To compare daily atropine to weekend atropine as prescribed treatments for moderate amblyopia in children younger than 7 years.
Prospective, randomized multicenter clinical trial (30 sites).
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.
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 in the amblyopic eye after 4 months.
The improvement in visual acuity of the amblyopic eye from baseline to 4 months averaged 2.3 lines in each group. The visual acuity of the amblyopic eye at study completion was either (1) at least 20/25 or (2) better than or equal to the sound eye in 39 children (47%) in the daily group and 45 children (53%) in the weekend group. The visual acuity 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 two groups.
Weekend atropine provides an improvement in visual acuity that is of similar magnitude to the improvement provided by daily atropine in treating moderate amblyopia in children aged 3 to 7 years.