Nearsightedness progression in children slowed down by medicated eye drops

http://www.eurekalert.org/pub_releases/2015-11/aaoo-npi111215.php

Public Release: 16-Nov-2015
Nearsightedness progression in children slowed down by medicated eye drops
Researchers present findings on five-year clinical trial of low-dose atropine for myopia at AAO 2015, the American Academy of Ophthalmology's annual meeting
American Academy of Ophthalmology

Researchers say medicated eye drops may be the key to fighting rapidly worsening eyesight in children with myopia. Results from a five-year clinical trial show that drops of low-dose atropine significantly slowed the progression of nearsightedness in children with fewer side effects than higher dosages. The research is being presented today at AAO 2015, the 119th annual meeting of the American Academy of Ophthalmology. The findings suggest that this medication could potentially be an effective treatment in the fight against the global surge in nearsightedness.

Nearsightedness, or myopia, has increased dramatically worldwide over the last few decades and remains a leading cause of visual impairment globally. In the United States, an estimated 42 percent of the population is myopic, up from 25 percent in the 1970s. Developed Asian countries report myopia rates of 80 to 90 percent among young adults. While vision can be corrected by glasses or contacts, severe nearsightedness has ramifications that include greater risk of retinal detachment, macular degeneration, premature cataracts and glaucoma.

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The researchers discovered the following key findings:

After five years of usage, children using the low-dose 0.01 percent atropine drops were the least myopic when compared to patients treated with higher doses.

Atropine eye drops at 0.01 percent slowed myopia progression by an estimated 50 percent compared to children not treated with the medication in an earlier study.

Atropine at .01 percent appears to be safe enough to use in children age 6 to 12 for up to five years, though more study is needed. The lower dose caused minimal pupil dilation (less than 1 mm), which minimized light sensitivity experienced at higher concentrations. Patients also experienced minimal near-vision loss with the low-dose drops.

Atropine inhibits axial growth of the eye associated with nearsightedness. But, the way the medication works remains largely unknown. In addition, the medication has several side effects when given at higher concentrations. For instance, at the concentration used for lazy eye, atropine dilates the pupils. This results in light sensitivity and blurry vision when looking at objects up close. Children taking higher concentrations often need to wear bifocals and sunglasses. In addition, higher concentrations have also caused allergic conjunctivitis and dermatitis. These drawbacks explain why atropine use for myopia to date remains fairly uncommon in the United States.

This trend could change now that much lower doses of atropine appear to offer the similar benefit in reducing nearsightedness progression, without the side effects.

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