’Weekend’ use matches daily drops for ’lazy eye’

Adults who dispense eye drops daily to correct a child’s “lazy eye” take note: a new study from researchers at the Johns Hopkins Children’s Center and 29 other centers across North America finds that giving the drops just twice during the weekend is just as effective as administering them every day of the week.

In what is believed to be the first clinical trial comparing treatment regimens of atropine sulfate eye drops for the treatment of amblyopia, the investigators concluded that “there is no obvious advantage to the daily administration of atropine eye drops in either the speed of improvement or in the magnitude of improvement after four months of treatment,” according to Michael Repka, M.D., the lead author of the study and a pediatric ophthalmologist at the Children’s Center. These findings are published by the Pediatric Eye Disease Investigator Group (PEDIG) in the November issue of Ophthalmology.

In the study, 168 children up to 7 years old with moderate amblyopia were randomly assigned to getting atropine eye drops either daily or on Saturday and Sunday only. After four months of treatment, children following both regimens were able to read an average of 2.3 lines higher on a standard eye chart. Additionally, 47 percent of children receiving daily drops and 53 percent getting weekend drops had vision in the amblyopic eye improve to normal levels by the four-month mark. This considerable degree of improvement is similar to that accomplished with daily eye patching, the mainstay of amblyopia treatment, the researchers note.

“The daily burden of administering drops usually falls on the parent, and if weekend eye drops are a good option, the regimen not only relieves some of this burden but may also encourage compliance with the treatment,” Repka adds. “Compliance is very important, since timely and successful treatment for amblyopia in childhood can prevent lifelong visual impairment.”

The most common cause of vision loss in children and young adults, amblyopia affects as many as 3 percent of children in the United States and usually begins in infancy or childhood. The condition is marked by poor vision in an otherwise healthy eye and occurs because the brain has learned to favor the other eye. Although the eye with amblyopia often looks normal, abnormal visual processing limits the development of a portion of the brain responsible for sight. The most common causes are crossed or wandering eyes, or significant differences in refractive error, such as farsightedness or nearsightedness, between the two eyes.

Atropine eye drops are designed to temporarily blur vision in the unaffected eye, thereby forcing the amblyopic eye to do most of the work. This helps strengthen the amblyopic eye and improves vision.

This research was conducted by the PEDIG at 30 clinical sites throughout North America and was funded by the National Eye Institute. The PEDIG focuses on studies of childhood eye disorders that can be implemented by both university-based and community-based practitioners as part of their routine practice.