Amblyopia Treatment Study (ATS) - Atropine vs. Patching

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Kids often dress up as pirates, but do they really want to keep their eye patches on after Halloween? Prior to this landmark study in 2002, the corrective treatment for amblyopia correction was almost exclusively patching. Still, concerns around compliance raised the question of whether medical penalization therapy (atropine) could be similarly effective. In this trial, children aged 3-7 with moderate amblyopia were randomized to be treated with either patching or 1% atropine in their non-amblyopic eye.

Key Points:

• Both patching and atropine led to significant visual improvement, with similar success rates (amblyopic eye VA 20/30 or better: 79% in atropine, 74% in patching)
• Patching offered a more rapid recovery of vision at 5 weeks, and slightly greater visual improvement at 6 months (3.16 lines vs. 2.84 lines), but this difference was thought to be clinically insignificant
• Patching compliance was slightly higher in the atropine group (95% in atropine, 83% in patching) 

The importance of this study was showing that both patching and atropine are effective in treating moderate amblyopia in children ages 3-7, with patching improving VA more rapidly and atropine being easier to administer as well as cheaper.