Patching, atropine for amblyopia: Both have pros, cons

WAIKOLOA, Hawaii — Patch therapy for children with amblyopia is still preferred over medical treatments such as atropine, a group of pediatric ophthalmologists said here during at the American Association for Pediatric Ophthalmology and Strabismus meeting.

“So far, I’ve only treated 3 patients, out of 1,000, with atropine,” said Kenneth P. Cheng, MD. “I am concerned about the phototoxicity effects of the drug.”

Naval Sondhi, MD, had similar reservations. “I share Dr. Cheng’s concern, so I have kept patching as my gold standard of practice.”

On the contrary, Robert S. Gold, MD, said he has noted a high failure rate for patching at his center. “We have very little compliance for patching, so I prescribe atropine when necessary. I have seen no cases of central toxicity, but results have been variable,” Dr. Gold said.

Roberto Warman, MD, has seen similar results. “I have been using atropine on and off for years. It is useful when the patient has poor compliance,” he said. However, both Drs. Gold and Warman believe that patching continues to be the most effective treatment for amblyopia.

Look for more on this subject in an upcoming issue of Ocular Surgery News.