"AIM: To observe fixation behaviors in amblyopes by optical coherence tomography（OCT）and to explore the possible mechanism of eccentric fixation so as to guide amblyopia treatment. METHODS: OCT was performed on a group of 31 cases (40 eyes) aged 3 to 12 with severe amblyopia of hyperopia refractive error respectively before and after treatment. The results were recorded and compared to detect the change and mode of their visual fixation. RESULTS: Among the 31 cases (40 eyes), 63% was foveal fixation, and 38% was eccentric fixation. For uniocular patients, eccentric and foveal fixation shared the same percentage of 50%. For binocular patients, eccentric fixation was present in 22% of the total cases; the remaining 78% was foveal fixation. After treatment, all of the 15 eyes with eccentric fixation visual acuity between 0.2-0.5 were successfully converted to foveal fixation. The time of treatment varied from one month to two years. Combined exotropia and accommodation esotropia did not affect the conversion. Moreover, regardless of the mode of fixation, there was no significant difference in the final visual acuity achieved after treatment. CONCLUSION: OCT examination is an objective and easy-to-operate means to assess of fixation behaviors in amblyopes. With the improvement of visual acuity during treatment, the patient-s eccentric fixation converted to foveal fixation. "