Although most people with myopia (near-sightedness) do not suffer from complications, highly near-sighted eyes (greater than 6 diopters) are at risk of vision loss. Myopia is fairly prevalent, affecting about 25-35% of adults in the United States. Extensive visual tasks focused at near may be increasing the risk of myopia. Highly myopic eyes are at increased risk of myopic macular degeneration, cataract, glaucoma, and retinal detachment. Therefore, treatment to reduce the progression of myopia is important to prevent loss of vision.
The simple act of spending time away from near work appears to offer help in reducing the onset of myopia. In one study the incidence of myopia was decreased by 10% by spending 40 minutes per day outdoors.
Recent studies support the use of dilute atropine eye drops to slow the progression of myopia. Atropine 0.01% must be prepared by a pharmacy with a doctor’s prescription. The cost is about $20-30 per month. The drop is used once per day. This low-concentration eye drop had minimal effects on the eye. A dilated pupil and difficulty focusing at near are rarely encountered. Therefore, light sensitivity is minimized. Very rare side effects of atropine including rapid heart rate, dry mouth, and urinary retention, constipation, and flushing of the skin are not generally reported with diluted atropine used to treat myopia. Allergic reactions with redness and itching are rare with low-concentration atropine, as well.
Eligible patients include children (aged 5-15) with progressively worsening myopia (1 diopter of more in one year). However, there are no hard and fast rules; a strong family history of high myopia may play into the decision to treat a child with myopia to slow its progression. Treatment may continue until age 18 years. More studies are needed to better define the best time to start treatment and the optimal duration of treatment. For now, however, it appears that atropine may be the safest and most effective pharmacological treatment to slow the progression of myopia.
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