Myopia Management: Does Atropine Work?

Dr. Russel Lazarus, June 16, 2021

Atropine eye drops may slow down the progression of myopia in children.

Myopia, also known as nearsightedness, is the inability to see things clearly unless they’re situated close to your eyes.

Is myopia serious?

Yes, myopia is more than an inconvenience; it can pose a serious risk to a child’s long-term eye health and vision.

Myopia can rapidly progress, leaving a child at a higher risk of developing dangerous eye diseases, such as glaucoma, retinal detachment, pathological myopia or cataracts, later in life.

Luckily, myopia management, which can include atropine eye drops, can help slow down the rapid visual deterioration that occurs with myopia.

Atropine sulfate is an antimuscarinic agent used as a mydriatic and cycloplegic. Atropine eye drops are also used in the treatment of uveitis and iritis to immobilize the ciliary muscle and iris to prevent or break down adhesions inside the eye.

What is atropine?

Atropine eye drops cause the muscles in your eye to become relaxed, aloso causing dilation of the pupil so that it will not respond to light, allowing the eye doctor a better internal view of the eye

Atropine eye drops are most commonly used by eye doctors during a comprehensive eye exam and are primarily used to dilate the pupils. However, they are also used for other purposes, including treating certain eye conditions, such as myopia.

Schedule an appointment with an eye doctor near you who can diagnose and manage your child’s myopia.

SEE RELATED: Myopia Management: The Optical Strategy

Find an eye doctor near you

How is atropine used for myopia management?

Atropine is a non-selective blocker of muscarinic receptors, present in the retina and sclera. Although the specific mechanism of atropine in myopia management is unknown, it is thought that atropine inhibits sclera thinning or stretching, and hence eye growth, by acting directly or indirectly on the retina or sclera.

Low-doses of atropine drops in 0.01%, 0.02%, and 0.05% concentrations have been found to be effective in slowing down the progression of myopia.

A clinical trial published in Ophthalmology (2015) by the Atropine for the Treatment of Myopia (ATOM2) study, compared the safety and efficacy of different concentrations of atropine eye drops to control myopia progression over 5 years.

In the double-masked study, children were randomized 2:2:1 to receive 0.5%, 0.1% or 0.01% of atropine drops respectively, once daily in both eyes for 2 years.

Results showed that children who received higher concentrations of atropine demonstrated a greater effect in slowing myopia progression. However, there was no significant difference in myopia between these dosage groups at 2 years.

The study suggests that the 0.01% concentration has minimal side effects while still reducing the rate of myopia progression by 50% to 60%.

However, it is believed that more studies are needed to make management options more customizable as one size doesn’t fit all.

The study also recommended that using atropine drops in conjunction with other treatments, such as ortho-k, multifocal contact lenses and optical lenses, as well as environmental and behavioral modifications, such as spending time outdoors, can help determine the optimum level of atropine to be prescribed.

Early diagnosis of myopia can improve your child’s performance in school and can help prevent serious sight-robbing eye diseases later in life.

LEARN MORE:  Guide to Myopia Management

If your child shows signs or symptoms of myopia, schedule an eye exam with an eye doctor near you to discuss a myopia management plan.