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Susan A. Cotter, for the Pediatric Eye Disease Investigator Group; Lessons learned from the Amblyopia Treatment Studies. Journal of Vision 2013;13(15):T33. doi: 10.1167/13.15.33.
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Recent developments in amblyopia treatment research have changed the clinical approach to the treatment of childhood amblyopia from anisometropia, strabismus, or both. Aggressive patching for the initial treatment of amblyopia is no longer considered the mainstay of treatment. Refractive correction has been shown to be a treatment in its own right, with many children demonstrating improvements in visual acuity for periods of up to 6 months, and with amblyopia resolution occurring approximately one-third of the time. Atropine penalization of the sound eye using as little as 1 drop twice per week provides essentially the same treatment effect as prescribing low-dose (2 hours/day) patching in children with moderate amblyopia; both of these treatments have also been shown to be effective in some patients with severe amblyopia. It is clear that amblyopia can be successfully treated beyond 6 years of age, with 7 to 12-year old children responding to treatment with refractive correction combined with patching, atropine, or both. Teenage children with previously untreated amblyopia have been found to be more likely to respond to treatment than those who have undergone prior treatment for amblyopia. Despite the availability of increased treatment options and the reduced treatment burden for amblyopic children and their families, treatment duration can be quite lengthy and a substantial proportion of children are left with residual amblyopia.
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