Amblyopia is normally defined as a reduction in vision in one eye -- although it occasionally affects both eyes � that is physically healthy and starts in the first year of life. It is normally due to a significant refractive error in one eye and little or no refractive error in the other. Strabismus may or may not be concurrent with this profile.

It should be understood that there are new concepts in visual processing and neurotransmitter activity that may better explain the �how and why� of amblyopia and its effective treatment modes. This is the first of a short series of reports on new research and techniques involving amblyopia treatment.

The SAVP ( Strabismus, Amblyopia and Visual Processing) Program of The National Eye Institute (NEI) supports a broad range of laboratory and clinical investigations. One such study, The Amblyopia Treatment study, was conducted by the Pediatric Eye Disease Investigator Group (PEDIG) involving optometrists and ophthalmologists from the United States, Canada and Mexico, based in Tampa, Fla., and coordinated by the Jaeb Center for Health Research and Wilmer Eye Institute of John Hopkins University. 1

During the study, 215 children received patching and 204 received atropine drops once a day. About a third had a strabismus, another third had a significant refractive error in one eye and the rest had both. At the end of six months, both groups achieved statistically similar results, although the group with patching advanced faster than their atropine counterparts. 2 These children were schedule to be followed until April.

It was also found that evaluating the acuity with the Baylor Video Acuity Tester (BVAT) vis-�-vis the HOTV optotype targets, that the BVAT had a significant correlation to the HOTV and is now incorporated in the study 4. In the end, they created a Treatment Index which accessed the relative adherence to the protocol and the impact of the treatment. 3

Best wishes for continued success,

Jeffrey C. Magun, O.D., F.A.A.O.

References:
[No authors listed] A randomized trial of atropine vs. patching for treatment of moderate amblyopia in children. Arch Ophthalmol. 2002 Mar;120(3):268-78.
[No authors listed] The clinical profile of moderate amblyopia in children younger than 7 years. Arch Ophthalmol. 2002 Mar;120
Cole SR, Beck RW, Moke PS, Celano MP, Drews CD, Repka MX, Holmes JM, Birch EE, Kraker RT, Kip KE. The amblyopia Treatment Index. J AAPOS. 2001 Aug;5(4): 250-4
Holmes, JM, Beck RW, Repka MX, Leske DA, Kraker RT, Blair RC, Moke PS, Birch EE, Saunders RA, Hertle RW, Quinn GE, Simons KA, Miller JM. The amblyopia Treatment study visual acuity testing protocol. Arch Ophthalmol. 2001 Sept;119(9):1345-53