Amblyopia in children is commonly treated by patching the unaffected eye to increase the use of the eye with impaired visual acuity, but compliance with patch wearing can be a problem. A recent Cochrane review suggests that treatment with atropine drops appears to be at least as effective as patching (level 2 [mid-level] evidence). In 3 trials with 518 children aged 2-10 years (525 amblyopic eyes), visual acuity was measured in both amblyopic and sound eyes at baseline and at various timepoints during follow-up. Adverse effects and difficulties associated with treatment were assessed with questionnaires. Patching and atropine drops were both well tolerated. In the largest, highest-quality trial, atropine was associated with higher compliance rates (78% vs. 49%) and greater mean improvement in acuity at 6 months (3.4 lines vs. 1.8 lines, p < 0.05). The other two trials showed no significant differences in acuity between groups, though both groups showed improvement at 24 months in 1 trial (Cochrane Database Syst Rev 2009 Oct 7;(4):CD006460).

For more information, see the Amblyopia topic in DynaMed.