Myopia (nearsightedness) is a condition that is most associated with blurred vision at distance. Increasing amounts of myopia do not only cause difficulty seeing. Myopia is also associated with an increase in sight threatening eye diseases such as myopic macular degeneration, cataract, glaucoma, retinal holes and tears, and retinal detachments later in life. Our doctors may have recommended that you consider an intervention to help limit the progression of your child’s increasing myopia.

The use of Atropine in slowing down the progression of myopia was first reported in the 19th century. The effectiveness of Atropine for myopia control is higher than any other form of treatment currently available. Due to side effects, the use of Atropine has historically not become widespread for myopia progression. The commercially available concentration for Atropine is 1.0%. At this concentration the medication causes blurred near vision, pupil dilation and considerable light sensitivity. There are also systemic side effects at this high concentration that can in very rare instances cause increased heart rate, flushing of the skin, dry mouth and confusion.

Recent peer reviewed research has proven that Atropine at lower concentrations should be considered as a treatment option for reducing the rate of myopia progression (see references below). As the concentration is reduced the effectiveness of myopia stabilization is proving to be less effective than stronger concentrations. Fortunately lower concentrations have a much lower likelihood of side effects than at the full concentration.

Your doctors at Carillon Vision Care will tailor a plan along with you and your child to find the appropriate concentration of Atropine to help reduce the rate of progression of myopia and limit the possible side effects.  Since the reduced concentration of Atropine is not commercially available, it will be formulated by a compounding pharmacy and will not be available at a standard pharmacy. Carillon Vision Care will provide these drops directly to you.

Our initial Atropine ophthalmic program will include all visits required to achieve the optimal therapeutic effect. This includes all professional services involved in monitoring the visual response, and ensuring optimal eye health response to the Atropine drops for a period of one year following the initial Myopia Management Ophthalmic Evaluation.

Following year one, an annual comprehensive eye health examination and Myopia Management Evaluation (subsequent) is required to ensure ongoing optimal visual health and the stability of the therapeutic effect. 6-month monitoring visits are scheduled on an ongoing basis.

Global Fees include:

  1. All medical office visits related to atropine therapy during the first year. The treatment protocol includes visits minimally at 1 week, 1 month, 3 months, and 6 months following initiation of therapy. However, other visits related to atropine therapy may be needed and are also included in the program fee. 
  2. All diagnostic testing involved in measuring for objective and subjective responses to therapy or detection of symptoms associated with potential side effects from the medication.
  3. All Atropine medication. Compounded Atropine has a shelf life of 6 months. We will provide 90 day supplies (three 5 mL bottles) at a time. Please note: due to the sterile compounding process, it may take up to 10 business days to order and receive bottles from our compounding pharmacy. Always notify Carillon Vision Care when you open your last bottle so we may have more compounded and ready for you to pick up.

Other options exist to treat, reduce, or eliminate myopia and astigmatism. They include; glasses, traditional contact lenses, corneal reshaping therapy (Ortho-K), myopia stabilization specialty multifocal contact lenses, MiSight contact lenses, and refractive surgical procedures. Each modality has its own unique advantages, disadvantages, risks, and benefits. Your doctor will review these options with you during your examination and consultation and determine which is best.

In some cases, it may be appropriate to utilize Atropine in combination with other myopia management treatment protocols.

References:

Two-Year Clinical Trial of the Low-Concentration Atropine for Myopia Progression (LAMP) Study: Phase 2 Report

The Use of Atropine 0.01% in the Prevention and Control of Myopia (ATOM3)

A Review of Advances in Myopia Management. Review of Ophthalmology. (August 2020)