Is Daily Use of 0.01% Atropine Eye Drops Effective for Preventing Myopia in Kids?

Can children use a daily dose of 0.01% long-acting atropine eye drops to "prevent myopia"?

Hello Doctor: My daughter is 8 years old, and her vision is 1.0 in both eyes, with 25 degrees of hyperopia in each eye.
A physician has suggested starting daily administration of 0.01% long-acting atropine eye drops to prolong her hyperopic condition and prevent myopia.
Is this an appropriate and effective approach? Thank you!

Xiao Zhuo, 0~9 year old female. Ask Date: 2023/02/09

Dr. He Jianxian reply Ophthalmology

Is it necessary to rely on medication to maintain this condition? Clinically, there is no strong evidence, as engaging in more outdoor activities can achieve the same effect.
Dr.
Ho Chien-Hsien, Ophthalmology Department, Nantou Hospital.

Reply Date: 2023/02/09

More Info

The use of 0.01% atropine eye drops for preventing myopia in children has gained attention in recent years, particularly as myopia rates continue to rise globally. Atropine, a muscarinic antagonist, is primarily known for its ability to dilate pupils and paralyze the ciliary muscle, which can temporarily affect near vision. However, its role in myopia control, especially in children, is a topic of ongoing research and clinical discussion.

In your case, your daughter is 8 years old with a visual acuity of 1.0 and a mild hyperopia of 25 diopters. The recommendation to start daily use of 0.01% atropine eye drops is based on the understanding that atropine can help slow the progression of myopia in children who are at risk. Studies have shown that low-dose atropine (0.01%) is effective in reducing the rate of myopia progression with a relatively favorable side effect profile compared to higher concentrations (0.1% or 0.5%).

The effectiveness of atropine in preventing myopia is supported by several clinical trials. For instance, a study published in the journal "Ophthalmology" found that children treated with 0.01% atropine experienced a significant reduction in myopia progression compared to those who received a placebo. This suggests that starting atropine at an early age, particularly in children with a predisposition to myopia, may be beneficial.

However, it is essential to consider the potential side effects of atropine. Common side effects include difficulty focusing on near objects, light sensitivity due to pupil dilation, and, in rare cases, increased intraocular pressure. These side effects can be particularly concerning in children, as they may affect daily activities such as reading and schoolwork. It is crucial to monitor your daughter for any adverse effects and communicate with her eye care provider about her experience with the medication.

Regarding the question of whether it is necessary to rely solely on medication to maintain her hyperopic state, it is worth noting that lifestyle factors also play a significant role in eye health. Increasing outdoor activities and reducing screen time have been associated with a lower risk of developing myopia. Therefore, while atropine can be a useful tool in managing myopia risk, it should ideally be part of a comprehensive approach that includes lifestyle modifications.

In summary, the daily use of 0.01% atropine eye drops can be an effective strategy for preventing myopia in children, particularly for those with mild hyperopia like your daughter. However, it is essential to weigh the benefits against potential side effects and to consider incorporating lifestyle changes that promote eye health. Regular follow-ups with an eye care professional will help ensure that her treatment plan remains appropriate as she grows.

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