Patching vs Atropine: Which Is the Better Treatment for Pediatric Amblyopia?

Rod Foroozan, MD


January 06, 2009


Amblyopia remains one of the most common causes of unilateral visual loss in children. The Pediatric Eye Disease Investigator Group conducted a randomized interventional trial in patients aged 7 to 17 years to evaluate the effectiveness of treating pediatric amblyopes.[1]The study showed that treatment was beneficial in older children with amblyopia. The authors then designed a trial to compare the effectiveness of patching vs atropine in amblyopic patients 7-12 years of age.


Patching vs atropine to treat amblyopia in children aged 7 to 12 years: a randomized trial


Scheiman MM, Hertle RW, Kraker RT, et al; Pediatric Eye Disease Investigator Group
Arch Ophthalmol. 2008;126:1634-1642


In this randomized trial, 193 patients with anisometropic or strabismic amblyopia were assigned to patching of the better seeing eye or atropine. The mean improvement in visual acuity was 7.6 letters in the atropine group and 8.6 letters in the patching group. After 17 weeks of treatment, approximately 20% of patients in each group were able to achieve a visual acuity of 20/25 or better in the amblyopic eye.




This multicenter trial found no statistical difference between patients treated with atropine and patients treated with patching for amblyopia. Both techniques were effective, and nearly 40% of patients showed an improvement in visual acuity by at least 2 lines. The severity of amblyopia did not appear to affect the rate of visual improvement.



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