In the treatment of amblyopia by penalisation (optical/pharmacological), atropine penalisation of the fellow (sound) eye works by which mechanism?
- A Inducing myopia in the sound eye, making the amblyopic eye preferred for distance
- B Cycloplegia blurring near vision in the sound eye, forcing use of the amblyopic eye for near tasks ✓
- C Reducing light transmission to the sound eye, causing equal retinal stimulation
- D Miosis in the amblyopic eye, improving its acuity and encouraging fixation
Correct answer: B. Cycloplegia blurring near vision in the sound eye, forcing use of the amblyopic eye for near tasks
Explanation
Atropine drops in the sound eye cause cycloplegia (ciliary muscle paralysis), preventing accommodation. This blurs near vision in the sound eye and forces the child to use the amblyopic eye for near tasks (reading, drawing), promoting cortical stimulation. Near vision tasks are particularly effective in driving cortical plasticity. Optical penalisation (plus lens added to the sound eye) works similarly. Atropine does not induce myopia; it causes a hyperopic shift by paralysing accommodation.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.