Eye Drops for the Tx of Amblyopia
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I Heard That There Are New Drops to Treat Amblyopia. What Do You Think of Them?

For over 20 years some eye doctors, like us, have used  drops or ointment to substitute for patching the good eye in the treatment of amblyopia.  Patching is uncomfortable and cosmetically conspicuous leaking to poor cooperation among some children.

The drops, which may be used in lieu of patching or to augment patching, eliminate the ability of the eye to focus.

A recent federally funded, long term, multi-centered study was carried out to compare patching to drops.  Drops were found to be as effective as patching and clearly were easier to do. The kids and parents were happier.  The child couldn't remove the drops like they do with patches and it was cosmetically acceptable.  We have been using this procedure for years and agree with the study.  We generally begin with patching but move to drops quickly.  The drops/ointment called atropine can have some side effects which are listed below (call if your child experiences any the ones in blue)

blurry vision
sensitivity to light
dilated pupils
burning from the ointment or drops
redness of the eyes, lids, face
temperature (uncommon)
short term psychosis with or without hallucinations (uncommon except in Down's syndrome)
increased heart rate (uncommon)
respiratory depression (very rare)

If your child is being treated with atropine and you are prescribed any other medication let both your pediatrician and pharmacist know.

Children with atropine treatment need special lenses that change power gradually, i.e., progressive lenses and should respond to the sunlight by darkening (transitional lenses).

How Do I Use the Atropine Drops/Ointment?

Apply approximately a 1/4 inch ribbon of the ointment in the better seeing eye, preferably along the eye lid margin.  Reduction of systemic effects can be accomplished by compressing the lacrimal sac located between the inner portion of the eye and the nose for a couple of minutes.  We usually use the ointment at night twice a week.  Sunglasses are often necessary and special eye glasses.

Is It True That There Are Clear Patches?

Not really, there are graded semi transparent patches that we use.  They are easily re-movable and allow us to vary the blur as the vision improves.  They are cosmetically very acceptable.  They have the ability to blur the lazy eye in decrements, thus, they may be beneficial in titrating vision.