Posted on March 28, 2002 at 4:00 p.m.

BIRMINGHAM, AL — Eye drops to treat the most common cause of visual impairment in children — amblyopia, or lazy eye — work as well as the standard treatment of patching, according to a study in the March issue of Archives of Ophthalmology.

“We hope these findings will lead to better compliance with treatment and improved quality of life in these children,” said Robert Rutstein, O.D., a UAB optometrist and an investigator in the national study.

Amblyopia is a condition of poor vision in an otherwise healthy eye because the brain has learned to favor one eye. Although the eye with amblyopia looks normal, there is interference with normal visual processing that limits the development of a portion of the brain responsible for vision. It is estimated that amblyopia affects two or three of every 100 children in the United States.

Currently, most eye care professionals treat amblyopia by placing an opaque adhesive patch, or “eye bandage,” on the skin to cover the unaffected eye. This forces the child to use the eye with amblyopia, which stimulates vision and brain development.

However, researchers participating in the Amblyopia Treatment Study (ATS 1) at 47 clinical sites in North America, including UAB, found that using eye drops containing the drug atropine works as well as eye patching and may encourage better compliance.

“Compliance is an important factor in the success of amblyopia treatment,” Rutstein said. “Parents usually don’t like the eye patch treatment because they have to monitor the child wearing the patch for six or more hours each day for many weeks or even months. And children typically don’t like the treatment because of the appearance of the patch and the accompanying social and psychological stigma. Both of these factors often result in unsuccessful treatment due to poor compliance.

“The advantage of the atropine treatment is that the parent simply places a drop in the child’s eye once a day.” The atropine eye drop temporarily dilates the pupil and blurs the image seen by the unaffected eye, forcing the child to use the “lazy” eye.

ATS 1, funded by the National Eye Institute, was conducted to determine whether atropine was as effective as patching for treating amblyopia in children younger than 7. More than 400 children were enrolled and were randomly assigned to receive either atropine or patching.

“Although we will continue to follow these children until April 2003, and follow up with research to determine whether there are any long term advantages to using atropine or the patch, these findings are significant,” Rutstein said. “Since these initial findings show atropine and patching work equally well, parents and eye care professionals now have another option in the treatment of amblyopia and it’s one that seems to be more acceptable among parents and children.”