This "miracle drug for myopia" is not suitable for every child!

The problem of myopia at younger ages has increasingly attracted social attention. Recently, the first domestically produced low-concentration atropine eye drops were approved for marketing, attracting the attention of parents. As an ophthalmic preparation used to delay the progression of myopia in children aged 6 to 12, can it be bought directly for children to use? How safe is it? What precautions should be taken when using it?

Delaying myopia progression

Atropine is an M receptor blocker and an anticholinergic drug. It can relieve gastrointestinal smooth muscle spasms and is commonly used in clinical practice for gastrointestinal colic and bladder irritation. It can also dilate the pupil to accommodate paralysis. In the field of ophthalmology, high-concentration atropine is commonly used for mydriasis and fundus examination (the commonly used dosage form in clinical practice is 1% atropine eye gel).

Early studies found that high concentrations of atropine can significantly inhibit the growth of the anterior-posterior diameter of the eyeball, thereby slowing down the progression of myopia, but at the same time there are adverse reactions such as severe photophobia, decreased near vision, and rebound effects after discontinuation of the drug. Later, through continuous research, it was found that low concentrations of atropine (0.01%) can block the effects of neurotransmitters in the central nervous system and peripheral nervous system to control the progression of myopia. It can not only effectively delay the progression of myopia, but also has fewer adverse reactions than higher concentrations of atropine, so it has gradually become favored by pharmaceutical companies.

In fact, low-concentration atropine eye drops are not a "magic drug for myopia". It can neither prevent myopia nor treat myopia. It can only delay the progression of myopia, and the control effect on different individuals may be different. The low-concentration atropine eye drops currently on the market in China are 0.01% atropine eye drops, which are mainly used to delay the progression of myopia in children aged 6 to 12 years with a spherical power of -1.00D to -4.00D (i.e. myopia 100 to 400 degrees, astigmatism ≤150 degrees, and anisometropia ≤150 degrees). It is not suitable for children with a history of scopolamine allergy, glaucoma or glaucoma tendency, craniocerebral trauma, heart disease, etc. Some eye diseases accompanied by photophobia symptoms (such as keratitis) need to be cured before they can be used.

Therefore, low-concentration atropine eye drops are not suitable for every myopic child, nor are they effective for every myopic child. Parents should be rational about this. The 0.01% concentration is a compromise option that takes into account both efficacy and safety. Therefore, parents can only purchase them from a regulated institution after a doctor has assessed the need and issued a prescription.

There are risks in using

The adverse reactions of atropine are obviously concentration-dependent. 1% atropine eye drops can cause systemic adverse reactions such as facial flushing, dry mouth and skin, rapid heartbeat, and constipation. However, as the concentration decreases, the systemic reactions of atropine eye drops are significantly reduced. Clinical studies have shown that no serious systemic adverse reactions have been found with 0.01% atropine eye drops, but there is still a possibility of eye discomfort, the most common of which are mydriasis, photophobia, increased intraocular pressure, itchy and stinging eyes, and even difficulty seeing the words in books. Although the symptoms are mild and the incidence is low, they still need to be taken seriously.

If eye discomfort occurs after using low-concentration atropine eye drops but can be tolerated, you can temporarily observe without treatment; if you cannot tolerate it, intervention is required. For example, if you are photophobic, you can wear a sun hat or photochromic glasses to relieve it; if an allergic reaction occurs, you should stop the drug immediately. Generally, the symptoms will be alleviated 24 hours after stopping the drug, and you can recover after 1 week of stopping the drug.

Standardized use is safer

1. Operation

As an external ophthalmic preparation, low-concentration atropine eye drops are recommended to be used once before bedtime, one drop at a time, and dripped into the conjunctival sac. At the same time, aseptic operation should be ensured during the medication process, such as washing hands before medication.

2. Guardianship

During medication, you should pay attention to eye discomfort symptoms. If you encounter any problems, you need to seek medical attention in time and do regular follow-up. For children who respond generally or poorly to the recommended method, you can adjust the treatment plan according to the doctor's advice (a good response means that the annual increase in myopia does not exceed 25 degrees; a general response means that the annual increase in myopia is between 25 degrees and 75 degrees; a poor response means that the annual increase in myopia is ≥ 75 degrees).

3. Understanding

Low-concentration atropine eye drops are prescription drugs. Before deciding to use them on children, doctors need to conduct strict clinical evaluations and risk factor assessments before prescribing them. Children should follow the doctor's instructions when using them, and should not increase the dose or stop the drug without authorization. For myopic patients, taking medication alone not only cannot prevent and control myopia, but may also delay the timing of correction. During the use of low-concentration atropine eye drops, remember to follow up and reexamine regularly.

The prevention and control of myopia cannot rely solely on drugs. Outdoor activities and healthy eye habits are equally important. The following points should be noted in protecting children's vision:

1. Improve your eye habits, maintain correct reading and writing posture, and ensure proper lighting in your learning environment.

2. Increase outdoor activities, at least 2 hours a day for school-age children and at least 3 hours a day for kindergarten children.

3. Pay attention to eye hygiene to reduce eye infections.

4. Enhance awareness of vision protection, reduce the use of electronic products, and ensure adequate sleep.

5. Parents should conduct regular vision screening for their children and intervene in a timely manner if any problems are discovered.