What are these "Atropine" drops to prevent / cure Myopia?

 This is a updated version of June 2024 as opposed to same post of the old on the same topic. This contains newer relevant information. We have retained the old post to just lend you a perspective. Under the guidance of a Kids Eye Doctor the Atropine drops does work.  The Drops are available in India. 

Old post=

This "New Treatment" of "Atropine drops to prevent progression of Myopia" has originated from a Study being done in Singapore, SNEC. 

Treatment: Atropine drops are instilled daily to prevent the progression of Myopia in Children.

100% of the Children of Singapore are Myopic (also a high percentage in Chinese).This is an alarming factor, as a statistic and a health concern for a nation.

When Atropine was used for other purposes, the progression of Myopia was arrested.

So a prospective study was started. 1% atropine drops were instilled once a day in eyes of Kids. This definitely arrested the myopia progression. But it got along with it, a dilated pupil, allowing much extra light to enter the eye, hence discomfort and unknown long term ill effects. It also brought along difficulty in near vision, where Kids had to be given glasses for near vision or progressive glasses. Plus logically, the treatment has to stop at some time, when the myopia came back, known as rebound myopia, in a much severe progression. So it did not serve the purpose.

So the next prospective study was done with 0.5 %  Atropine drops. Again same results. This definitely arrested the myopia progression. But it got along with it, a dilated pupil, allowing much extra light to enter the eye, hence discomfort and unknown long term ill effects. It also brought along difficulty in near vision, where Kids had to be given glasses for near vision or progressive glasses. Plus logically, the treatment has to stop at some time, when the myopia came back, known as rebound myopia, in a much severe progression. So it did not serve the purpose.

So now the latest study is on with 0.01% Atropine drops. It does stop the progression of Myopia. But the questions and ill effects still remain. 

So whenever my patients hear or read about these "New treatements" i talk to them in detail about this. Ask them to read about it. Then again discuss. Then ask them to get drops from Singapore . The 0.01 % drops are not available in India, and the doctors in India are diluting physically the 1 % drops and giving to their patients.

After all these deliberations , only a small % of my patients have opted for this treatment.  But as a researcher i am as yet not dismissing it, i am awaiting definite conclusions.

THESE  DROPS  ARE  NOW  AVAILABLE  IN INDIA  BY INDIAN COMAPNIES.

Updated February 2019: American Academy of Paediatric Ophthalomology has published that the new figures for Myopia in USA are 40% of kids below 15 years of age. Use of iPads, Phones and TV being the main culprit again.

Why does my child complain of headaches and burning eyes while studying.

 This is a common complain in children studying everyday.

First reason for burning eyes i will attribute to the horrible pollution and AQI.

Secondly when you study your blink rate reduces, causing dry eye and burning. This in turn causes watering from the eyes. 

Headaches usually have to do with faulty glasses, anxiety, bad lighting and over worked eyes.

Screen Time during #COVID #Lockdown

At a time like this, #Lockdown due to COVID,  when all of us are indoors, our screen time has increased.

The use of TV, computers, I pads, mobile phones is way more than the recommended time for any age, especially young ones and teenagers.

This is turning out to be a good way to continue education, learn new and fun things, keep in touch with friends and family in these difficult times but it also comes with its own set of problems.

What bad things can increased screen time do?

1.    Can cause eye strain resulting in a feeling of discomfort, eye pain, watering, blinking, headaches and rarely double vision.

2.    Can cause dry eye resulting in again a feeling of discomfort, rubbing , pink or red eye and frequent blinking

3.    Can cause eye muscle balance problems  especially for near work, like accommodation and convergence issues.

4.    May aggravate some kinds of squint.

5.    Excessive near work associated with small screen use may cause existing myopia to increase in predisposed children.

6.    Can cause mental and physical fatigue to some extent with neck pain, back pain etc.

Recommendations to reduce the bad effects of screens.

1.    Frequent breaks from screens. Follow the 20-20 rule. Every 20 minutes there should be a break of atleast 20-40 seconds maybe more for children.

2.    Use larger screens which can be viewed  at a distance versus smaller screens. The TV is better then the laptop which is better than the mobile phone.

