COMPARATIVE STUDY OF MYOPIA PROGRESSION IN SUBJECTS ON LOW DOSAGE OFATROPINE WITH MATCHED CONTROLS OF DIFFERENT AGE GROUPS

Control of myopia progression has become an important goal, as myopia is a leading cause of visual disability throughout the world. In India uncorrected refractive errors are one of the most common causes of visual impairment. Currently, on average, 30% of the world is myopic and by 2050, based on current trends, almost 50% will be myopic, that’s 5 billion people.High Myopia may be associated with significantly increased risks of retinal degeneration, retinal detachment, glaucoma and cataract associated with high myopia. Several methods including use of progressive addition lenses, rigid gas-permeable contact lenses, and life-style modifications (increased outdoor activity) have reported to alter myopia progression with varying efficacy. In general they have yielded clinical results of marginal significance. Atropine sulphate eye drops (1%) has consistently been demonstrated to inhibit axial myopia progression in both humans and animal models. Yet, it has not found widespread clinical application for myopia control due to ocular side-effects of cycloplegia and pupil dilation. Recently, 0.01% atropine has been shown to be effective in arresting myopia progression without side-effects of cycloplegia and near vision impairment and pupil dilation and increased light sensitivity. However, almost all studies on atropine have been carried out on children of Chinese origin (SE Asia). Efficacy (concentration and dosing)and safety need to be established in the population of interest, before routine use can be recommended. We plan to evaluate the efficacy and safety of topical atropine eye drops(0.01%) in slowing the progression of myopia and ocular axial elongation in Indian children. A total of 80 children of ages 6-18 years will be classified into two groups based on age, which will further be randomized into two sub groups. Intervention subgroup for each age group will receive atropine 0.01% once daily in each eye. Control group will not receive any medications. Follow up visits will be scheduled every six months The progression of myopia (change in refractive error and axial length) will be compared in the two groups by objective methods. It will alsobe compared on different grades of myopia and different age groups to state the best time to start myopia control.