Myopia Control – Treatment Options

A promising treatment for childhood near-sightedness (myopia) is welcome news at a time when more and more kids are being diagnosed with the condition. Studies show that a low-dose of atropine, typically given as eye drops at bedtime, can significantly slow the progression of myopia in children, possibly preventing severe near-sightedness. Childhood myopia is usually diagnosed when kids are around 5 to 7 years old. Often, vision gets worse during the eye’s rapid growing years, and levels off at about age 12. People with myopia can see well close-up, but not in the distance. Until recently, the only treatment for pediatric myopia was glasses, with frequent prescription updates as vision gets worse. Myopia isn’t reversible and kids treated with low-dose atropine still need glasses. But in most cases, their near-sightedness doesn’t get nearly as bad as it does for kids who haven’t received the treatment.

Some of the most common treatments for myopia consist of corrective glasses and contact lenses, or medical procedures like LASIK and laser surgeries.However, these options may be inconvenient, uncomfortable, or even come with unwanted side effects, especially for those who develop myopia at a young age.

Alternatively, recent studies on low-dose atropine as a treatment option have shown effectiveness in slowing the progression of myopia before severe correction is needed later in life. One study states that super-diluted atropine (0.01% concentration) reduced myopic progression by 25%. If myopia has already progressed to a certain point, kids treated with low-dose atropine may still need glasses; however, the rate of progression will significantly decrease.2 

Studies of Atropine in the Treatment of Myopia (specifically the ATOM2 trial) have shown the effectiveness of low-dose atropine (0.01%) in Asian children; additional studies show that it can also work in other ethnic groups.5 While atropine is already being used medically to dilate the pupil or treat lazy eye, its use in slowing the progression of childhood myopia is becoming more mainstream in the US as ophthalmologists learn of low- dose atropine’s benefits and risks.

Benefits of low-dose atropine include a low occurrence of ocular and systemic side effects, particularly in children, who are the primary candidates for atropine therapy. It could also potentially circumvent the dis- comfort or unwanted side effects of corrective lenses and laser surgeries. Some risks of atropine in higher doses include: tachycardia, altered mental status, dry mouth, urinary retention, constipation, flushing of skin; however, none of these were reported among children using low doses of atropine (0.05%, 0.025% or 0.01%). There is also the potential for long-term development of an allergy to treatment. Eye growth is most rapid during childhood, so it is imperative to get “a diagnosis as early as possible and [use] atropine consistently through the eye’s growth years.”2

  1. Pineles SL. Kraker RT. Et.al. Atropine for the Prevention of Myopia Progression in Children. American Academy of Ophthalmology. 2017; Vol.124, Number 12
  2. Kate Rauch. (2017, August31) Low Dose Atropine for Kids with Myopia. American Academy of Ophthamology. Retreived June 27, 2018 from hops://www.aao.org/eye-health/news/low-dose-atropinekids-with-myopia
  3. Facts About Myopia. (2017 October.) National Eye Institute. Retreived June 27,2018 from hops://neo.nih.gov/health/errors/myopia
  4. Diaz-Llopis M., Pinazo-Duran MD. Super diluted atropine at 0.01% reduces progression in children and adolescents. A 5-year study of safety and effectiveness. Arch Soc Esp O;almol. 2018; 93:182-185.

  5. Nicola Parry, Contributing Writer, interviewing K. David Epley, MD, R. Michael Siatkowski, MD, and Donald Tan, MD, FRCS, FRCOphth. (2016, December). How to Use Low-Dose Atropine to Slow Myopic Progression in Kids. American Academy of Ophthamology. Retrieved June 21, 2018 from hops://www.aao.org/eyenet/article/how-to-use-low-dose-atropine-to-slow-myopic-progre   

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