Low-dose Atropine Slows Myopia Progression in Children

From http://www.aao.org/newsroom/news-releases/detail/nearsightedness-progression-in-children-slowed-dow:

[To slow the progression of myopia in kids], investigators in Singapore turned to atropine, a treatment commonly used to treat lazy eye. In this study, which began in 2006, 400 children age 6 to 12 were randomly assigned a daily dose of atropine. Three different groups took drops nightly at concentrations of 0.5, 0.1, or .01 percent for two years. Doctors then stopped the medication for 12 months. For children whose eyes became more myopic during that year off (-0.5 D or more), researchers started another round at 0.01 percent for another two years. The researchers discovered the following key findings:

  • After five years of usage, children using the low-dose 0.01 percent atropine drops were the least myopic when compared to patients treated with higher doses.
  • Atropine eye drops at 0.01 percent slowed myopia progression by an estimated 50 percent compared to children not treated with the medication in an earlier study.
  • Atropine at .01 percent appears to be safe enough to use in children age 6 to 12 for up to five years, though more study is needed. The lower dose caused minimal pupil dilation (less than 1 mm), which minimized light sensitivity experienced at higher concentrations. Patients also experienced minimal near-vision loss with the low-dose drops.

Atropine inhibits axial growth of the eye associated with nearsightedness. But, the way the medication works remains largely unknown. In addition, the medication has several side effects when given at higher concentrations. For instance, at the concentration used for lazy eye, atropine dilates the pupils. This results in light sensitivity and blurry vision when looking at objects up close. Children taking higher concentrations often need to wear bifocals and sunglasses. In addition, higher concentrations have also caused allergic conjunctivitis and dermatitis.  These drawbacks explain why atropine use for myopia to date remains fairly uncommon in the United States.

This trend could change now that much lower doses of atropine appear to offer the similar benefit in reducing nearsightedness progression, without the side effects.