Researchers at The Children's Hospital of Philadelphia Find Eye Drops Work as Well as Patches for Lazy Eye, Are Better Accepted by Children; Children's Hospital Researchers Participate in Multicenter National Trial of Eye Treatments

03/13/2002

PHILADELPHIA, March 13 /PRNewswire/ -- Researchers at The Children's Hospital of Philadelphia have concluded that the use of an eye patch or atropine eye drops are equally effective treatments for amblyopia, also referred to as lazy eye. This research finding may lead to better compliance with treatment and improved quality of life for children with this disorder. The results are published in the March issue of Archives of Ophthalmology.

Amblyopia, or impaired visual development in one eye, is the most common cause of visual impairment in children. In the Amblyopia Treatment Study, sponsored by the National Institutes of Health, 215 children were randomly assigned to receive patching, 204 were assigned to receive the eyedrops. Researchers found that 79 percent of those receiving the eye patch were successfully treated, compared to 74 percent of those receiving atropine drops, a clinically insignificant difference. Although vision in the amblyopic eye improved faster in the patching group, the difference between the groups at six months was small and not statistically significant. Study participants were seven years old and younger, with visual acuities in the amblyopic eye between 20/40 and 20/100.

Amblyopia is a condition in which the vision in one eye is reduced because one eye, while anatomically normal, is not favored by the brain. It may be caused by a crossing in or turning out of the eyes, or by a difference in the level of nearsightedness or farsightedness between the eyes.

"Traditionally, amblyopia treatment included wearing a patch over the strong eye for long periods of time to strengthen the weaker eye. This study shows us that atropine drops are as effective as the patch and may ultimately lead to better compliance because children are reluctant to keep the patch on for the periods of time that therapy requires. Very young children tear off the patch; older ones find a patch socially inhibiting," said Brian Forbes, M.D., Ph.D, the primary investigator from The Children's Hospital of Philadelphia. "Atropine drops are now a proven treatment option for eye care professionals in consultation with parents."

Atropine eye drops work by temporarily blurring vision in the unaffected eye, 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 child's eye once a day. With patching, the parent must monitor the child wearing the patch sometimes for six or more hours daily for weeks or months.

Treatment for amblyopia is most effective when started before age seven. 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, stimulating vision in that eye and helping the part of the brain that manages vision to develop more completely.

Unless successfully treated in early childhood, amblyopia usually persists into adulthood, and is the most common cause of monocular (one eye) visual impairment among children as well as young and middle-aged adults. Consequently, it is crucial for children to comply with treatment.

However, many children do not like the appearance of the eye patch and teasing that may accompany it, and will not fully cooperate, which can lead to treatment failure. Active children in particular may resist keeping the patch in place.

Brian Forbes, M.D., Ph.D., and Graham E. Quinn, M.D., were the study's primary investigators at Children's Hospital. Co-investigators of the study were: Jane E. Edmond, M.D.; Ellie Francis, O.D., Ph.D.; Monte D. Mills, M.D.; Eric Pierce, M.D., Ph.D.; and Terri L. Young, M.D.; all of the Division of Pediatric Ophthalmology, The Children's Hospital of Philadelphia.

The study was conducted by the Pediatric Eye Disease Investigator Group at 47 clinical sites throughout North America, and was funded by the National Eye Institute, part of the National Institutes of Health.

Founded in 1855 as the nation's first pediatric hospital, The Children's Hospital of Philadelphia is ranked today as the best pediatric hospital in the nation by a comprehensive Child magazine survey. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking second in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 381-bed hospital recognition as a leading advocate for children and adolescents from before birth through age 19.

CONTACT: Joey Marie McCool of The Children's Hospital of Philadelphia, +1-215-590-7092, or mccool@email.chop.edu.