Objective: To compare the effects of occlusion and pharmacological penalization on visual acuity in the treatment of amblyopia.

Material and Method: Thirty-nine patients followed up in our strabismus unit due to amblyopia were included in our study. The patients were randomly divided into two groups as occlusion and pharmacological penalization. and visual acuities of both groups were compared before and after treatment. All patients underwent a complete ophthalmological examination. In the occlusion group, alternating occlusion for 3 days in the healthy eye and 1 day in the amblyopic eye (3:1) for 6 months was applied for 1 to 6 hours, depending on the degree of amblyopia and the age of the patient, while pharmacological penalization was applied once a day to the healthy eyes of the patients with 1%. Atropine sulfate was instilled dropwise and continued for one month. Then, intermittent treatment was started and atropine was dripped into the healthy eye twice a week, and this treatment was continued for 6 months.

Results: Pharmacological penalization therapy was applied to 19 of the patients (8 girls, 11 boys), and occlusion therapy was applied to 20 (8 girls, 12 boys). While the mean visual acuity of amblyopic eyes in the pharmacological penalization group was 0.15±0.07 according to the Snellen chart before the treatment, it was 0.41±0.17 at the 6th month after the treatment. The mean visual acuity of the amblyopic eye was increased by 0.26±0.13 with treatment (p <0.001). The visual acuity in amblyopic eyes in the occlusion group was 0.27±0.18 according to the Snellen chart before the treatment, and 0.40±0.25 at the 6th month after the treatment. A mean increase of 0.22±0.11 was detected in the visual acuity of the amblyopic eyes (p <0.001). There was no statistically significant difference between the visual acuity improvement rates of the two groups (p >0.05).

Conclusion: In our study, occlusion and pharmacological penalization applied in the treatment of amblyopia were found to be effective at a rate similar to the increase in visual acuity, Penalization of atropine should be kept in mind in children who do not comply with occlusion therapy.