Research has suggested that myopia in children may be linked to focusing fatigue - spending too much time on a near activity. Atropine is an anticholinergic agent - in low doses, Atropine works to dilate the eyes and disable the eye’s focusing muscle to control myopia.
Low dose Atropine, while currently “off-label” for myopia control, is being used around the world to reduce myopia progression. The side effects of blurry near vision and light sensitivity are rare. Systemic toxicity through an ocular preparation of low dose Atropine would be difficult. Nevertheless, caution is taken in children with pre-existing heart conditions, developmental delays, and a history of asthma or lung disease. Caution is also taken when patients are taking other medications that may have anticholinergic or antimuscarinic effects to avoid increased side effects - including medications used to treat depression.
Atropine is a good option for younger children who are not ready for contact lenses – it is applied once daily at bedtime, and has shown to slow myopia progression in children. While Atropine works therapeutically, it will not correct for blurry distance vision, so wearing glasses or contact lenses is still needed for a child to see clearly during the day. Alternatively, Atropine can also be used along with CRT or Multifocal Soft Contacts for better myopia control.