Amblyopia caused by unilateral atropinization.

Unilateral atropinization is used in infants and children in the treatment of amblyopia (penalization). It is also used to prevent amblyopia in eyes with cataracts involving only the central portions of the lens. It is not generally realized, however, that unilateral atropinization during visual immaturity may actually cause amblyopia. Three reported cases demonstrate this point. Experiments in monkeys raised with unilateral cycloplegia demonstrated shrinkage of cells in the lateral geniculate nucleus and loss of cortical binocularity and of neurons responding to stimulation of the atropinized eye. The clinical data reported in this study, in conjunction with information gleaned from animal models, indicate that caution must be applied when considering prolonged unilateral atropinization of infants and young children.