Page 152 - July-August 2020

improve VA even if amblyopia
AMBLYOPIA IS A has been previously treated.
VISUAL DISORDER  For older children aged 13-
IN WHICH A LACK 17, prescribing patching can
OF PROPER VISUAL improve VA when amblyopia has
INPUT DURING NOT been previously treated.
DEVELOPMENT  Performing near activities does
IMPAIRS THE not improve VA when treating
VISUAL PATHWAY, amblyopia with patching.
RESULTING IN Other visual functions were
DECREASED VISUAL not studied, thus the benefit
ACUITY of near activities on other
visual functions including
accommodation, pursuit,

Glasses alone can improve saccades, and eye and hand
amblyopia. The first line of coordination are unknown
treatment is prescribing a  There is a risk of recurrence
spectacle prescription if warranted. of amblyopia after stopping
The studies have found that treatment with patching or
optimal spectacles can lead to atropine, especially within the
improvements in vision in children first three months. Recurrence
with anisometropic amblyopia, HOURS OF PATCHING risk is low when 2 hours of
strabismic amblyopia, bilateral RECOMMENDED FOR patching is stopped, and is more
refractive amblyopia, and combined CHILDREN AGES 3-7: common when patching is not
mechanism amblyopia, and these tapered from 6 or more hours.
improvements are more significant  Moderate amblyopia: patch 2 Thus patients should be tapered
if the children are younger or have hours a day (similar in efficacy to to 2 hours before stopping
better baseline VA. patching 6 hours a day) treatment.
Additional treatment with  Severe amblyopia: patch 6 hours A good understanding of the
patching, atropine, or a Bangerter a day (similar in efficacy to full research is crucial to providing
filter can then be initiated if time patching); may respond to the best care for your amblyopic
amblyopia persists. Before the ATS 2 hours a day patients. Treatment is dependent
studies, there was no consensus DOSING OF ATROPINE on many factors such as the
about the number of hours severity of amblyopia, age of the
amblyopic patients should be RECOMMENDED FOR patient, and parental and patient
patched and full time occlusion was CHILDREN AGES 3-12: motivation. Early intervention is
often recommended. There was  Moderate amblyopia: weekend key! Know when to treat and if you
also no consensus on the dosage of atropine (similar in efficacy to don’t feel comfortable, refer to an
atropine, and its efficacy compared daily atropine) OD who does.
to patching. The ATS studies have
found that both patching and ADDITIONAL FINDINGS:
atropine are effective treatments  When the VA in the amblyopia
for amblyopia, and provide us with eye stops improving with 2
recommendations for treatment hours of patching, increase the
based on amblyopia severity and hours of patching to 6 hours for
patient age. PEDIG has defined children aged 3 to 7.
amblyopia as mild (20/30 or better),
moderate (20/40-20/80), and severe  For children aged 7-12,
(20/100-20/400). prescribing patching can

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