Your child may be suitable for a new treatment that could slow the progression of myopia
To date, atropine has been demonstrated in research studies consistently to be effective slowing down progression of myopia. A low dose is used because higher doses such as 0.5% or 1% – although they are very effective in slowing down myopia progression – have a high rate of photophobia as a side-effect because of the wide dilation that the higher concentration causes. These higher doses also have potential longer-term systemic and ocular side-effects.
The exact mechanism chemically of the use of topical atropine is not known, but it is believed to be to do with the muscarinic receptors, which it influences. Atropine inhibits myopia induction in humans due to its anti-muscarinic effect. Based on all the randomised controlled studies done to date, atropine treatment is now ready for use in clinical practice, and medical authorities have already introduced it in some countries, mostly in Asia.
Here in Europe, our clinical management of myopia has been predominantly on the structural side with refractive correction with glasses and contact lenses and less on the prevention side. In order to know whether your child may be suitable for low-dose atropine treatment in the future, your child will require an initial assessment where the refractive error is determined accurately using what is called cycloplegic refraction, accommodative amplitudes and other measurements of the eye shape, length and size. At present we are waiting in Europe for the best formulation of these drops, called Low Dose Atropine 0.01%, therefore we cannot yet offer this treatment. We can offer advice on your child’s myopia, lifestyle adjustments and suitable glasses.
Eventually when we can treat patients with eye drops, and this is likely in the next couple of years, we will have to assess your child first. If your child is found to be suitable, then we will offer atropine treatment with the aim of slowing down the progression of myopia, not eliminating it.
The treating ophthalmologist at Clinica London will explain the aims of the treatment and what is involved. They will explain that you need to put in eyedrops once a day, and they will advise you of any potential side-effects, and how to measure the success of the treatment.
The treatment regime is likely to be for a minimum of two years initially, during which time we will monitor your child’s myopia status. Usually, monitoring continues until the end of adolescence.
If you would like to know more about this potential treatment to reduce progression of myopia in your child, contact Miss Naz Raoof at Clinica London for more information and an assessment.
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Naz Raoof, BA, BM BCh, FRCOphth
Ophthalmologist specialising in Paediatrics, Strabismus & Neuro-ophthalmology
Resident expert – Naz Raoof
I am a Consultant Ophthalmologist at Moorfields Eye Hospital and the Royal London Hospital (appointed 2017).
At Clinica London, I am responsible for paediatric ophthalmology, strabismus treatment and neuro-ophthalmology. I also see adults and children with general and urgent eye problems and carry out routine and urgent procedures at Clinica London.
I trained as a doctor at the University of Oxford, qualifying in 2004. Following my training, the Royal Hallamshire Hospital (Sheffield) and the University of Sheffield employed me as a junior doctor in Ophthalmology.
I undertook two post-training specialist Fellowships in paediatrics, strabismus and neuro-ophthalmology, including 12 months at Moorfields Eye Hospital, London and in Auckland, New Zealand, before becoming a Consultant.
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