title: Use of atropine penalization to treat amblyopia in UK orthoptic practice.
abstract: OBJECTIVE
  To compare clinical practice patterns regarding atropine penalization use by UK orthoptists to the current evidence base and identify any existing barriers against use of AP as first-line treatment.
  
  
  METHODS
  An online survey was designed to assess current practice patterns of UK orthoptists using atropine penalization. They were asked to identify issues limiting their use of atropine penalization and give opinions on its effectiveness compared to occlusion. Descriptive statistics and content analysis were applied to the results.
  
  
  RESULTS
  Responses were obtained from 151 orthoptists throughout the United Kingdom. The main perceived barriers to use of atropine penalization were inability to prescribe atropine and supply difficulties. However, respondents also did not consider atropine penalization as effective as occlusion in treating amblyopia, contrary to recent research findings. Patient selection criteria and treatment administration largely follow current evidence. More orthoptists use atropine penalization as first-line treatment than previously reported.
  
  
  CONCLUSIONS
  Practitioners tend to closely follow the current evidence base when using atropine penalization, but reluctance in offering it as first-line treatment or providing a choice for parents between occlusion and atropine still remains. This may result from concerns regarding atropine's general efficacy, side effects, and risk of reverse amblyopia. Alternatively, as demonstrated in other areas of medicine, it may reflect the inherent delay of research findings translating to clinical practice changes.
authors.forename: Marianne
authors.initials: M
authors.lastname: Piano
authors.forename: Anna R
authors.initials: AR
authors.lastname: O'Connor
authors.forename: David
authors.initials: D
authors.lastname: Newsham
mesh_terms: D000293:Adolescent; D000550:Amblyopia / Q000188:drug therapy*; D015858:Anisometropia / Q000188:drug therapy; D001285:Atropine / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions; D004363:Drug Utilization / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D009184:Mydriatics / Q000008:administration & dosage*; D009883:Ophthalmic Solutions; D009988:Orthoptics / Q000706:statistics & numerical data*; D011364:Professional Practice / Q000706:statistics & numerical data*; D013285:Strabismus / Q000188:drug therapy; D006113:United Kingdom; D014792:Visual Acuity
chemical_list: D009184:Mydriatics; D009883:Ophthalmic Solutions; D001285:Atropine