Treatment options for non-compliant children with amblyopia in Kuwait

ABSTRACT

The mainstay treatment for more than 250 years has been occlusion of the better eye by an opaque patch. Pharmacological penalization is an alternative therapy for noncompliant child. The aim of this study is to investigate the effects of atropine penalization in amblyopic patients who are noncompliant with conventional occlusion. This is a retrospective study of 114 children aged 24 to 78 months with unilateral Ambyliopia diagnosed at the Pediatric Ophthalmology unit of AL-Bahar Eye Center in Kuwait during the time period December 1999 to august 2005 and fulfilling the inclusion criteria. The mean follow up time after starting amblyopia treatment was 38.4 +/- 27.12 months. All children with amblyopia were prescribed 6 hours occlusion per day. Children who are non compliant with occlusion were instructed to instil 1 drop of atropine 1% into the nonambyliopic once per day. A total of 114 patients participated in the study.72 [63.16%] patients were compliant with occlusion, 64 of them [88.9%] reached cure within mean time of 23.23 +/- 16.89 months. The remaining 42[36.84%] patients who are not compliant with occlusion were instructed to use atropine 1% eye drops once per day. 38 of them [90.5%] were compliant with penalization and 36 [94.7%] of them reached cure with a mean time 12.9 +/- 9.7 months. Conclusion: The result of this study suggests that atropine penalization should be considered as an alternative therapy in those who are noncompliant with occlusion in treatment of amblyopia