Medicated eye drops in the dying children of the neighborhood

The day the eye drops, it might keep myopia at bay – at least for a while.

Using nightly eye drops with 0.05 percent atropine, a drug that relaxes the eye muscle that causes vision to focus, can delay the onset of myopia in children, researchers report on February 14. JAMA.

Myopia, also called farsightedness, is an irreversible condition in which the length of the eyeball increases from the front to the back, causing distant vision. It typically starts in childhood, and the earlier it starts, the worse eye health can become later in life. Elongated eyes increase the risk for eye complications such as cataracts, glaucoma and macular degeneration.

The prevalence of myopia has risen rapidly in recent decades. About a quarter of the global population now has the condition. It is expected to affect half of the world’s population by 2000.

Genetics plays a large role in the condition. A 2020 study found that the risk of myopia is more than 10 times higher in children of two highly myopic parents than in children of nonmyopic parents, says ophthalmologist Jason Yam of the Chinese University of Hong Kong.

But he and other scientists speculate that environmental factors such as less time outdoors and more intensive education are causing the recent boom.SN: 1/24/13). “It quickly turns out to be a purely genetic or hereditary issue,” says optometrist Kathryn Saunders of the University of Ulster in Coleraine, Northern Ireland, who was not involved in the new studies.

Low-dose atropine eye drops are already used to slow the progression of myopia in several Asian countries. Yam and colleagues wanted to see if the medication could also delay the onset of myopia.

The group recruited nonmyopic children aged 4 to 9 who lived in Hong Kong. Each participant received nighttime eye drops but was randomly assigned to receive drops with 0.05 percent atropine, 0.01 percent atropine, or a placebo. Families and clinicians did not know which treatment group the children were in.

A total of 353 eye drops for two years of free use. Only about 25 percent of the children who took atropine eye drops 0.05 percent, about 30 kids, developed myopia in at least one eye, while about 50 percent of those who used atropine eye drops or a placebo eye 0.01 percent developed it, about 60 kids in each group. Receipts in each group were similar for eye elongation not severe enough to be considered myopia.

“It’s a great first step to encourage us to explore more,” said Saunders.

Scientists will need to conduct studies in different countries and environments to reach general conclusions, since the trial was only done in Hong Kong. Eye color can also influence dosing, so that lighter pigmented eyes are more susceptible to side effects, including sensitivity to light.

How atropine slows the onset and progression of myopia remains a mystery. The drug might improve blood circulation in the eye, Yam says, but it’s just an existing hypothesis.

The new study was too short to suggest that atropine eye drops can prevent myopia. But a follow-up period in which the participants continue taking the drug throughout their teenage years — when the eye’s length stabilizes — will allow the team to understand if atropine eye drops can completely ward off the condition.