3.    For children who wear prescription glasses, they  should keep glasses on while using screens

4.    Preferably use screens in day light in a well lit room where some sunlight  also comes in.

5.    Reduce personal screen time involving games.

6.    Most newer electronic devices have an inbuilt UV protection screen and extra glasses for the same are not required.

7.    Correct upright posture will reduce fatigue. No lying down.

8. To teach children to view distant objects or just look out of the window or close their eyes intermittently

For symptomatic children. (Children exhibiting some complaints)

For mild symptoms of some discomfort off and on, some blinking, feeling of tired eyes etc

a.     Begin by taking frequent breaks

b.    Practice distance viewing

c.      Can do cold compresses

d.    Can use lubricating eye drops after discussing with your Kids Eye Doctor

For moderate to severe symptoms: Consult your Kids eye doctor.

Recommendations for online learning:

1.    Schools should be encouraged to not have online learning for very young children ( maybe less then 10 years of age) If still needed it should be at a minimum time of 1or 2 sessions of 20-30 minutes each

2.    For older children it is preferred that the school uploads the teaching videos and the children be allowed to view them at their convenience over the day

3.    If continuous session necessary for evaluation purposes etc frequent  and adequate breaks recommended.

4.    Self or guided book learning be an integral part of education as well.

Stay home. Stay safe. Reduce your screen time. Keep your eyes healthy.

Squint

Can you explain to us what is Squint ? And what is the treatment.

When you look at something both your eyes are looking together.

Therefore this requires three or four assumptions for good vision.

One, your eyes are aligned in same direction.

Two, they have to move in conjunction.

Imagine a chariot, that is your brain, the 2 horses are the eyes and the multiple 8-10 reins are the muscles. The horses have to be of same strength, same speed and to turn together on pull of reins.

Thirdly your eyes have to be seeing clearly (means they have NO refractive errors).

Fourthly your brain has to be able to mix all the images (messages) from both eyes and show you one picture (with depth, 3 Dimension).

To understand how 2 eyes are different and yet brain mixes and show you one Picture, do this experiment.

Close your left eye and look at a scene with right eye, now close right eye and look at same scene with left eye. This is how 2 different pictures are then mixed by the brain and you see a single picture.

Now, when the 2 eyes are not aligned straight , in simple words it is known as Squint. (Your horses are not in synchronicity)

The commonest cause in children is Refractive error, and hence the treatment is right correction, that is Glasses/ Spectacles.  Therefore every child, should be seen by a Kids Eye Doctor , at the latest by four years of age. Especially Kids with Squint should be seen as early as possible..

There are other causes of Squint too : Birth Trauma, Infection, Paralysis, Weakness of Muscle, Weak eye, Lazy eye, etc etc.

Everything can be treated. But how much treatment is necessary, when to treat, how to treat, whether to delay is the decision of the Kids Eye Doctor.

The next common treatment for Squint is Surgery. Where the muscle is shortened, lengthened or position is changed. This sounds easy, but is a delicate surgery, as you have to adjust the 8-10 reins of your horses, so that the horses align perfectly.

Trust your Kids  Eye Doctor and ask as many questions as need be.

The other treatments of Squint are dependent on the specific cause.

What if we do not treat the Squint, as per the instructions of Kids Eye Doctor?

Then you stand to definitely have one of these, or more:

Permanent Squinting Eyes.

Weak Eyes.

Double Vision.

Impaired mobility for lifetime of the child.

Abnormal head posture, leading to it becoming permanent.  .

MYOPIA

What is myopia ?

It is a Refractive error of the eye which is corrected by minus number glasses (eg -2.25 D spherical).

In very layman terms, near objects are seen clearly and distant objects , or things far away are seen blurred.

What is the best treatment ?

Myopia can  easily and commonly corrected with (a) glasses (b) contact lenses. There are also newer surgeries for Myopia but they have to be taken up only after a certain age of the patient , after thorough assessment and after reviewing the side effects.

How does age affect myopia ?  or

Why do numbers increase ?

Normally every one is born with a little plus (+) numbers and as we grow (till  10-12 years) due to changes or growth in the eye this becomes zero (emmotropia).

