As an eye care specialist, I prescribe many kids their first pair of glasses so they can function in school and see the world around them clearly. This is one of my least favorite things to do and let me explain why.
There are better options from a health standpoint than giving a child glasses to see far. If I prescribe a child glasses to correct nearsightedness (aka myopia), I expect that child will need a stronger prescription within a year. Glasses can even accelerate how fast the child’s eyesight will worsen.
Glasses do nothing to address the main issue. The child’s eyes are starting the long process of becoming extremely nearsighted and we add gasoline to the fire by only prescribing glasses. This is the most important time in a child’s life to intervene and do something about them becoming nearsighted (myopic).
The term “Myopia control” means slowing down how fast nearsightedness is becoming worse year-after-year. There are currently 3 myopia control methods. Two of the three involve special contact lenses called Ortho K and multifocal contacts, and one involves a special eye drop. I’ll be focusing on the eye drop in this particular discussion.
The special eye drop is called atropine, which is typically used in eye care to dilate the eyes and treat inflammation. The normal dose to treat inflammation and dilate the eyes is 1.0%. Recent studies indicate that an ultra-low dose of just 0.01% atropine is an effective treatment to slow the progression of myopia in children and has essentially no side-effects. [ATOM I and ATOM II studies*]
The eye drop does not completely stop myopia from becoming worse, but it should slow the progress by about 50%. So if your child’s eyes were worsening by 1.00 dioptor (the # on the glasses prescription) every year, we would expect only a 0.50 dioptor change every year after starting the atropine eye drop.
Using the drops will not improve eyesight, but it will decrease how bad a child’s eyesight will become. Many kids using the atropine treatment will need glasses for reading and some may need progressive lens glasses for the classroom.
The drops are most effective when used throughout childhood and the best results occur when used until the mid-to-late teen years. The lower we are able to keep the glasses prescription, the less eye disease the child will be at risk for as an adult, so treatment is recommended until the eyes are no longer becoming more nearsighted.
Like many things in medicine nowadays, the use of atropine for myopia control is considered an “off-label” use because it has not been evaluated by the FDA. Because of this, children using atropine for myopia control are monitored every few months to make sure the treatment plan is safe and working effectively.
*The ATOM studies refer to Atropine Treatment of Myopia and can be read here [https://www.aao.org/assets/28fe020e-5f93-4d06-aac1-889cecb15fb2/635835505202800000/atropine-for-myopia-5-yr-clinical-trial-ophthalmology-2015-pdf?inline=1]