Evaluating the burden of amblyopia treatment from the parent and child's perspective

J AAPOS. 2010 Oct;14(5):389-95. doi: 10.1016/j.jaapos.2010.07.009.


Purpose: To evaluate the psychometric properties of the original Parent and new Child Amblyopia Treatment Index (ATI), questionnaires that assess the burden of amblyopia treatment in children and families, and to compare scores between children treated with atropine or patching.

Methods: Parent ATI and Child ATI were administered to 233 children 7 to <13 years old and their parents as part of a randomized trial comparing patching and atropine for amblyopia treatment. For each ATI version, construct validity was assessed using factor analysis; internal consistency reliability was assessed using Cronbach's alpha. Data from the Parent ATI and Child ATI were correlated and scores for each version were compared between treatment groups.

Results: We analyzed the 3 subscales found in prior Parent ATI studies in younger children and confirmed subscales for adverse effects and treatment compliance, but not for social stigma, in both parent and child versions. Overall and subscale scores on the Parent ATI and Child ATI were moderately to well correlated except for the social stigma subscale. For both the Parent ATI and the Child ATI, children treated with atropine had better scores than those treated with patching, both overall and on treatment compliance and social stigma subscales (all p values ≤ 0.01).

Conclusions: When used for children 7 to <13 years old, the Parent ATI and Child ATI have similar factor structures to each other and to the Parent ATI for children 3 to <7 years old. Atropine treatment was found to have less negative impact than patching.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Amblyopia / drug therapy*
  • Amblyopia / psychology*
  • Atropine / administration & dosage*
  • Bandages*
  • Child
  • Cost of Illness
  • Humans
  • Mydriatics / administration & dosage*
  • Ophthalmic Solutions
  • Parents / psychology
  • Patient Acceptance of Health Care*
  • Patient Compliance
  • Psychology, Child
  • Psychometrics
  • Surveys and Questionnaires


  • Mydriatics
  • Ophthalmic Solutions
  • Atropine