Adults who dispense eye drops daily to correct a
child's "lazy eye" take note: A new study from researchers
at the Johns Hopkins Children's Center and 29 other centers
across North America finds that giving the drops just twice
during the weekend is just as effective as administering
them every day of the week.
In what is believed to be the first clinical trial
comparing treatment regimens of atropine sulfate eye drops
for the treatment of amblyopia, the investigators concluded
that "there is no obvious advantage to the daily
administration of atropine eye drops in either the speed of
improvement or in the magnitude of improvement after four
months of treatment," according to Michael Repka, the lead
author of the study and a pediatric
ophthalmologist at
the Children's
Center.
These findings are published by the Pediatric Eye
Disease Investigator Group, known as PEDIG, in the November
issue of Ophthalmology.
In the study, 168 children up to 7 years old with
moderate amblyopia were randomly assigned to get atropine
eye drops either daily or only on Saturday and Sunday.
After four months of treatment, children following both
regimens were able to read an average of 2.3 lines higher
on a standard eye chart. Additionally, 47 percent of
children receiving daily drops and 53 percent getting
weekend drops had vision in the amblyopic eye improve to
normal levels by the four-month mark. This considerable
degree of improvement is similar to that accomplished with
daily eye patching, the mainstay of amblyopia treatment,
the researchers note.
"The daily burden of administering drops usually falls
on the parent, and if weekend eye drops are a good option,
the regimen not only relieves some of this burden but may
also encourage compliance with the treatment," Repka says.
"Compliance is very important, since timely and successful
treatment for amblyopia in childhood can prevent lifelong
visual impairment."
The most common cause of vision loss in children and
young adults, amblyopia affects as many as 3 percent of
children in the United States and usually begins in infancy
or childhood. The condition is marked by poor vision in an
otherwise healthy eye and occurs because the brain has
learned to favor the other eye. Although the eye with
amblyopia often looks normal, abnormal visual processing
limits the development of a portion of the brain
responsible for sight. The most common causes are crossed
or wandering eyes, or significant differences in refractive
error, such as farsightedness or nearsightedness, between
the two eyes. Atropine eye drops are designed to
temporarily blur vision in the unaffected eye, thereby
forcing the amblyopic eye to do most of the work. This
helps strengthen the amblyopic eye and improves vision.
This research was conducted by the PEDIG at 30
clinical sites throughout North America and was funded by
the National Eye Institute. The PEDIG focuses on studies of
childhood eye disorders that can be implemented by both
university-based and community-based practitioners as part
of their routine practice.
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