Atropine Eye Drops For Myopia Control in Children

Did you know there’s a simple eye drop that could slow down your child’s worsening eyesight? Atropine eye drop treatment can be a simple, non-invasive and safe solution for addressing childhood myopia.

Myopia is a progressive condition. Not only does it lead to nearsightedness in the short term. But in advanced cases it can significantly raise the risk profile for serious eye disease later in life. Overlooking the importance of early intervention in myopia could result in costly and more invasive treatments later, as the condition worsens.

I’m Juliet Menakaya, the owner and principal paediatric optometrist at Junic Eye Care. Our practice caters to everyone, from the youngest infants to octogenarians. I ensure that every client receives thorough, individualized attention, whether it’s your first pair of glasses or advanced care for your age-related vision changes.

In Australia, therapeutically endorsed optometrists are qualified to prescribe atropine eye drops for myopia control. Professionals such as myself have undergone additional training to ensure we can safely manage and prescribe medications for eye health. If you’re considering atropine for your child, visiting an optometrist with this endorsement is essential.

So why delay? Book a time to come and talk with me about how atropine eye drops could be the missing solution to your son or daughters worsening eye condition. Keep reading to find out more.

Overview of Myopia in Children

Myopia is a common vision condition, often known as short-sightedness, and is increasing in prevalence both in Australia and around the globe. Myopia occurs when the eye grows too long, causing light to focus in front of the retina instead of directly on it. This results in distant objects appearing blurry while close objects remain clear.

What causes myopia in children? Studies have shown that lifestyle factors, such as prolonged near work and limited time outdoors, contribute significantly to this trend. Internationally, the numbers are even more concerning, with some countries in East and South East Asia reporting myopia rates exceeding 80% among young adults.

Early-stage myopia isn’t just a minor inconvenience. Children with myopia are at higher risk of developing conditions such as retinal detachment, glaucoma, and macular degeneration later in life. The progression of myopia typically accelerates during school years, making early detection and management crucial.

Recognising the signs of myopia in children, such as squinting, frequent headaches, and difficulty seeing the board at school, is the first step towards effective management.

Introduction to Atropine Eye Drops

So what are atropine eye drops, and how can they help with myopia? Atropine, derived from the deadly nightshade plant, has been used in eye care for more than a century. Initially, it was employed to dilate pupils during eye examinations and treat conditions like lazy eye (amblyopia) and eye inflammation. More recently, its role in managing myopia in children has gained attention.

Atropine eye drops work by temporarily relaxing the muscles in the eye, preventing the eye from focusing too tightly on close objects. This relaxation helps to slow down the elongation of the eye, which is a primary cause of myopia progression. The drops are typically administered once daily, usually at bedtime, to minimise any discomfort or side effects.

Atropine is often part of a broader myopia management strategy. Combining atropine with other treatments, such as myopia control lenses (like Stellest), can enhance effectiveness. Parents should discuss with their optometrist whether atropine eye drops alone or in combination with other treatments are best suited for their child’s specific needs.

If you’ like to learn more about the science behind atropine for treating myopia, watch the following video from Dr Natalie Chai.

Efficacy of Atropine Eye Drops in Controlling Myopia

Numerous clinical studies have shown that atropine eye drops can significantly slow progressive myopia. One of the landmark studies, the Atropine for the Treatment of Myopia (ATOM) study, demonstrated that children using atropine had a much slower rate of eyeball elongation compared to those who did not.

Concentration of atropine used is a critical factor. Higher concentrations like 1% atropine were initially used but were found to cause side effects such as light sensitivity and difficulty focusing on close objects. These side effects made the treatment less suitable for everyday use in children. More recent studies have explored lower concentrations, finding a balance between efficacy and minimal side effects (see sources below).

Research indicates that 0.02%, 0.025%, and 0.05% atropine are still quite effective. These lower doses are more tolerable, making them a better option for long-term use. Parents often worry about the safety of using these drops over an extended period, but clinical evidence supports their safety when used as directed.

The ages at which children can benefit from atropine treatment typically range from 6 to 14 years. Starting treatment early is beneficial as it can prevent significant progression of myopia, thereby reducing the risk of severe eye conditions in the future. It’s also worth noting that the treatment’s success varies among individuals.

Sources:
https://pubmed.ncbi.nlm.nih.gov/30514630/
https://pubmed.ncbi.nlm.nih.gov/32019700/
https://pubmed.ncbi.nlm.nih.gov/34627809/

Side Effects, Usage and Safety

Common side effects of low-dose atropine include mild photophobia (sensitivity to light) and occasional blurred near vision. These effects are typically mild and can be managed by administering the drops at bedtime, allowing most of the potential discomfort to occur during sleep. For many children, these minor inconveniences are a small price to pay for the long-term benefits of slowed myopia progression.

Administering atropine eye drops is straightforward, but it requires diligence. The drops are typically applied once daily, usually before bedtime. This timing helps minimise any mild side effects, such as light sensitivity, that might occur shortly after administration. It’s crucial to follow the prescribed dosage carefully and not to exceed it, as improper use can lead to adverse effects.

Safety is especially important when considering treatments for young children who may not yet be ready for other myopia control methods like contact lenses. For these younger patients, atropine eye drops offer a simple, non-invasive option that can be easily incorporated into their daily routine with minimal disruption.

Atropine liquid must NEVER be swallowed. Atropine eye drops are formulated specifically for ocular use, significantly diluting the active ingredient to safe levels. Despite this, there is the potential for toxic effects if taken orally. Parents should be diligent in following instructions and keeping the medication out of reach of children when not in use.

Making Atropine Part of Your Nightly Schedule

For parents, administering eye drops to children can sometimes be challenging. Here are a few tips to make the process smoother:

• Explain to your child why the drops are necessary and how they will help protect their vision.
• Establish a calm environment and perhaps incorporate the drops into a nightly routine to help your child become accustomed to the process.
• Use a reward system for cooperation can also be beneficial, making the experience more positive for both the child and the parent.

The recommended length of treatment with atropine eye drops varies, but it often spans several years, depending on the child’s age and the progression of their myopia. Regular follow-ups with the optometrist are critical to monitor the effectiveness of the treatment and make any necessary adjustments. These appointments provide an opportunity to assess whether the current concentration of atropine is effective or if changes are needed.

CONCLUSION

Atropine eye drops offer a scientifically backed method to slow the progression of myopia in children, with minimal side effects at low doses. Comparative studies indicate that atropine is as effective as other myopia control methods but with easier administration and management.

Failing to manage myopia early can increase the likelihood of needing more invasive treatments later, such as surgery or high-strength corrective lenses.

Join the many parents who have chosen proactive myopia management for their children; schedule your consultation with Junic Eye Care and see the difference it makes.

To visit our optometry practice, click the “Book Online” button at the top of the page or call (02) 6152 8585 today.