Aims/background-Pharmacological penalisation of non-amblyopic eyes is an infrequently used alternative to occlusion for treating amblyopia. The authors compared the eYcacy of atropine penalisation and that of occlusion as a primary treatment for amblyopia. Methods-Thirty six newly diagnosed patients with amblyopia were allocated to two groups for treatment. Eighteen patients in each group were treated either with atropine penalisation (group A) or occlusion therapy (group P). Results-There was a statistically significant improvement in visual acuity in both groups treated. In group A improvement of the geometric mean visual acuity of the amblyopic eye was from 6/50 to 6/11 (p<0.001). In group P improvement of the geometric mean visual acuity was from 6/60 to 6/19 (p<0.001). In group A noncompliance with treatment was only 6% (2/18). Non-compliance in group P was 45% (8/18) at some stages of the treatment. Neither group produced an incidence of occlusion amblyopia. Conclusions-In this study atropine penalisation has been shown to be as eVective as occlusion therapy in the treatment of amblyopia. Patient acceptance of atropine penalisation was superior to that for occlusion therapy as was shown by the compliance rate. Atropine treatment was also advantageous in that compliance could be readily checked by inspection. (Br J Ophthalmol 1997;81:54-57) Occlusion of the non-amblyopic eye is the most commonly used treatment for children with amblyopia. Pharmacological penalisation is an alternative to occlusion in the treatment of this condition.1 Pharmacological penalisation involves the daily instillation of a cycloplegic agent into the fornix of the non-amblyopic eye to prevent accommodation, thus causing the patient to prefer the amblyopic eye at near.Pharmacological penalisation is infrequently used. Repka and Ray reported on the eYcacy of optical and pharmacological penalisation in 1993.2 They reported an improvement in visual acuity in 76% of 79 amblyopic eyes treated with pharmacological penalisation. In our study atropine penalisation was compared with occlusion therapy as a first line treatment for patients with significant (all of the patients had initial visual acuity of 6/18 or less) amblyopia. This comparison of treatments has not been reported in the literature before. Materials and methodsAll of the patients entering into this trial were new patients who presented to our outpatient clinic having never had any previous treatment for their amblyopia. The trial began in January 1994, and the last patient was entered in December 1994. All new patients due to commence treatment for amblyopia were allocated either to treatment with atropine penalisation (treatment A), or to occlusion therapy (treatment P). This was achieved on a strict alternate patient basis. Appointments were organised by an independent observer (clinic sister) in order to prevent any possibility of bias being introduced.Data collected included age, previous and family ocular history, type of amblyopia, visual acuity, and refractiv...

Laser in situ keratomileusis represents a step forward in the surgical correction of high myopia, but the accuracy of the corneal ablation location must be improved. Suction ring fixation of the globe or real time tracking systems may help improve centration.

Background-Laser intrastromal keratomileusis (LASIK) is an evolving technique which enables high degrees of myopia (>8.0 dioptres) and myopic astigmatism to be corrected. This paper describes initial experience with this procedure. It also details the methodology, the results, the problems encountered, and discusses retreatment procedures.

Ophthalmic findings are reported in 31 eyes of 28 children with herpes simplex keratitis. Twenty two had dendritic ulcers, and nine had geographic ulcers or disciform stromal keratitis. After resolution of keratitis, 80% (19/22) of children with dendritic ulcers achieved corrected visual acuity of6/9 or better, 50% (11/22) had induced astigmatism, 45% (9/22) had one to five recurrences. In the group with geographic or disciform lesions, 89% (8/9) had reduced corrected vision, 78% (7/9) had induced astigmatism which was predominantly against the rule, and 87% (7/9) had one to six recurrences.

Polyacrylic acid gel was as safe as and more effective than polyvinylalcohol in the treatment of patients with dry eyes.