Dr. Mihir Kothari, a pediatric ophthalmologist and an educator begins by explaining what is myopia. He elaborates on myopia has been classified by the international myopia institute and how myopia is classified in India. He enlist the myopia categories where atropine is useful in treating myopia.
He explains what is atropine and what actions of mechanism the drug has on the eye for treating myopia. We learn a brief history of how and when atropine became a popular drug of choice to treat myopia. Dr. Kothari elaborates on the treatment of myopia using atropine for a few categories of myopia
- Typical school myopia.He elaborates on the efficacy and the safety of the drug.
- Rebound myopia described with a particular case. We also learn about the importance of axial length measurements
- Break through response
- Suboptimal response
- Premyopia
Along with the different types of myopia to be managed with atropine, we learn about the efficacy and safety of the treatment. We also learn the importance of axial length measurements and and patient compliance. We are explained about the contraindications of using atropine for certain specific conditions. Atropine allergy is an uncommon complication, Dr. Kothari explains how to tackle atropine allergy.
We talk about another atropine complication, convergence excess esotropia. Dr. Kothari explains how to manage this condition effectively. Lastly, he concludes with some very important take home message for eyecare practitioners who treat myopia in children. The session ends with a Q and A session for the live audience.
References
Papers
Flitcroft DI, He M, Jonas JB, Jong M, Naidoo K, Ohno-Matsui K, Rahi J, Resnikoff S, Vitale S, Yannuzzi L. IMI – Defining and Classifying Myopia: A Proposed Set of Standards for Clinical and Epidemiologic Studies. Invest Ophthalmol Vis Sci. 2019 Feb 28;60(3):M20-M30.
https://pubmed.ncbi.nlm.nih.gov/30817826/
Chia A, Lu QS, Tan D. Five-Year Clinical Trial on Atropine for the Treatment of Myopia 2: Myopia Control with Atropine 0.01% Eyedrops. Ophthalmology. 2016 Feb;123(2):391-399.
https://pubmed.ncbi.nlm.nih.gov/26271839/
Kothari M, Rathod V. Efficacy of 1% atropine eye drops in retarding progressive axial myopia in Indian eyes. Indian J Ophthalmol. 2017 Nov;65(11):1178-1181.
https://pubmed.ncbi.nlm.nih.gov/29133646/
Kothari M, Jain R, Khadse N, Rathod V, Mutha S. Allergic reactions to atropine eye drops for retardation of progressive myopia in children. Indian J Ophthalmol. 2018 Oct;66(10):1446-1450.
https://pubmed.ncbi.nlm.nih.gov/30249831/
Kothari M, Modak M, Khan H, Jahan S, Solanki M, Rathod V. Convergence excess consecutive esotropia associated with 0.01% atropine eye drops usage in patients operated for intermittent exotropia. Indian J Ophthalmol. 2020 Apr;68(4):653-656.
https://pubmed.ncbi.nlm.nih.gov/32174596/
Kesarwani SS; Mumbai Group of Paediatric Ophthalmologists and Strabismologists. Consensus statement and guidelines for use of dilute atropine sulphate in myopia control. Indian J Ophthalmol. 2019 Apr;67(4):461-463.
https://pubmed.ncbi.nlm.nih.gov/30900574/
Websites
BHVI Myopia Calculator