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The acceptability and visual impact of 0.01% atropine in a Caucasian population
  1. James Loughman1,2,
  2. DI Flitcroft3
  1. 1Department of Optometry, School of Physics, College of Sciences & Health, Dublin Institute of Technology, Dublin, Ireland
  2. 2Faculty of Health Sciences, African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa
  3. 3Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland
  1. Correspondence to Professor James Loughman, Department of Optometry, School of Physics, College of Sciences & Health, Dublin Institute of Technology, Dublin, D08 NF82, Ireland; james.loughman{at}dit.ie

Abstract

Background Myopia is a condition of enormous public health concern, affecting up to 2.5 billion people worldwide. The most effective treatment to prevent myopia progression is atropine but at the cost of accommodative paresis and mydriasis, necessitating the use of bifocal glasses. Low-dose atropine (0.01%) has been found to be almost as effective with significantly reduced side effects. Since there are well-recognised differences in the effect of atropine between heavily pigmented Asian eyes and Caucasian eyes, this study aimed to determine the acceptability and tolerability of 0.01% atropine (by measuring visual performance and quality of life) as a treatment for myopia control in a Caucasian population exhibiting light irides.

Methods 14 university students aged 18–27 were recruited to the study. Participants received one drop of 0.01% atropine daily into each eye over 5 days. A range of physiological, functional and quality of life measures were assessed at baseline, day 3 and day 5.

Results The effect of atropine was statistically significant for pupil size (p=0.04) and responsiveness (p<0.01). While amplitude of accommodation reduced, the change was not statistically significant. Visual acuity (distance and near) and reading speed were not adversely affected. While there was a slight increase in symptoms such as glare, overall there was no quality of life impact associated with the use of low-dose atropine.

Conclusions Overall, 0.01% of atropine was generally well tolerated bilaterally and no serious adverse effects were observed. Therefore this dose appears to provide a viable therapeutic option for myopia control among Caucasian eyes.

  • Child health (paediatrics)
  • Ciliary body
  • Physiology
  • Pharmacology
  • Public health

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Footnotes

  • Contributors JL contributed to the conception and design of the study, data capture, analysis and interpretation. He drafted the initial paper, approved the final version and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. DIF contributed to the conception and design of the study, and interpretation of study findings. He reviewed the initial paper and provided recommendations for change. He also approved the final version and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Research Ethics Committee, Dublin Institute of Technology.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data is stored electronically on an encrypted system, and hard copy in a locked filing cabinet. Only the two investigators have access to the study data.

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