e for vision. The most common causes of amblyopia are misalignment of the eyes (crossed eyes) or significant differences in refractive error, such as farsightedness or nearsightedness, between the two eyes. Amblyopia usually begins in infancy or childhood. It is estimated that as many as three percent of children in the U.S. have some degree of vision impairment due to amblyopia.

Treatment for amblyopia is most effective when started in young children less than seven years old. Response to treatment in older children is much less effective. 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 in the eye with amblyopia and helps the part of the brain that manages vision to develop more completely.

However, many children do not like the appearance of the eye patch and the accompanying social and psychological stigma and will not fully cooperate, which can lead to treatment failure. Also, patching forces a child to use an eye that has poor vision, often making compliance difficult for active children. Unless it is successfully treated in early childhood, amblyopia usually persists into adulthood, and is the most common cause of monocular (one eye) visual impairment among children and young and middle-aged adults. Consequently, it is crucial for children to comply with treatment.

The atropine eye drop works by temporarily blurring vision in the unaffected eye, thereby forcing the eye with amblyopia to be used. This strengthens it and improves vision. The advantage of atropine treatment is that the parent simply places a drop in the childs eye once a day. With patching, the parent must monitor the child wearing the patch for six or more hours each day for many weeks or months.

In the Amblyopia Treatment Study, 215 children were randomly assigned to receive patching, and 204 were ass
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Contact: Michael Coogan
mjc@nei.nih.gov
301-496-5248
NIH/National Eye Institute
13-Mar-2002

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