Sunshine and Atropine

Wednesday, April 29th, 2015

East Asia is growing increasingly myopicliterally — but ophthalmologists there have a solution:

Jason Yam, an ophthalmologist and professor at the Chinese University of Hong Kong, says it’s the first piece of advice he gives parents who bring in their nearsighted children. “The parents say yes, but they don’t do it,” he says.

Usually they come back and say their children didn’t have time to go outside because of homework. However, when he brings up another prevention strategy — using daily atropine eye drops — parents are very committed, Dr. Yam says.

Atropine, a drug used for decades to dilate the pupils, appears to slow the progression of myopia once it has started, according to several randomized, controlled trials. But used daily at the typical concentration of 1%, there are side effects, most notably sensitivity to light, as well as difficulty focusing on up-close images.

In recent years, studies in Singapore and Taiwan found that a lower dose of atropine reduces myopia progression by 50% to 60% in children without those side effects, says Donald Tan, professor of ophthalmology at the Singapore National Eye Centre. He has spearheaded many of the studies. Large-scale trials on low-dose atropine are expected to start soon in Japan and in Europe, he says.

Researchers are unsure how long children should use the eye drops for maximum effect. So far, the longest study has followed children for five years. In Singapore, children typically receive drops for three to six months at the first sign they’re becoming nearsighted. If their myopia continues to progress, they typically continue the drops for up to a year, Dr. Tan says.

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