Prescribing six hours of daily patching for the unaffected eye of children with severe amblyopia works as well as prescribing full-time patching. This research finding should lead to better compliance with treatment and improved quality of life for children with severe amblyopia, or “lazy eye,” the most common cause of visual impairment in childhood. The findings appear in the November issue of Ophthalmology.
These research results will change the way doctors treat severe amblyopia and make a difference in treatment compliance and the quality of life for children with this eye disorder. It is estimated that as many as three percent of children in the U.S. have some degree of vision impairment due to amblyopia. The study was funded by the National Eye Institute (NEI), part of the National Institutes of Health.
Amblyopia, which begins in infancy or childhood, is a condition of poor vision in an otherwise healthy eye because the brain has learned to favor the other eye. Severe amblyopia is defined as amblyopia causing a reduction in visual acuity ranging from 20/100 to 20/400. Placing an opaque adhesive patch, or eye bandage, over the unaffected eye full time has been considered one of the standard treatments for severe amblyopia. It is crucial for young children to comply with the recommended treatment because visual impairment can persist into adulthood if amblyopia is not successfully treated in early childhood.
In this study, conducted at 32 clinical centers nationwide, 175 children less than seven years old with severe amblyopia were randomly assigned to receive either six hours of prescribed daily patching or full-time prescribed patching. Both groups of children performed one hour a day of “near” work, such as coloring, tracing, reading, and crafts, while their unaffected eye was patched. After four months, both groups showed similar and substantial improvement in the vision of the eye with amblyopia.
These findings make it easier for parents to monitor their children and encourage children to successfully comply with treatment. Timely and successful treatment for amblyopia in childhood can prevent lifelong visual impairment.
“This is the latest in a series of important research results that will help to preserve the vision of children with amblyopia,” said Paul A. Sieving, M.D., Ph.D., director of the NEI. In May 2003, researchers funded by the NEI reported a finding for moderate amblyopia, discovering that prescribing two hours daily patching of the unaffected eye works as well as prescribing patching six hours a day. In March 2002, NEI-funded researchers reported that atropine eye drops, placed in the unaffected eye to temporarily blur vision, was as effective as patching the eye of children with moderate amblyopia. Children with moderate amblyopia have vision ranging from 20/40 to 20/80.
The National Eye Institute (NEI) conducts and supports research that leads to sight-saving treatments and plays a key role in reducing visual impairment and blindness. The NEI is part of the National Institutes of Health (NIH), an agency of the U.S. Department of Health and Human Services.
Holmes JM, Kraker RT, Beck RW, Birch EE, Cotter SA, Everett DF, Hertle RW, Quinn GE, Repka MX, Scheiman MM, Wallace DK, Pediatric Eye Disease Investigator Group. A Randomized Trial of Prescribed Patching Regimens for Treatment of Severe Amblyopia in Children. Ophthalmology. 2003 Nov. PubMed