Does your child have myopia (or shortsightedness)? If so, you’re probably curious about a cure.
With myopia affecting more children by the year, and the recent publication of some convincing clinical studies, there has never been a better time to nip this eye problem in the bud.
Far from being just a pair of distance vision glasses, myopia affects the whole eye throughout your life, putting you (or your child) at far higher risk of developing eye diseases such as glaucoma, cataract and macular disease.
While we can’t offer a cure just yet, there ARE well-established ways to slow down your child’s myopia. This is myopia control (rather than cure). These techniques have been used for decades. But it is only in recent years – with the marked increase in the incidence of myopia around the world – that myopia control has really taken off.
Is my child at risk?
In some East Asian countries, such as Taiwan, over 90% of children are shortsighted by the time they leave school.
But what about here in Australia? The recent Sydney Myopia Study found 31% of 17 year olds were myopic, double the prevalence reported by the Blue Mountain Eye Study more than a decade ago.
So, one child in three is shortsighted by the time they leave school. But is that really so bad?
Unfortunately, myopia isn’t just glasses. The shortsighted eye is larger than normal and delicate structures are stretched thinner. The less shortsighted you are, the better. This is where myopia control comes in.
What is atropine therapy?
Atropine eye drops have a long history in eye medicine. They are used to keep the pupil of the eye dilated in people suffering from iritis or uveitis. (Atropine use actually dates back thousands of years, when it was used in tiny doses to enlarge the pupils as a means of becoming more attractive!
Atropine works by blocking the muscles of the eye that constrict the pupil and focus up close. Studies have linked myopia progression to focussing fatigue, and this is where atropine therapy comes in. By switching off the focusing mechanism of the eye, myopia can be slowed down or even stopped.
What do the studies show?
The landmark ATOM (Atropine Treatment of Myopia) clinical trials were conducted on 400 Asian children over 5 years. These studies looked at the safety and efficacy of different strengths of atropine eye drops in controlling myopia.
The latest ATOM studies, (published in 2015) showed some startling results. Even at concentrations as low as 0.01% (100th the concentration used in the management of eye disease) the rate of progression of myopia was slowed by 50%. Even better, at this dose there were no significant side effects.
What was also startling about the ATOM 2 studies was what happened when the atropine therapy was stopped after 5 years. The lower the concentration of atropine, the more sustained the myopia control and the less likely the child was to become more shortsighted. 0.01% atropine caused less ‘rebound’ myopia than 0.5% or 0.1%.
What is actually being prescribed today?
Many optometrists and ophthalmologists are still reluctant to prescribe atropine for children because the long-term (longer than 5 years) effects of treatment are unknown. The ATOM 2 study, however, was conducted over 5 years, with no clinically significant side effects in the children treated with the lowest concentration of atropine.
At The Eye Practice, we prescribe .01% atropine for myopia control where it is indicated. We strongly feel that the minor side effects and inconvenience of low-concentration atropine is a much better option than the increased risk of eye disease associated with moderate to high myopia.
What do I do if my child is short-sighted?
If your child’s myopia is progressive (or worsening) from year to year, see your optometrist to discuss options for myopia control including atropine therapy. (Ortho k and multifocal contact lenses are other options, as are bifocal glasses).
If your child undergoes atropine therapy, you will need to fill a prescription for a low concentration of atropine eyedrops. These drops are used once a day (before sleep) for the duration of the therapy – usually several years. The goal is to slow of halt the myopia.
The advantages are very significant. Avoiding moderate to high myopia means thinner glasses, more options with contact lenses and laser eye surgery and, most importantly of all, healthier eyes for life. Myopia is not just a pair of glasses – it has implications for eye health all through life and can threaten eye sight. Don’t just leave it to take its course.