Protect Your Child's Eyes: Treating Myopia with Atropine Drops

One of the most common scenarios for a pediatric eye doctor is seeing the child who is beginning to develop myopia, or nearsightedness.

Some families take the diagnosis in stride - 'Everybody in the family wears glasses, so no big surprise.' For others, it's as if a horrible disease was diagnosed - 'This is a very sad day in my child's life.'

In fact, there can be vision threatening issues associated with myopia, aside from just having to wear glasses, when kids become adults, said Peter Rabiah, MD, an ophthalmologist with NorthShore University HealthSystem.

Parents always want to know: What can be done to prevent the myopia from getting worse?

For many years, ophthalmologists have talked about and tried many different interventions, but nothing proved to be effective, low in side effects and convenient.

In the past few years, Dr. Rabiah said, promising studies strongly support the use of low-dose atropine drops to reduce the progression of myopia in children. These drops are typically given once daily at bedtime.

"The results have been very encouraging," Dr Rabiah said. "Myopia isn't reversible and children will still need glasses, but in most cases, their nearsightedness doesn't worsen as much compared to if they were not using the atropine drops. And most children do not experience side effects."

It's important to know about atropine treatment because many countries, including the United States, are seeing skyrocketing myopia rates. In the U.S., 40 percent of kids have myopia, compared to just 20 percent three decades ago, according to the American Academy of Ophthalmology.

Research shows that kids who are exposed to less outdoor daylight in early childhood are more likely to become myopic. A hypothesis is that kids today are getting less exposure to natural light, spending more indoor time with computers, TVs, smartphones and traditional books.

"There is much we don't know yet - whether the light needs to be bright sunlight versus a cloudy day or whether it is really the natural light exposure versus just that kids are not in a dim house doing "near" work for those hours, such as reading books or playing on screens," Dr. Rabiah said.

Parents always ask if screens are bad for the eyes, Dr. Rabiah said. Most ophthalmologists believe that it is not the screens per se that worsen myopia, but looking at screens is "near" work for the eyes, the same as reading a book, and it is the excessive amount of "near" work that may be harmful.

What can parents do? Dr. Rabiah suggests two hours/day of outdoor time for children, because studies show that is associated with less myopia progression. Children should also get their vision screened at a young age, especially if myopia runs in the family, to catch myopia early in case parents want to be aggressive in trying to reduce progression over time.

Dr. Peter Rabiah, MD, is a pediatric and adult ophthalmologist with NorthShore University HealthSystem.

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