M X Repka1, J M Ray. 1. Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Abstract
PURPOSE: Optical and pharmacological penalization of sound eyes are infrequently used alternatives to occlusion for treating amblyopia. The authors evaluated the efficacy of penalization as their primary treatment of amblyopia. METHODS: One hundred sixty-six patients underwent penalization treatment for strabismic or anisometropic amblyopia for a minimum of 3 months. Both atropine and optical penalization methods were used. RESULTS: Visual acuity improved in 67 (77%) of 87 patients treated with optical penalization. There was a significant improvement of the geometric mean visual acuity of the amblyopic eyes from 20/38 to 20/28 (P < 0.001). Visual acuity of 60 (76%) of 79 patients treated with pharmacological penalization improved. There was a significant improvement of mean visual acuity of the amblyopic eyes from 20/61 to 20/40 (P < 0.001). Neither therapy produced an instance of occlusion amblyopia. Thirteen patients discontinued therapy because of blur or discomfort. CONCLUSION: This study demonstrates that penalization methods are effective methods for the treatment of amblyopia, with a low risk of occlusion amblyopia. Patient acceptance of these methods was excellent. Penalization should be considered more often for the primary treatment of amblyopia.
PURPOSE: Optical and pharmacological penalization of sound eyes are infrequently used alternatives to occlusion for treating amblyopia. The authors evaluated the efficacy of penalization as their primary treatment of amblyopia. METHODS: One hundred sixty-six patients underwent penalization treatment for strabismic or anisometropic amblyopia for a minimum of 3 months. Both atropine and optical penalization methods were used. RESULTS: Visual acuity improved in 67 (77%) of 87 patients treated with optical penalization. There was a significant improvement of the geometric mean visual acuity of the amblyopic eyes from 20/38 to 20/28 (P < 0.001). Visual acuity of 60 (76%) of 79 patients treated with pharmacological penalization improved. There was a significant improvement of mean visual acuity of the amblyopic eyes from 20/61 to 20/40 (P < 0.001). Neither therapy produced an instance of occlusion amblyopia. Thirteen patients discontinued therapy because of blur or discomfort. CONCLUSION: This study demonstrates that penalization methods are effective methods for the treatment of amblyopia, with a low risk of occlusion amblyopia. Patient acceptance of these methods was excellent. Penalization should be considered more often for the primary treatment of amblyopia.
Authors: David K Wallace; Elizabeth L Lazar; Michael X Repka; Jonathan M Holmes; Raymond T Kraker; Darren L Hoover; Katherine K Weise; Amy L Waters; Melissa L Rice; Robert J Peters Journal: J AAPOS Date: 2015-02 Impact factor: 1.220
Authors: Michael X Repka; Raymond T Kraker; Roy W Beck; Eileen Birch; Susan A Cotter; Jonathan M Holmes; Richard W Hertle; Darren L Hoover; Deborah L Klimek; Wendy Marsh-Tootle; Mitchell M Scheiman; Donny W Suh; David R Weakley Journal: J AAPOS Date: 2009-06 Impact factor: 1.220