Myopia and Atropine

What is Myopia?

  • Short-sightedness or Near-sightedness
  • Person is able to see near objects well but has difficulty seeing objects that are far away
  • Occurs when an eyeball is too long, causing light rays to fall in front of the retina, and not focus accurately on it
    • Usually expressed with a “minus” sign in diopters (D)
      myopia and atropine
  • Spectacles, contact lenses and LASIK can be used to achieve good vision but do not address the problem of increased eyeball length
  • High myopia may be associated with potentially blinding conditions such as retinal tears, glaucoma, cataracts and choroidal neovascularization.

 

Causes of Myopia

  • Myopia is a highly heritable trait
  • Environmental factors are also known to play a key role
    • Levels of education
    • Time spent outdoors
    • Pre-natal factors

 

How do I slow progression of myopia?

  • Spend more time outdoors
  • Visual training and biofeedback
    • No significant reduction in myopia
  • Under-correcting myopia
    • Under-correction of 0.75D leads to a more rapid progression of myopia
  • Use of bifocal or progressive spectacle lenses
    • No significant difference
  • Peripheral lens design
    • Spectacle lens designs with a concentric zone with peripheral defocus were found to influence refractive development in chicks and some reduction in myopic progression.
    • Studies in children found no significant effect in slowing the progression of myopia though and were related to the constant changing of eye position when viewing through the lenses
    • Contact lenses adopting a similar design have shown promising results for reducing myopic progression.
  • Pharmacotherapy
    • Atropine eye drops have been found to have good effects in slowing myopia progression
  • Contact lenses and orthokeratology
    • Risk of cornea infections and permanent scarring

Atropine eye drops

  • Study on atropine for myopia in children first done in the 70s.
    • More recently, atropine has been tested on 400 myopic children in Singapore
    • Results showed that over a 2 year period, average increase in myopia in children on atropine was 25 degrees compared to 125 degrees in those not using atropine
    • Atropine eye drops generally slows progression by 60%
    • The effects persisted at 1 year after stopping the medications, but there was some rebound in myopia progression
    • Latest research shown that a lower concentration of atropine (0.01%) has minimal side effects but comparable efficacy and less rebound
    • Conclusion is the use of atropine in the short term is safe and can reduce myopia progression
  • Atropine eye drops is to be administered every night
  • May need to be used for 2 years or more
  • Possible side effects
    • Glare in bright sunlight
      • Photochromatic lenses or sunglasses may need to be used
    • Blurring of near vision
      • Progressive glasses or bifocals may need to be worn to help with near vision
    • Above side effects common with 1% atropine; with lower concentration of 0.01%, pupil dilation and blurring of near vision almost always negligible
    • Systemic side effects such as flushed face, fever, rapid heart rate, dry mouth and skin, constipation, drowsiness, occurs mostly in infants and toddlers, and not been reported in myopic children treated with atropine in Singapore.
    • Side effects are temporary and will disappear sometime after stopping the eyedrops
    • Possible long term effects not known or reported, but increased light exposure on the lens and retina may lead to premature cataracts, retinal dysfunction or macular degeneration.

To schedule an appointment or to know more about atropine eye drops as treatment for myopia for your child, please call 6777 6058. Alternatively please send us an enquiry.

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