Seeing Clearly

Atropine Drops ... A Game-Changer For Childhood Myopia

by Brandee Nelson, OD // July - August - September 2024

In today’s digital era, an increasing number of children are grappling with nearsightedness, a condition where their near vision is clear, while distant objects appear blurry. Myopia, commonly referred to as nearsightedness, is on the rise, not only in the United States, but also globally. Alarmingly, it is estimated that by 2050, half of the world’s population will be nearsighted. Beyond the need for glasses and contact lenses to see better, myopia is linked to a range of eye diseases, including glaucoma, retinal detachments, and maculopathy. Hence, it’s crucial to take proactive measures during childhood to slow down the progression of nearsightedness and reduce the risk of these complications.

While children with nearsighted parents are at higher risk of becoming nearsighted themselves, the condition can also occur without a family history. Environmental factors such as decreased outdoor time and increased screen or reading time can also contribute to myopia progression. Signs that a child has nearsightedness include squinting, eye strain, and difficulty seeing objects at a distance.

Traditionally, the treatment for myopia has involved corrective lenses like glasses or contacts to improve vision. However, there are now multiple treatments, called myopia control, aimed at slowing down the progression of myopia in children. While these treatments do not reverse nearsightedness a child already has, they can help to slow it from increasing further. The three types of myopia control treatments are soft contact lenses, hard contact lenses, and eye drops. All have been studied and shown to be effective in reducing myopia progression in children.

Eye drops, particularly those containing atropine, are a great treatment option for children who are not yet ready for contact lenses or find them intimidating. Atropine works by slowing down the elongation of the eye, and in clinical trials has shown great success in reducing myopia progression. These drops are great for younger children who cannot tolerate contact lenses or children who do not qualify for them because of their prescription. When used for myopia control, atropine, a dilating eye drop that has been safely used in eye care for many years, is diluted to a very low concentration; thus, most don’t experience any stinging sensation when the drop is administered. Dosage is one drop in each eye at night before bedtime. Atropine is safe to use with other drops such as artificial tears. While on atropine, children still wear their regular glasses during the day and sunglasses while outside. Most children on atropine treatment do not experience significant pupil dilation, but some may notice mild near blurriness or light sensitivity.

Many children will stay on the treatment until their prescription stabilizes, usually occurring in their late teens or early twenties. At that point, they can transition out of treatment and can continue to wear glasses or contact lenses as usual.

Some growth and change to the prescription are still expected even with treatment as the normal aging process continues, but the goal with myopia control is to prevent large prescription jumps. Children undergoing treatment are monitored regularly to ensure that the atropine is working. As atropine comes in three concentrations, if a child is still progressing on a lower concentration, they can be transitioned to a slightly higher concentration. Atropine drops are available via a compounding pharmacy in the Raleigh area so that they can be safely diluted. Unlike a typical pharmacy, the compounding pharmacy can quickly prepare and deliver the drops directly to the child’s home.

Atropine treatment presents an effective and easy-to-follow approach to managing myopia in children, aiming to prevent future complications and preserve visual health. To determine if your child qualifies for myopia treatment, it’s essential to schedule their annual eye exam for a comprehensive assessment of their vision. Even children with minor prescriptions can benefit from atropine treatment to prevent the progression of their myopia. Regular screening exams are crucial for all children, particularly those with a family history of nearsightedness, to ensure early detection and intervention.

Brandee Nelson, OD

With McPherson Family Eye Care.