June 1, 2022 By Dwight Akerman, OD, MBA, FAAO, FBCLA, FIACLE The International Myopia Institute’s white paper on Defining and Classifying Myopia introduced the concept of pre-myopia, which they define as: “A refractive state of an eye of between +0.75 D & -0.50 D in children where a combination of baseline refraction, age, and other quantifiable risk factors provide a sufficient likelihood of the future development of myopia to merit preventative interventions.” In other words, progression is highly likely once a child is identified as pre-myopic, and interventions that reduce the incidence of myopia are necessary.   Researchers from China conducted a retrospective cohort study with 50 children 6 to 12 years old. The aim of the study was to evaluate the efficacy of a 0.025% atropine solution for the prevention of myopic shift and myopia onset in pre-myopic children. Twenty-four children (average age 7.6 years old) were in the 0.025% atropine group, and 26 children (average age: 8.2 years old) were in the control group. All children were followed for a minimum of 12 months. In multiple linear regression analysis, 0.025% atropine treatment was the only independent variable preventing myopia shift. The authors concluded that nightly administration of one drop of 0.025% atropine may be considered a feasible option for delaying the onset of myopia in pre-myopic children. Randomized controlled trials with topical low-dose atropine and pre-myopic children are currently underway to corroborate these encouraging results. Abstract Prevention of Myopia Onset with 0.025% Atropine in Pre-Myopic Children Po-Chiung Fang, Mei-Yung Chung, Hun-Ju Yu, Pei-Chang Wu Purpose: To evaluate the efficacy of 0.025% atropine solution for prevention of myopic shift and myopia onset in pre-myopic children.  Methods: This study was designed as a retrospective cohort study. Six- to 12-year-old children with spherical equivalent refraction of <+1 diopter (D) (defined as pre-myopia), with cylindrical refraction of <-1 D, without amblyopia, and who received 0.025% atropine eye drops at bedtime every night or no treatment after follow-up for at least 12 months were enrolled. Fast myopic shift is defined as a myopic shift >-0.5 D per year.  Results: Fifty children were enrolled in the study. Twenty-four children (average age 7.6 years old) were in the 0.025% atropine group, and 26 children (average age: 8.2 years old) were in the control group. The mean spherical refraction myopic shift in the 0.025% atropine group was -0.14 +/- 0.24 D/year, significantly lower than that in the … Continue reading Preventing Myopia Onset