Can We Prevent Nearsightedness from Advancing in Young Children?

Can We Prevent Nearsightedness from Advancing in Young Children?

Nearsightedness that increases every year is common in school-aged children. First, there is a small amount of nearsightedness and then it advances as the child or teenager grows. Is there any way to slow down this progression?

First of all, many things have been tried and promoted as effective. What does not seems to work? Bifocal glasses and hard contact lenses. Both of these methods have been widely promoted as methods to slow down the progression of nearsightedness, but large studies have shown that these methods do not work. Atropine 1%, a dilating eyedrop, does work to slow down nearsightedenss progression. However, the side effects of atropine 1% usage are too great: dilated pupils with sensitivity to light and loss of closeup focusing ability requiring the need to wear bifocal glasses and sunglasses at the same time.

What does seem to work, without the significant side effects, is low dose atropine drops. When used at 0.01%, or 1/100th the concentration of the normal atropine 1%, low-concentratiion atropine seems to cut down the myopic progression by 60%. At least this is the finding by a large and well-controlled double-blind study conducted in Singapore, where atropine 0.01% is becoming a very common treatment.

How well this will work in European eyes, which tend to be less pigmented than Asian eyes, has not been proven. Preliminary data from a study in Dublin appear very promising in this regard. With the lower dose of atropine there is no need for bifocal glasses as with the higher dose eyedrop and the amount of light sensitivity is not great. Since this is a medication that has been used for decades there is little concern about longer term consequences.