Myopia, commonly known as nearsightedness, is a refractive error in which the eye has difficulty focusing on distant objects. It is a common condition affecting millions of people worldwide, and its incidence is increasing at an alarming rate, particularly in Asia. High myopia, defined as a refractive error of -6 diopters or worse, is associated with a higher risk of ocular complications such as retinal detachment, myopic maculopathy, and glaucoma.

The increasing prevalence of myopia has led to a growing interest in finding ways to prevent or slow down its progression, particularly in children. One promising approach is the use of low-concentration atropine eye drops, which have been shown to reduce the progression in high-risk children.

What is atropine?

Atropine is a medication that belongs to a class of drugs known as anticholinergics. It is commonly used to dilate the pupil during eye exams, but it can also be used to treat a variety of medical conditions, such as bradycardia, irritable bowel syndrome, and asthma.

How does atropine work in myopia?

Atropine works by blocking the action of acetylcholine, a neurotransmitter that regulates the shape of the lens and the amount of light that enters the eye. In myopia, the eye is elongated, which causes light to focus in front of the retina instead of on it, leading to blurred vision. Atropine works by relaxing the ciliary muscle, which controls the shape of the lens, and by inhibiting the growth of the eye, which can slow down the progression.

Low-concentration atropine eye drops

Low-concentration atropine eye drops are a recent development in the treatment of myopia. Unlike higher concentrations of atropine, which can cause side effects such as photophobia (light sensitivity), dry mouth, and blurred vision, low-concentration atropine has been shown to be safe and well-tolerated, with few side effects.

Studies have shown that low-concentration atropine eye drops can reduce the progression of myopia by up to 60%, with minimal side effects. The mechanism by which atropine works is not fully understood, but it is thought to involve the inhibition of the growth of the eye and the relaxation of the ciliary muscle.

Who is at risk of myopia?

Myopia tends to run in families and is more common in people of Asian descent. Other risk factors include a high level of education, spending long periods of time doing near work, such as reading or using electronic devices, and spending less time outdoors.

Children who have one or more of these risk factors are more likely to develop myopia and are therefore good candidates for treatment with low-concentration atropine eye drops.

When should treatment with atropine be started?

The optimal age to start treatment with atropine is still a matter of debate. Some studies suggest that earlier treatment may be more effective, while others suggest that starting treatment later, when myopia has already developed, may be just as effective.

The American Academy of Ophthalmology recommends that children with myopia greater than -0.75 diopters and one or more risk factors for myopia be evaluated annually by an eye care professional. If the child’s myopia is progressing rapidly, treatment with low-concentration atropine eye drops may be considered.

Conclusion

Low-concentration atropine eye drops are a promising treatment option for children who are at risk of developing myopia or who have already developed myopia. They have been shown to be safe and effective, with minimal side effects. However, it is important to note that atropine eye drops should only be used under the supervision of an eye care professional.

Parents and caregivers can help reduce the risk of myopia in children by encouraging outdoor activities, limiting screen time, and ensuring that children take frequent breaks when doing near work. Additionally, regular eye exams can help detect myopia early and allow for prompt treatment.

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