Skip to main content
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1997 Jan;81(1):54–57. doi: 10.1136/bjo.81.1.54

Atropine penalisation versus occlusion as the primary treatment for amblyopia

A Foley-Nolan 1, A McCann 1, M O'Keefe 1
PMCID: PMC1721990  PMID: 9135409

Abstract

AIMS/BACKGROUND—Pharmacological penalisation of non-amblyopic eyes is an infrequently used alternative to occlusion for treating amblyopia. The authors compared the efficacy of atropine penalisation and that of occlusion as a primary treatment for amblyopia.
METHODS—Thirty six newly diagnosed patients with amblyopia were allocated to two groups for treatment. Eighteen patients in each group were treated either with atropine penalisation (group A) or occlusion therapy (group P).
RESULTS—There was a statistically significant improvement in visual acuity in both groups treated. In group A improvement of the geometric mean visual acuity of the amblyopic eye was from 6/50 to 6/11 (p<0.001). In group P improvement of the geometric mean visual acuity was from 6/60 to 6/19 (p<0.001). In group A non-compliance with treatment was only 6% (2/18). Non-compliance in group P was 45% (8/18) at some stages of the treatment. Neither group produced an incidence of occlusion amblyopia.
CONCLUSIONS—In this study atropine penalisation has been shown to be as effective as occlusion therapy in the treatment of amblyopia. Patient acceptance of atropine penalisation was superior to that for occlusion therapy as was shown by the compliance rate. Atropine treatment was also advantageous in that compliance could be readily checked by inspection.



Full Text

The Full Text of this article is available as a PDF (81.3 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Holladay J. T., Prager T. C. Mean visual acuity. Am J Ophthalmol. 1991 Mar 15;111(3):372–374. doi: 10.1016/s0002-9394(14)72328-1. [DOI] [PubMed] [Google Scholar]
  2. Levartovsky S., Gottesman N., Shimshoni M., Oliver M. Factors affecting long-term results of successfully treated amblyopia: age at beginning of treatment and age at cessation of monitoring. J Pediatr Ophthalmol Strabismus. 1992 Jul-Aug;29(4):219–223. doi: 10.3928/0191-3913-19920701-08. [DOI] [PubMed] [Google Scholar]
  3. Movshon J. A., Eggers H. M., Gizzi M. S., Hendrickson A. E., Kiorpes L., Boothe R. G. Effects of early unilateral blur on the macaque's visual system. III. Physiological observations. J Neurosci. 1987 May;7(5):1340–1351. doi: 10.1523/JNEUROSCI.07-05-01340.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. North R. V., Kelly M. E. Atropine occlusion in the treatment of strabismic amblyopia and its effect upon the non-amblyopic eye. Ophthalmic Physiol Opt. 1991 Apr;11(2):113–117. doi: 10.1111/j.1475-1313.1991.tb00209.x. [DOI] [PubMed] [Google Scholar]
  5. Repka M. X., Gallin P. F., Scholz R. T., Guyton D. L. Determination of optical penalization by vectographic fixation reversal. Ophthalmology. 1985 Nov;92(11):1584–1586. doi: 10.1016/s0161-6420(85)33821-6. [DOI] [PubMed] [Google Scholar]
  6. Repka M. X., Ray J. M. The efficacy of optical and pharmacological penalization. Ophthalmology. 1993 May;100(5):769–775. doi: 10.1016/s0161-6420(93)31577-0. [DOI] [PubMed] [Google Scholar]
  7. Sloper J. J. Edridge-Green Lecture. Competition and cooperation in visual development. Eye (Lond) 1993;7(Pt 3):319–331. doi: 10.1038/eye.1993.70. [DOI] [PubMed] [Google Scholar]
  8. Von Noorden G. K. Factors involved in the production of amblyopia. Br J Ophthalmol. 1974 Mar;58(3):158–164. doi: 10.1136/bjo.58.3.158. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. von Noorden G. K., Milam J. B. Penalization in the treatment of amblyopia. Am J Ophthalmol. 1979 Sep;88(3 Pt 1):511–518. doi: 10.1016/0002-9394(79)90656-1. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES