Michael X Repka, Susan A Cotter, Roy W Beck, Raymond T Kraker, Eileen E Birch, Donald F Everett, Richard W Hertle, Jonathan M Holmes, Graham E Quinn, Nicholas A Sala, Mitchell M Scheiman, David R Stager Sr, David K Wallace

A randomized trial of atropine regimens for treatment of moderate amblyopia in children

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Objective: To compare daily atropine to weekend atropine as prescribed treatments for moderate amblyopia in children younger than 7 years.


Design: Prospective, randomized multicenter clinical trial (30 sites).


Participants: One hundred sixty-eight children younger than 7 years with amblyopia in the range of 20/40 to 20/80 associated with strabismus, anisometropia, or both.


Intervention: Randomization either to daily atropine or to weekend atropine for 4 months. Partial responders were continued on the randomized treatment until no further improvement was noted.

Main outcome measure: Visual acuity (VA) in the amblyopic eye after 4 months.


Results: The improvement in VA of the amblyopic eye from baseline to 4 months averaged 2.3 lines in each group. The VA of the amblyopic eye at study completion was either (1) at least 20/25 or (2) better than or equal to that of the sound eye in 39 children (47%) in the daily group and 45 children (53%) in the weekend group. The VA of the sound eye at the end of follow-up was reduced by 2 lines in one patient in each group. Stereoacuity outcomes were similar in the 2 groups.

Conclusions: Weekend atropine provides an improvement in VA of a magnitude similar to that of the improvement provided by daily atropine in treating moderate amblyopia in children 3 to 7 years old. This article contains additional online-only material available at

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