Atropine Eye Drops

Atropine eye drops have been used for many years to try and control the progression of myopia; however, until recently they have been prescribed at a concentration of 0.5% – 1%. Atropine at this concentration in children and teenagers makes the eye unable to focus for near tasks and dilates the pupil significantly. There is also a higher incidence of light sensitivity and allergic reactions to the Atropine drops at these higher concentrations.

We now have clear evidence from large research studies such as the ATOM1 study in 2006 and the ATOM2 study in 2015 showing that lower concentration Atropine eye drops also reduce the progression of myopia and have a very low incidence of side effects. However, re-analysis of the data showed the concentration of Atropine eye drops used in this study of 0.01% was not as effective at slowing myopia progression as originally thought.

The latest research from the Low Concentration Atropine for Myopia Progression (LAMP) research released in April 2018 shows that the degree of control of myopia progression depends on the concentration of Atropine eye drops that are used.

The current concentration of Atropine eye drops most commonly used has been and still is 0.01%. While this has minimal to no side effects, the re-analysis of the data from the ATOM2 study shows it only reduces the growth of the length of the eye by 12%. Change in the growth of the length of the eye is the only true and accurate way to assess myopia progression. The best myopia control effect with Atropine eye drops in the LAMP study was achieved with 0.05% concentration, which to date slows myopia progression by 51%.

Importantly, 0.05% concentration was well tolerated with few incidents of side effects such as near focusing difficulty, increased pupil size or allergic reactions, such as dermatitis. In line with this and previous research, at Visique we use 0.05% concentration Atropine eye drops for this method of myopia control. In the unlikely event there might be tolerance issues or concerns we have 0.025% Atropine eye drops (29% myopia control effect in the LAMP study) as a second line option.

It is important to note that the ATOM1, ATOM2 and LAMP research was completed in Asian children aged 4 to 12. This is an important consideration as we know the genes for myopia in Asian populations are different from other ethnic groups, and the incidence and progression of myopia is also a lot higher compared with the rest of the world. The summary of research shows at this stage that Atropine eye drop Treatment is not as effective for other ethnic groups.

While the initial information we are getting from Australia and the United States shows us that atropine eye drops slow myopia progression for myopic children and teenagers, we don’t have conclusive evidence about how much it slows myopia progression long term, or how effective it is over the age of 12, but based on the LAMP research we do expect a good myopia control effect when using 0.05% concentration Atropine eye drops.

To have the maximum benefit from Atropine Treatment, the drops need to be used for as long as there is potential for myopia to change. Once in the late teens between 17 and 20 we expect myopia to naturally stabilise.

The most effective and proven method for controlling myopia progression is Ortho K, due to its proven effect at substantially slowing (and in many cases halting) the growth of the length of the eye (the only definitive measure for assessing whether myopia has progressed). For those who are not suitable for Ortho K, Atropine Treatment is the next best option for controlling myopia progression.

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