ATROPINE PENALISATION VERSUS OCCLUSION AS THE PRIMARY-TREATMENT FOR AMBLYOPIA

Aims/background-Pharmacological penalisation of non-amblyopic eyes is an infrequently used alternative to occlusion for treating amblyopia. The authors compared the efficacy of atropine penalisation and that of occlusion as a primary treatment for amblyopia. Methods-Thirty six ne wly diagnosed patients with amblyopia were allocated to two groups for treatment. Eighteen patients in each group were treated either with a tropine penalisation (group A) or occlusion therapy (group P). Results -There was a statistically significant improvement in visual acuity in both groups treated. In group A improvement of the geometric mean vis ual acuity of the amblyopic eye was from 6/50 to 6/11 (p < 0.001). In group P improvement of the geometric mean visual acuity was from 6/60 to 6/19 (p < 0.001), In group A noncompliance with treatment was only 6% (2/18). Non-compliance in group P was 45% (8/18) at some stages of the treatment. Neither group produced an incidence of occlusion amblyo pia. Conclusions-In this study atropine penalisation has been shown to be as effective as occlusion therapy in the treatment of amblyopia. P atient acceptance of atropine penalisation was superior to that for oc clusion therapy as was shown by the compliance rate. Atropine treatmen t was also advantageous in that compliance could be readily checked by inspection.