Penalization Revisited: Refractive Penalization in the Treatment of Amblyopia

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Abstract
Penalization of the dominant eye in the treatment of amblyopia can be achieved medically by using cycloplegics (e.g. atropine) and refractively, by increasing the plus correction of the lens for that eye. When the dominant eye is over plused, distance penalization is achieved with the amblyopic eye required to fixate at the distance but allowing the dominant eye to fixate at near. Twenty-four patients have been treated from one to 30 months by the method of refractive penalization of the dominant eye. Ninety-one percent (22/24) had stable or improved vision using this technique. Refractive penalization can be a useful additional tool in the treatment of amblyopia in the school age patient where compliance with direct occlusion therapy is poor.

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