Eye drops are as effective as an eye patch for treating amblyopia, the most common cause of vision impairment in children.
The results of a 47-center study that included the University of Utah Moran Eye Center are being published Wednesday in the March issue of the journal Archives of Ophthalmology.
About 3 percent of children have amblyopia, which if not detected and treated early can lead to permanent vision loss. Amblyopia is sometimes confused with strabismus, or "lazy eye," because the two conditions often coexist. Amblyopia is actually a condition where a healthy eye does not see as well as it should because the brain has decided to favor the other eye, said Dr. Richard J. Olson, lead investigator for the study at Moran and an assistant professor of ophthalmology who specializes in treating children. "It is lazy in that way."
Patching is the traditional treatment. It works by covering the good eye and forcing the brain to recognize what the affected eye is seeing, thus strengthening it.
The eye drops, which contain the drug atropine, work the same way. The atropine is put in the eye that sees well to blur the vision. The brain then starts to rely on the weaker eye. Either treatment may take weeks or even years, and one is apparently not better than the other.
The findings don't mean that patching will be replaced, said Dr. Robert Hoffman, head of Moran's pediatric division. It will simply give physicians another option, tailored to the child's needs and personality.
Some children hate the patches for social reasons or because they can cause skin irritation. The eye drops can sting and make the treated eye sensitive to light. Having the two options could improve treatment compliance.
"Many kids are happy with the eye drops, but sometimes the patch is a better answer," said Olson. "We'll try to suit it to the child. And sometimes it's nice to have a backup."
Children tend to be "amazingly resilient," he said, and usually adapt to either treatment, although they "may not enjoy" either one.
Compliance is a concern, Olson said, because so much is at stake. Failure to treat amblyopia can result in lifelong vision loss in the affected eye. Left untreated, it usually persists in adulthood.
Utah children are screened for amblyopia when they enter kindergarten, but some slip through or are misdiagnosed, Hoffman said. "There is no reason a child in the United States in the year 2002 should be at risk for vision loss due to amblyopia."
The study was funded by the National Eye Institute in the National Institutes of Health. It's available online at ( www.nei.nih.gov/amblyopia).
E-MAIL: lois@desnews.com