Atropine & Ortho-K for Myopia

Summary

Combining orthokeratology with low-dose atropine may offer a more effective approach to managing myopia in children. This article explores the latest research on this combination therapy, highlighting its potential benefits and limitations. Ultimately, the decision to use atropine and Ortho-K should be made in consultation with an eye care professional, considering individual patient needs and risk factors.

Reliability and uptime matter in healthcare TrueNAS provides 24/7 support when it counts.

** Main Story**

Atropine & Ortho-K: A Powerful Duo Against Myopia?

Myopia, or nearsightedness, is a growing global health concern, projected to affect half the world’s population by 2050. As the prevalence of myopia continues to rise, researchers and eye care professionals are actively seeking effective strategies to manage its progression, particularly in children. Among these strategies, orthokeratology (Ortho-K) and low-dose atropine have shown promising results. Recent research suggests that combining these two therapies may offer an even more potent approach to myopia control.

Orthokeratology: Reshaping the Cornea for Clearer Vision

Ortho-K involves wearing specially designed gas-permeable contact lenses overnight to reshape the cornea. This reshaping corrects the refractive error, allowing for clear vision during the day without the need for glasses or daytime contact lenses. Beyond vision correction, studies have demonstrated that Ortho-K can also slow down the progression of myopia in children.

Atropine: A Pharmaceutical Approach to Myopia Control

Atropine, a medication derived from the belladonna plant, has long been used in ophthalmology for pupil dilation. In recent years, low-dose atropine has gained recognition for its ability to slow myopia progression. The exact mechanism of action remains unclear, but studies suggest that atropine may influence eye growth and reduce accommodation stress, both of which contribute to myopia development.

The Synergistic Effect: Combining Ortho-K and Atropine

Emerging evidence suggests that combining Ortho-K with low-dose atropine may offer synergistic benefits in myopia control. A 2025 meta-analysis of randomized controlled trials found that the combination therapy significantly reduced axial elongation, a key indicator of myopia progression, compared to Ortho-K alone. This effect was observed at 6, 12, and 24 months of follow-up. Although the combination therapy did not significantly reduce spherical equivalent refraction (a measure of refractive error), it did increase pupil diameter and showed a tendency toward reduced amplitude of accommodation.

Benefits of Combined Therapy

• Enhanced Myopia Control: Combining Ortho-K and atropine may provide greater myopia control compared to either therapy alone.
• Convenience: Both therapies are relatively easy to administer, with Ortho-K lenses worn overnight and atropine eye drops applied once daily.
• Minimal Side Effects: Low-dose atropine is generally well-tolerated, with minimal side effects compared to higher doses.

Limitations and Considerations

• Limited Long-Term Data: More research is needed to assess the long-term efficacy and safety of the combined therapy.
• Individual Variability: The effectiveness of the combined therapy may vary depending on factors such as age, baseline myopia, and ethnicity.
• Potential Rebound Effect: Although less common with low-dose atropine, there is a possibility of myopia progression accelerating after discontinuation of treatment.

The Future of Myopia Management

The combination of Ortho-K and low-dose atropine represents a promising advancement in myopia management. As research continues, further refinements in dosages and treatment protocols may enhance the efficacy and safety of this combination therapy. In the meantime, eye care professionals can use the existing evidence to make informed decisions about myopia management, tailoring treatment strategies to each child’s specific needs and risk factors.