Atropine therapy is a form of myopia control. Atropine has been used as a treatment for myopia since the 1920’s. However, at the commercially available concentration of 1% there were significant side effects of blurred near vision, pupil dilation and significant light sensitivities. At this concentration there were also potential systemic side effects.
Recently the ATOM2 study has shown us that lower doses of atropine can give effective control of myopia progression with very minimal side effects, if any. This reduced concentration of atropine is not produced commercially; however it can be specially made by a compounding pharmacy.
What are the possible side effects?
Potential side effects of atropine treatment are reduced clarity of near vision, light sensitivity due to increased pupil size, and allergic reaction to the eye drops.
In the ATOM2 study children on 0.01% atropine experienced only a very small change to their pupil sizes, and no effect on their ability to read print at near.
If your child experiences blurred near vision as a result of the atropine treatment, this may be remedied with multifocal glasses, or you may choose to use a different form of myopia control treatment.
With high dose atropine it is possible to have systemic effects such as dry mouth, fever, or changes to heart beat or breathing. There have been no reported systemic side effects reported to atropine at the level we are using for myopia control therapy. However, if you have any concerns that your child may be experiencing symptoms related to the treatment, please cease using the drops and contact your health care professional.
What is involved in atropine therapy?
At your child’s eye examination your optometrist will measure their prescription, discuss the likely risk of myopia progression, and different options for controlling the progression of myopia that could suit your child. If you choose to proceed with atropine therapy a cycloplegic refraction may also be required.
When treatment commences the optometrist will write a prescription for low dose atropine eye drops. This prescription will be sent to the compounding pharmacy, who will manufacture the eye drops. You will use approximately one bottle per month.
One drop is used in each eye before bed. After inserting the drops, instruct your child to keep their eyes closed for 1-2minutes to allow the drop to be affective without being blinked away.
You will have a follow up appointment at two weeks to check your child’s response to the eye drops, and then require checkups every 6 months to monitor the effectiveness of the treatment.