Using Atropine for Low Hyperopia in Children: Concerns and Recommendations

Q: Using Atropine for Low Hyperopia in Children: Concerns and Recommendations

Hello： 1. <br>For a 7-year-old child, even with a hyperopia of only +2.50 diopters, some physicians may consider using Atropine 0.05% to control the progression of myopia. <br>However, the decision to initiate Atropine treatment and the appropriate timing for its use should be ba

Questions about the use of atropine?

Hello, Director Gao.
For a 7-year-old child who has no myopia but has 25 diopters of hyperopia, the doctor mentioned that children at this age should have around 100 diopters of hyperopia, and 25 diopters is considered low.
Therefore, atropine 0.05% was prescribed.
I would like to ask you:
1.
Should we start using atropine to control the low hyperopia in this 7-year-old child to prevent myopia?
2.
If we have just administered atropine 0.05% once, is there a concern about rebound effects after stopping the medication, as mentioned in some online articles?
Thank you for taking the time to answer my questions.

Jin, 30~39 year old female. Ask Date: 2023/12/22

Dr. Gao Pilin reply Ophthalmology

Hello: 1.
For a 7-year-old child, even with a hyperopia of only +2.50 diopters, some physicians may consider using Atropine 0.05% to control the progression of myopia.
However, the decision to initiate Atropine treatment and the appropriate timing for its use should be based on the evaluation of an ophthalmologist.
An eye examination can provide more precise guidance, as the physician will consider the overall condition of the eyes, family history of myopia, and other factors to develop a treatment plan tailored to the child.
2.
Regarding the rebound effect after discontinuing Atropine, some online articles mention the possibility of myopia progression rebound after stopping the medication.
However, there is no consensus on whether such rebound effects will occur after discontinuation, as this may vary from person to person.
This is one of the reasons why it is important for the ophthalmologist to establish a suitable treatment plan for the child after the eye examination and to conduct regular follow-up assessments of the eye condition.

Reply Date: 2023/12/22

More Info

When considering the use of Atropine for a 7-year-old child with low hyperopia (25 diopters), there are several important factors to take into account. Atropine, particularly in a low concentration of 0.05%, has been studied for its potential to slow the progression of myopia in children. However, its application in managing low hyperopia is less straightforward and requires careful consideration.

1. Should Atropine be used for low hyperopia in a 7-year-old?
The decision to start Atropine treatment in a child with low hyperopia should be based on a comprehensive evaluation by an eye care professional. While the child’s hyperopia is below the expected norm (100 diopters), it is essential to assess the overall ocular health, visual function, and family history of refractive errors. In some cases, low hyperopia may not necessitate treatment, especially if the child is not experiencing any visual difficulties. However, if there is a concern about the potential for developing myopia or if the child is showing signs of visual stress, the use of Atropine may be considered as a preventive measure. The eye care provider may also suggest regular monitoring to track any changes in refractive status.

2. Concerns about rebound effects after stopping Atropine:
The concern regarding rebound effects after discontinuing Atropine treatment is a topic of ongoing research and discussion. Some studies have indicated that children who have been treated with Atropine may experience a rebound increase in myopia upon cessation of the medication. However, this rebound effect is not universally observed and can vary significantly among individuals. Factors such as the duration of treatment, the initial degree of myopia, and the child’s age at the time of treatment may influence the likelihood of experiencing rebound myopia.

In the case of your child, having only one application of Atropine 0.05% may not be sufficient to trigger a significant rebound effect. It is crucial to follow up with the prescribing physician to discuss any concerns about stopping the medication. The physician may recommend a gradual tapering of the medication rather than an abrupt cessation, especially if the treatment is intended for long-term management.

In summary, the use of Atropine in a child with low hyperopia should be approached with caution and under the guidance of an eye care professional. Regular follow-ups and assessments are vital to ensure that the treatment is effective and to monitor for any potential side effects or changes in refractive status. If there are any concerns about the treatment plan or its implications, it is always best to have an open dialogue with the healthcare provider to address these issues comprehensively.

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