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OLDER CHILDREN CAN BENEFIT FROM TREATMENT FOR CHILDHOOD'S MOST
COMMON EYE DISORDER
Note: Prevent
Blindness America is excited to provide the following report from
the National Eye Institute about groundbreaking research into the
prevention of vision loss from amblyopia.
Surprising results
from a nationwide clinical trial show that many children age seven
through 17 with amblyopia (lazy eye) may benefit from treatments
that are more commonly used on younger children.
Treatment improved
the vision of many of the 507 older children with amblyopia studied
at 49 eye centers. Previously, eye care professionals often thought
that treating amblyopia in older children would be of little benefit.
The study results, funded by the National Eye Institute (NEI), part
of the National Institutes of Health (NIH), appear in the April
issue of Archives of Ophthalmology.
"Doctors can
now feel confident that traditional treatments for amblyopia will
work for many older children, said Paul A. Sieving, M.D., Ph.D.,
director of the NEI. "This is important because it is estimated
that as many as three percent of children in the United States have
some degree of vision impairment due to amblyopia. Many of these
children do not receive treatment while they are young," he said.
Amblyopia is
a leading cause of vision impairment in children and usually begins
in infancy or childhood. It is a condition resulting in poor vision
in an otherwise healthy eye due to unequal or abnormal visual input
while the brain is developing in infancy and childhood. The most
common causes of amblyopia are crossed or wandering eye (strabismus)
or significant differences between the eyes in refractive error,
such as, astigmatism, farsightedness, or nearsightedness.
Children in
the study were divided randomly into two groups. One group was fitted
with new prescription glasses only. The other group was fitted with
glasses as well as an eye patch, or the eye patch along with special
eye drops, to limit use of the unaffected eye. These children were
also asked to perform near vision activities. The patching, near
activities, and eye drops force a child to use the eye with amblyopia.
Patching was prescribed for periods of two to six hours daily, while
the eye drops were administered daily for the children seven though
twelve years of age.
The study investigators
defined successful vision improvement as the ability to read (with
the eye with amblyopia) at least two more lines on a standard eye
chart. The study investigators found that 53 percent of children
age seven through twelve years who received both glasses and treatment
with patches and near activity met this standard, while only 25
percent of those children in this age group who received glasses
alone met the standard. For children age 13 through 17 years who
were treated with both glasses and patches (these children did not
get drops), 25 percent met the standard while 23 percent of children
of these ages who received only glasses met the standard.
The study also
revealed that among children age 13 through 17 years who had not
been previously treated for amblyopia, 47 percent of those who were
treated with glasses, patching and near activities improved two
lines or more compared with only 20 percent of those treated with
glasses alone. Despite the benefits of the treatment, most children,
including those who responded to treatment, were left with some
visual impairment. They did not obtain "20/20" vision.
"This study
shows how important it is to screen children of all ages for amblyopia."
said study co-chairman Richard W. Hertle, M.D., Children's Hospital
of Pittsburgh.
Commented co-chairman
Mitchell M. Scheiman, O.D., Pennsylvania College of Optometry, "This
study shows that age alone should not be used as a factor to decide
whether or not to treat a child for amblyopia. The opportunity to
treat amblyopia does not end with the pre-school years."
It is not known,
say the authors of the current study, whether vision improvement
will be sustained in these children once treatment is discontinued.
The NEI is supporting a one-year, follow-up study to determine the
percentage of amblyopia that recurs among the children who responded
well to treatment, as well as many other clinical studies of amblyopia
at eye centers nationwide.
Dr. Sieving
also commented that the current study results are "a wonderful example
of the adaptability of the human visual system and brain. The NIH
is exploring ways to take advantage of this adaptability in order
to better understand and treat vision problems and other neurological
conditions."
The study described
in this release was conducted by the NEI-funded Pediatric Eye Disease
Investigator Group. The Group focuses on studies of childhood eye
disorders that can be implemented by both university-based and community-based
practitioners as part of their routine practice. The study was coordinated
by the Jaeb Center for Health Research in Tampa, Florida. A list
of study centers is attached.
For more information
on the study, visit the website of the National Eye Institute at
http://www.nei.nih.gov/ats3/.
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