the same time, we should emphasize the reduction of corneal vertex distance and increase the stability of the frame, such as contact lenses, the effect is better, because the tremor of the eye wearing high number of lenses will cause object tremor greater and affect the improvement of vision. (5) High myopia or farsightedness must emphasize the optical center of the horizontal shift shall not be greater than 2mm, up and down shift shall not be greater than 1mm, in order to avoid the inhibition of binocular objects can not be well integrated, thus hindering the improvement of visual acuity. The second is the use of high generation amblyopia instrument treatment: amblyopia can essentially be seen as a kind of visual “atrophy” or visual cell “sleep”, the role of amblyopia instrument is to wake up the “sleeping” visual cells or exercise “atrophy”. The role of the amblyopia device is to wake up the “sleeping” vision cells or exercise the “atrophied” vision to increase visual acuity. Thus, the principle of amblyopia instrument to increase vision can be summarized into two categories: (1) “wake up” the visual cells with the function of color scale: by looking at various “color scale” to complete: such as light brush blue light, red flash, rear image black dot light, visual physiological grid light, etc. The “color scale” can selectively excite the visual cone cells or visual center cells and indirectly increase vision. The color scale is divided into monochromatic static, monochromatic or multicolor two-dimensional dynamic, AGB three-dimensional dynamic, of which the light brush and enhanced color scale (two-dimensional and three-dimensional dynamic color scale) has the best effect of vision enhancement, because it can wake up three kinds of color-sensitive cone cells in 360 degrees; BS3~5 generation compound amblyopia instrument has this function. Therefore, BS3~5 generation compound amblyopia apparatus should be used for refractory amblyopia. (2) Exercise the “atrophy” vision with the function of visual markers (icons): through the recognition of various “visual markers” to complete, such as tracing work, threading needles, beads, jacks, grade fine vision, flying point visual markers, bifocal threshold flying point visual markers and other training. The “sight marker” can be divided into static and dynamic, threshold quantitative and non-threshold quantitative, monofocal and bifocal, etc., of which dynamic, threshold quantitative and bifocal sight marker is to strengthen the vision enhancement sight marker, the highest degree of refinement can reach 0.001, can be 360 degrees of excitement of the cone cells and achieve the effect of strengthening vision enhancement; BS3~5 generation compound amblyopia instrument has this function. Therefore, the BS3~5 generation compound amblyopia instrument should be used for refractory amblyopia. (3) Establishing and restoring stereo vision: By training the three-level function of binocular monovision (simultaneous vision, fusion vision and stereo vision), establishing and restoring stereo vision; the full AGB stereo vision, oblique stereo vision and solid stereo vision training in BS3~5 generations are advanced stereo vision enhancement functions, which are suitable for refractory amblyopia. Third, the last is the cover, cover good eye forging poor eye: it should be stressed that only when one eye is healthy (0.9 or above), the other eye visual acuity is low more than two rows can cover the healthy eye. If the visual acuity of the good eye does not reach 0.9 or above, covering the good eye in order to treat the poor eye may cause the visual acuity of the good eye not to increase, resulting in low vision in both eyes in the future and affecting life and learning. Therefore, for refractory amblyopia with a large difference in vision between the two eyes, priority should be given to curing the good eye, and only afterwards can the good eye (healthy eye) be covered to cure the poor eye, so as to ensure that the vision of at least one eye is normal in the future, without greatly affecting future life and learning.