Wednesday, August 28, 2002

Study promotes easy, effective treatment for lazy eye

Lazy eye (amblyopia) is a common cause of visual impairment in children, affecting an estimated 3 percent of children in the United States. Timely and successful treatment for amblyopia in childhood can prevent lifelong visual impairment. Treatment should be started when the child is young, since amblyopia is more effectively treated in children under 7 years old.

Lazy eye is a condition of poor vision in an otherwise healthy eye because the brain has learned to favor the other eye. Although the eye with amblyopia looks normal, there is interference with normal visual processing that limits the development of a portion of the brain responsible for vision. The most common causes of amblyopia are misalignment of the eyes (crossed eyes) or significant differences in refractive error, such as farsightedness or nearsightedness, between the two eyes.

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, which stimulates vision in the eye with amblyopia and helps the part of the brain that manages vision to develop more completely.

However, many children do not like the eye patch because of quality of life issues, such as irritation of the skin and teasing by other children, and will not fully cooperate, which can lead to treatment failure. Also, patching forces a child to use an eye that has poor vision, often making compliance difficult for active children.

A new study sponsored by the National Eye Institute (NEI), one of the Federal government's National Institutes of Health, shows that atropine eye drops given once a day work as well as patching to correct lazy eye. The atropine eye drop works by temporarily blurring the vision in the unaffected eye, thereby forcing the eye with amblyopia to be used. This strengthens it and improves vision.

Just as important, the study shows that this treatment may encourage better compliance with treatment by both children and parents. "These results are important because they provide an effective alternative treatment that helps prevent permanent vision impairment for children with amblyopia," said Paul A. Sieving, M.D., Ph.D., director of NEI. 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 for six or more hours each day for weeks or months.

"The daily burden to administer treatment of amblyopia falls on the parent," said Sieving. "This study shows that one drop a day of atropine works as well as patching the eye for some children with amblyopia. Since both patching and atropine work equally well, the choice of treatment can be made by the eye care professional in consultation with the parent."

For more information, visit NEI's Web site, www.nei.nih.gov/health/index.htm.

The National Eye Institute (NEI) is part of the National Institutes of Health (NIH) and is the Federal government's lead agency for vision research that leads to sight-saving treatments and plays a key role in reducing visual impairment and blindness. The NIH is an agency of the U.S. Department of Health and Human Services.

The study was conducted by the Pediatric Eye Disease Investigator Group at 47 clinical sites throughout North America. The study was funded by NEI and coordinated by the Jaeb Center for Health Research in Tampa, Fla. and the Wilmer Eye Institute of Johns Hopkins University in Baltimore.

The children who were treated in this study will continue to be followed until April 2003, allowing researchers to learn whether there is any longer term advantage to treating amblyopia with either patching or atropine.