Vol. 10, Issue 11, Part D (2024)

Background: Amblyopia, commonly referred to as "lazy eye", is a prevalent visual impairment that originates in childhood. It is characterized by reduced vision in one eye, which cannot be corrected by glasses or contact lenses and is not caused by any structural abnormalities. This condition affects about 2–3% of the population and can lead to lifelong visual impairment if not properly treated. Various treatment modalities, including occlusion therapy (patching), atropine penalization, binocular training, and pharmacological approaches, have been employed. This review aims to provide a comprehensive evaluation of current amblyopia treatment strategies, focusing on their effectiveness, recent advancements, and areas needing further investigation.

Methodology: This narrative review followed the PRISMA guidelines, including a comprehensive search of databases such as PubMed, Scopus, and Google Scholar. Studies published between 2000 and 2023 were considered. The inclusion criteria were randomized controlled trials (RCTs), meta-analyses, and clinical studies focusing on different amblyopia treatment modalities in paediatric populations. A total of 320 records were identified, of which 56 full-text articles were screened, and 30 studies were included in the final analysis.

Results: The review found that patching therapy remains a gold standard but has limitations, particularly regarding compliance, with success rates varying between 50% and 75%. Atropine penalization was found to have comparable efficacy, with fewer compliance issues. Binocular training, especially dichoptic techniques, demonstrated promising results, with some studies showing up to a 60% improvement in stereopsis and visual acuity. Pharmacological agents such as levodopa and citicoline showed potential benefits in enhancing neural plasticity, particularly in older children and adolescents, with mean visual acuity improvements ranging between 0.1 and 0.3 logMAR. However, variability in outcomes was observed based on age, severity, and treatment adherence.

Conclusion: Amblyopia treatment has evolved from traditional patching to more advanced methods like binocular training and pharmacological interventions. While traditional therapies remain effective, newer treatments show promise, especially for older patients. The challenge remains in optimizing treatment protocols, improving compliance, and developing age-appropriate therapies. Future research should continue to explore personalized approaches to maximize treatment outcomes.