But suppose you are detected with minus numbers (myopia) at age 4-10 then these numbers will increase till you grow to 18-21 years of age and then they will stabilize. Usually there is no change in numbers after this.  

Why should a myopia patient get a Retina check regularly ?

Retina, as it is is a very thin and delicate , innermost layer to the eyeball. In myopia it is extra thin. Further more there are some extra thin, frayed areas, called as Lattice found majorly in Myopes. These have to be specially looked for by a Retina Specialist.

These make a myope more prone or liable to Retina Problems (especially Retinal Detachment).

Cautions or Self Tests in Myopia ?.

Decrease in vision

Decrease in field of vision

Sudden increase in floaters (black spots)

Flashes of lightening

Curtain of darkness (Retinal Detachment)

The above 2 ** are an Emergency and you should contact and see your eye doctor immediately.

Why do I see these Black spots (Floaters) or Wiggly lines ?

In certain conditions the jelly that fills your eye (vitreous) it starts converting to liquid. The strands that float in the pockets of liquid formed, you see them as black flecks (floaters)  or wiggly lines. They will not harm you. You will learn to ignore them.

What is Laser therapy sometimes advised to a Myopia patient, even children?

When the thin areas, Lattice, seem likely to produce a potential to damage, they are welded more firmly to the eye by Laser. It is a very painless, OPD procedure.

Can Myopia be cured by “Special medicines” / Yoga / exercises ?

Myopia can be treated, it can not be cured. Patients can lead a normal life with the aid of glasses and contact lenses and should enthusiastically do so.

Updated February 2019: American Academy of Paediatric Ophthalomology has published that the new figures for Myopia in USA are 40% of kids below 15 years of age. Use of iPads, Phones and TV being the main culprit again.

What is this new "Atropine to prevent Myopia" ?

This is a updated version of June 2024 to the old post. This contains newer relevant information. We have retained the old post to just lend you a perspective. Under the guidance of a Kids Eye Doctor the Atropine drops does work.  The Drops are available in India. 

Old post=

This "New Treatment" of "Atropine drops to prevent progression of Myopia" has originated from a Study being done in Singapore, SNEC. 

Treatment: Atropine drops are instilled daily to prevent the progression of Myopia in Children.

100% of the Children of Singapore are Myopic (also a high percentage in Chinese).This is an alarming factor, as a statistic and a health concern for a nation.

When Atropine was used for other purposes, the progression of Myopia was arrested.

So a prospective study was started. 1% atropine drops were instilled once a day in eyes of Kids. This definitely arrested the myopia progression. But it got along with it, a dilated pupil, allowing much extra light to enter the eye, hence discomfort and unknown long term ill effects. It also brought along difficulty in near vision, where Kids had to be given glasses for near vision or progressive glasses. Plus logically, the treatment has to stop at some time, when the myopia came back, known as rebound myopia, in a much severe progression. So it did not serve the purpose.

So the next prospective study was done with 0.5 %  Atropine drops. Again same results. This definitely arrested the myopia progression. But it got along with it, a dilated pupil, allowing much extra light to enter the eye, hence discomfort and unknown long term ill effects. It also brought along difficulty in near vision, where Kids had to be given glasses for near vision or progressive glasses. Plus logically, the treatment has to stop at some time, when the myopia came back, known as rebound myopia, in a much severe progression. So it did not serve the purpose.

So now the latest study is on with 0.01% Atropine drops. It does stop the progression of Myopia. But the questions and ill effects still remain. 

So whenever my patients hear or read about these "New treatements" i talk to them in detail about this. Ask them to read about it. Then again discuss. Then ask them to get drops from Singapore . The 0.01 % drops are not available in India, and the doctors in India are diluting physically the 1 % drops and giving to their patients.

After all these deliberations , only a small % of my patients have opted for this treatment.  But as a researcher i am as yet not dismissing it, i am awaiting definite conclusions.

THESE  DROPS  ARE  NOW  AVAILABLE  IN INDIA  BY INDIAN COMAPNIES.

Updated February 2019: American Academy of Paediatric Ophthalomology has published that the new figures for Myopia in USA are 40% of kids below 15 years of age. Use of iPads, Phones and TV being the main culprit again.