Contact:
Nancy Solomon
Phone: 314.977.8017
solomonn@slu.edu

March 13, 2002

ST. LOUIS -- For decades, treating amblyopia (lazy eye) meant coaxing, bribing or begging children to wear an eye patch, but those days may be over.

A new study sponsored by the National Institutes of Health's National Eye Institute found that atropine eye drops given once a day work just as well as patching an eye and may encourage better compliance with treatment. The results are published in the March issue of the Archives of Ophthalmology.

"The drops have been around for decades but until this study we didn't know whether they were as effective as patching to treat amblyopia," said Oscar A. Cruz, M.D., chairman and associate professor of pediatric ophthalmology at Saint Louis University Eye Institute and one of the national study investigators. "The results mean we now have two options to treat the most common cause of visual impairment in children."

Amblyopia usually begins in infancy or childhood. It develops because the brain has learned to favor one eye over the other. Although the eye with amblyopia looks normal, there is interference with normal visual processing. Approximately three out of 100 children in the United States have some degree of vision impairment due to amblyopia.

Standard treatment is patching the stronger eye to encourage the "lazy" eye to work harder and grow stronger. Compliance with treatment, however, is difficult because children are resistant to wearing an eye patch. The adhesive patch can irritate skin and prompts teasing from other children.

"It's also difficult to get children to wear the patch when they're sick or when it's summer or during school hours because of the teasing," said Cruz. "Toddlers tear them off because they want to use their dominant or favored eye. It can be very trying for parents to help their children stay compliant with treatment."

The atropine eye drops work by temporarily blurring vision in the unaffected eye, thereby forcing the eye with amblyopia to be used and strengthened.

"The advantage of atropine treatment is that the parent simply places a drop in the child's eye once a day as opposed to patching and monitoring a child wearing the patch for six or more hours each day for many weeks or months," said Cruz. "And successful treatment for amblyopia in childhood can prevent lifelong visual impairment."

The amblyopia treatment study involved more than 400 children at 47 clinical sites across the country. About half were treated with eye patches and the others were treated with atropine eye drops. Treatment was successful in about three quarters of each group (79 percent success rate with patches and 74 percent with eye drops). Children in the study will be followed until April of 2003 to determine whether there is any longer term advantage to treating amblyopia with either patching or atropine drops. Cruz's co-investigator at the Saint Louis University study site was Bradley Davitt, M.D., assistant professor of ophthalmology at the School of Medicine.