Amblyopia treatment trials

Abstract

AbstractRecent randomized clinical trials and observational studies conducted by the Pediatric Eye Disease Investigator Group, and other research teams, have led to an evidence‐based approach for treating anisometropic and strabismic amblyopia. Starting spectacle correction first, as optical treatment alone, results in resolution of amblyopia in at least a quarter of children. Starting low intensity treatment is the next reasonable step, offering parents a choice between 2 hours a day of patching the fellow eye or atropine drops to the fellow eye at the weekend. If amblyopia does not completely respond to these low‐intensity approaches, then more intense patching is warranted, such as patching 6 to 8 hours a day or changing the spectacle lens to plano while using atropine to increase penalization. We also have evidence that treating older children (13‐17 years old) has merit, particularly if not previously offered treatment. But despite these advances in treatment of amblyopia, one of our ongoing challenges is that a proportion of children are still left with residual amblyopia, so we continue to investigate alternative approaches such as oral levodopa as an adjunct to patching and a new treatment approach based on binocularity.