A Randomized Trial of Atropine vs Patching for Treatment of Moderate Amblyopia

Background: amblyopia is a major cause of visual impairment in children. Our aim is to compare patching and atropine penalization for treatment of moderate amblyopia in 4-10 years old children. Methods: During 2004-2007, in a randomized clinical trial, 120 patients aged 4-10 years old with moderate amblyopia in the range of 20/40 -20/100 were enrolled. Subjects randomized either to patch therapy or twice weekly atropine penalization in equal groups and were followed for 2 years. The success rate was defined as increment of 2 or more lines of visual acuity or final visual acuity of 20/25 or better. Results: The visual acuity in amblyopic eye improved from base line to a mean of 3.8 lines in patching group and mean of 3.7 lines in atropine group at the end of follow up. The average visual acuity in both groups was 0.5 Log MAR acuity that increased to 0.18 in patching group and 0.2 in atropine group. Conclusion: Twice weekly atropine penalization could improve visual acuity of a magnitude like to improvement provided by patching in treatment of moderate amblyopia in patients aged 4-10 years.