In the News
Older Children Can Benefit From Treatment
For Childhood's Most Common Eye Disorder
Surprising results from a nationwide clinical trial show that many children age
seven through 17 with amblyopia (lazy eye) may benefit from treatments that
are more commonly used on younger children.
Treatment improved the vision of many of the 507 older children with
amblyopia studied at 49 eye centers. Previously, eye care professionals often
thought that treating amblyopia in older children would be of little benefit.
"Doctors can now feel confident that traditional treatments for amblyopia will
work for many older children," said Paul A. Sieving, M.D., Ph.D., director of the
NEI. "This is important because it is estimated that as many as three percent
of children in the United States have some degree of vision impairment due to
amblyopia. Many of these children do not receive treatment while they are
young," he said.
Amblyopia is a leading cause of vision impairment in children and usually
begins in infancy or childhood. It is a condition resulting in poor vision in an
otherwise healthy eye due to unequal or abnormal visual input while the brain
is developing in infancy and childhood. The most common causes of amblyopia
are crossed or wandering eye (strabismus) or significant differences between
the eyes in refractive error, such as, astigmatism, farsightedness, or
Children in the study were divided randomly into two groups. One group was
fitted with new prescription glasses only. The other group was fitted with
glasses as well as an eye patch, or the eye patch along with special eye drops, to
limit use of the unaffected eye. These children were also asked to perform near
vision activities. The patching, near activities, and eye drops force a child to use
the eye with amblyopia. Patching was prescribed for periods of two to six hours
daily, while the eye drops were administered daily for the children seven
though 12 years of age.
The study investigators defined successful vision improvement as the ability to
read (with the eye with amblyopia) at least two more lines on a standard eye
chart. The study investigators found that 53 percent of children age seven
through 12 years who received both glasses and treatment with patches and
near activity met this standard, while only 25 percent of those children in this
age group who received glasses alone met the standard. For children age 13
through 17 years who were treated with both glasses and patches (these
children did not get drops), 25 percent met the standard while 23 percent of
children of these ages who received only glasses met the standard.
The study also revealed that among children age 13 through 17 years who had
not been previously treated for amblyopia, 47 percent of those who were
treated with glasses, patching and near activities improved two lines or more
compared with only 20 percent of those treated with glasses alone. Despite the
benefits of the treatment, most children, including those who responded to
treatment, were left with some visual impairment. They did not obtain
Commented study co-chairman Mitchell M. Scheiman, O.D., Pennsylvania
College of Optometry, "This study shows that age alone should not be used as a
factor to decide whether or not to treat a child for amblyopia. The opportunity
to treat amblyopia does not end with the pre-school years."
Dr. Sieving also commented that the current study results are "a wonderful
example of the adaptability of the human visual system and brain. The NIH is
exploring ways to take advantage of this adaptability in order to better
understand and treat vision problems and other neurological conditions."
The National Eye Institute (NEI) a component of the National Institutes of
Health is the federal government's lead agency for vision research that leads to
sight saving treatments and plays a key role in reducing visual impairment and
blindness. For more information, visit the NEI Web site at www.nei.nih.gov/.
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