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Original article

An audit of atropine penalisation as a primary treatment for amblyopia

Authors:

Kate Taylor ,

Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne
About Kate
BSc (Orthoptics)
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Catherine Hudson,

Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne
About Catherine
DBO
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Kinnar Merchant

Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne
About Kinnar
FRCSEd (Ophth) MRCOphth
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Abstract

Background: Amblyopia is defined as defective visual acuity in one or both eyes which persists after correction of refractive error and removal of pathological obstacles to vision. Pharmacological treatment for amblyopia is an alternative treatment but until recently tended to be prescribed less frequently than conventional occlusion. Pharmacological penalization involves the instillation of a cycloplegic agent, such as atropine, into the non-amblyopic eye.

Methods: In 2005 a new departmental policy was introduced to allow for the use of atropine as firstline treatment for amblyopia. At diagnosis parents are offered the choice of treatment: atropine or conventional occlusion. This retrospective audit analysed the final visual acuity results of children treated with atropine under the new protocol.

Results: Sixty-five patients were included. Starting average visual acuity was 0.645 logMAR (SD = 0.288). Final average visual acuity achieved at the immediate cessation of treatment was 0.366 logMAR (SD = 0.277). Average duration of treatment was 3.6 months (range 6 weeks to 6 months). Adverse events were documented in 8 cases (12%). Two year followup data are available for 62 patients. Twenty-one (33%) patients required additional treatment to maintain the vision improvement. At 2 years posttreatment the visual acuity in the treated amblyopic eye was 0.378 logMAR (SD = 0.373).

Conclusion: This audit has reconfirmed the efficacy of atropine, with 50% of patients (n = 32) achieving a cure result (0.250 or better) and 34% a satisfactory outcome (0.275–0.500). Visual acuity change in the amblyopic eye did not have a statistically significant dependence on type of amblyopia (p = 0.46).
DOI: https://doi.org/10.22599/bioj.20
How to Cite: Taylor, K., Hudson, C. and Merchant, K., 2010. An audit of atropine penalisation as a primary treatment for amblyopia. British and Irish Orthoptic Journal, 7, pp.20–26. DOI: http://doi.org/10.22599/bioj.20
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Published on 01 Aug 2010.
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