Atropine Eyedrops (0.01%)
In cases where myopia is progressing rapidly interventional measures such as once a day atropine eye-drops can be considered to reduce the rate of progression of myopia.
Clinical trials by Singapore National Eye Centre and Singapore Eye Research Institute have shown that low-dose (0.01%) atropine is effective in slowing myopia progression by 50-60% over a two-year period, and with very little side-effects.
The effect of low-dose atropine appears to build over time, being better in the second than first year. As it causes minimal increase in pupil size, children do not require tinted or progressive add glasses. Children are less likely to have other side-effects like dry eye or allergy.
As such, low-dose (0.01%) atropine is safer and it is a more comfortable eyedrop to use than higher-dose atropine (1%, for example). However, some myopia progression may still occur, and if this is till rapid, we may need to discuss if your child needs a higher dose atropine. Studies showed that 10% of children respond poorly (i.e. myopia continues to progress rapidly) even to a higher-dose atropine.
Amblyopia (Lazy Eye)
Treating amblyopia involves resolving the cause of poor vision and promoting the use of the eye with weaker vision. There are two common ways to treat amblyopia:
An adhesive patch is worn over the stronger eye for weeks to months. This therapy forces the child to use the eye with amblyopia. Patching stimulates vision in the weaker eye and helps parts of the brain involved in vision develop more completely.
An National Eye Institute (NEI) funded study showed that patching the unaffected eye of children with moderate amblyopia for two hours daily works as well as patching for six hours daily. Shorter patching time can lead to better compliance with treatment and improved quality of life for children with amblyopia.
A recent study showed that children whose amblyopia persists despite two hours of daily patching may improve if daily patching is extended to 6 hours.Previously, eye care professionals thought that treating amblyopia would be of little benefit to older children. However, results from clinical trials showed that many children from ages seven to 17 years old benefited from treatment for amblyopia. This study shows that age alone should not be used as the sole factor to decide whether or not to treat a child for amblyopia.
A drop of atropine is placed in the stronger eye to temporarily blur vision so that the child will use the eye with amblyopia, especially when focusing on near objects.
NEI-supported research has shown that atropine eye drops, when placed in the unaffected eye once a day, work as well as eye patching. Atropine eye drops are sometimes easier for parents and children to use.