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

Ophthalmology. 2004 Nov;111(11):2076-85. doi: 10.1016/j.ophtha.2004.04.032.


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 http://www.ophsource.com/periodicals/ophtha.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Amblyopia / drug therapy*
  • Atropine / administration & dosage*
  • Atropine / adverse effects
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mydriatics / administration & dosage*
  • Mydriatics / adverse effects
  • Ophthalmic Solutions / administration & dosage
  • Prospective Studies
  • Visual Acuity / drug effects
  • Visual Acuity / physiology


  • Mydriatics
  • Ophthalmic Solutions
  • Atropine