Yogapriya Vijayaragavan, B.Optom
Optometrist-Myopia Clinic, Aravind Eye Care System, Chennai, India
Introduction
Myopia is a common refractive error and is a leading cause of permanent blindness. Myopia is burgeoning around the world. With the recent study it is estimated that on average 50% of the world will be myopic by the year 2050. (1)
Atropine to the Rescue
As the myopia is progressing among the kids day-by-day, the exemplary myopia control treatments rely on many factors including their ocular measurements, competence, routine activities and more. (2) The controlling strategies like myopia controlling glasses, atropine drops, and orthokeratology were foreseen in controlling myopia. Out of which, parents were more partial to atropine drops. The Atropine Drop which is shown in Figure 1 is an anticholinergic drug and it comes up with a concentration of 0.01%, 0.025% and 0.05%. The mechanism and site of action of atropine to control progression is still unknown. (3)
Figure 1: Atropine Drops
image Courtesy: The image was taken in Myopia clinic, Aravind Eye Care System-Chennai.
Snippet on Atropine Study in Controlling Myopia
Few studies were established to understand the efficacy of atropine in controlling myopia. Studies like Atropine for the treatment of childhood myopia (ATOM 1), ATOM 2 study evaluate the lower concentration for myopia progression to determine the lower optimal concentration for controlling myopia progression. Low concentration atropine of myopia progression (LAMP) study evaluated 0.025%, 0.05% and 0.01% concentration.
Pro’s and Con’s
Most of the parents strongly prefer atropine as a controlling strategy for their kids because of the reasons as follows: the most cost effective strategy and its moderate efficacy in controlling myopia progression. Here are few Pros of atropine strategy:
- Most cost effective than other controlling strategies
- Easy to use (7)
- Shows moderate efficacy in controlling myopia progression
There are few parents who were steer clear of from Atropine drops and to know why, here are few Cons of atropine strategy for your erudition:
- Although it is easy to use, these drops will cause few side effects like near vision discomfort, photosensitivity. (7)
- These drops were inapt for kids with certain pathological conditions like glaucoma, urinary retention, heart disease and gastrointestinal obstruction (4)
- Most of the parents will not prefer this strategy as it is a prolonged (7) medicinal therapy as the parents will be foreboding on its consequences.
- Few patients will be allergic to these drops and it is not recommended for them to use it.
- These drops have to be administered potentially for a long time period starting from 6 months to 2 years. (7) Patients who are very much erratic will not prefer this drop strategy and is not recommended too.
Conclusion
Since the myopia is escalating globally and its inexorable ramifications exhort the need to implement the efficient way to control the myopia progression. (5) Despite the fact that atropine has moderate efficacy in controlling myopia progression pattern, the combination therapy like atropine drops with the optical intervention shows better efficacy in controlling progression. As per the reports, it is revealed that the combined measures not only subside the side effects of single intervention but also show greater effective size promptly.(6) It has insignificant pros and predominantly cons. Rather than leaving the patient left untreated, it’s better to treat them with at least any of the controlling options, thereby making the patient benefit in either way.
References:
- International Myopia Institute. (2024, February 19). Myopia – Myopia Institute. Myopia Institute –https://myopiainstitute.org/myopia/#:~:text=Evidence%20is%20mounting%20that%20myopia,a%20staggering%205%20billion%20people [Last Accessed: 16Oct2024; 19:36hrs AEDT]
- Atropine eye drops for myopia control in children | My Kids Vision. (n.d.). https://www.mykidsvision.org/knowledge-centre/atropine-eye-drops-for-myopia-control-in-children [Last Accessed: 16Oct2024; 19:45hrs AEDT]
- Russ. (2023, May 4). Are atropine eye drops the answer for worsening myopia? – Optometrists.org. Optometrists.org. https://www.optometrists.org/general-practice-optometry/guide-to-myopia-management/are-atropine-eye-drops-the-answer-for-worsening-myopia
[Last Accessed: 16Oct2024; 19:56hrs AEDT] - CARE Hospitals. (n.d.). CARE hospitals. https://www.carehospitals.com/medicine-detail/atropine#:~:text=Allergies%3A%20If%20you%20have%20a,heart%20disease%2C%20and%20gastrointestinal%20obstruction [Last Accessed: 16Oct2024; 19:58hrs AEDT]Â
- Kaiti R, Shyangbo R, Sharma IP. Role of Atropine in the control of Myopia Progression-A Review. Beyoglu Eye J. 2022 Aug 5;7(3):157-66.
- Combination Therapy for Myopia Yields Best Results. Www.review of optometry.com. Retrieved July 20, 2024, from https://www.reviewofoptometry.com/article/combination-therapy-for-myopia-yields-best-results [Last Accessed: 16Oct2024; 19:48hrs AEDT]
- Atropine eye drops show promise as a treatment for myopia. John O’Connor Optometrists. https://www.johnoconnor.co.nz/pros-and-cons-of-atropine-eyedrops-for-myopia-control/[Last Accessed: 16Oct2024; 19:47hrs AEDT].
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