Plain English Summary
Background and study aims
Short-sightedness, or myopia, is a common eye condition resulting in distant objects appearing blurred to the sufferer. The condition usually starts from around puberty, but can develop in younger children. The condition gradually gets worse over time. It is caused by the eye stretching and becoming slightly longer than it should. This means that light does not focus on the retina (light-sensitive tissue) of the eye but just in front of it, causing far away objects to look blurred. Myopia is associated with an increase in pressure within the eye (intraocular pressure) over a long period of time. Some studies have shown that the drug atropine slows down the progression of myopia. This study looks at the effects of topical atropine (atropine given as eye drops) on the intraocular pressure of the eye and myopia progression in children and aims to find out the smallest amount of drug that needed (lowest concentration) to get results.
Who can participate?
Short-sighted children aged between 6 and 12 and living in Northern Taiwan.
What does the study involve?
Children are assigned to one of three groups. If the parents state a preference for the child not to be treated with medication, they are assigned to the control group and given glasses to correct their vision if required. If the parents state a preference for their child to be treated with medication, they are randomly allocated to one of two groups. Children in group 2 are given eye drops containing 0.125% atropine in addition to corrective glasses if required. Children in group 3 are given eye drops containing 0.25% atropine in addition to corrective glasses if required. Myopia progression and intraocular pressure is measured at the start of the study and then every 3 months for the next 12 months for all participants.
What are the possible benefits and risks of participating?
In general, there is almost no risk for taking part in this study because atropine use in Taiwan is routine and general practice for myopic children. The only risk, if any, is that those who did not use atropine (control group) will run a rapid myopic progression speed and have a greater chance of high myopia and associated complications during their late adult life.
Where is the study run from?
Chang Gung Memorial Hospital (Taiwan)
When is the study starting and how long is it expected to run for?
March 2009 to March 2011
Who is funding the study?
Chang Gung Medical Research Foundation
Who is the main contact?
Dr Chi-Chin Sun
Effects of topical atropine on intraocular pressure and myopia progression
Topical atropine has been used for a long time to control myopia progression. However, the minimal effective concentration has not been established. Moreover, its effect on intraocular pressure is still in debate. Therefore, we conducted this prospective study.
Institutional Review Board at Chang Gung Memorial Hospital, Taiwan, 30/01/2009, ref: 97-1988A3
Single site prospective, interventional longitudinal and non-randomized study
Primary study design
Secondary study design
Non randomised study
Patient information sheet
Not available in web format, please use contact details to request a participant information sheet
Myopia in children
This is an interventional study that enrolled children with myopia. If the parents state a preference for their child to not receive any medications, they are assigned to the control group with spectacles correction if needed.
If their parents state a preference for their child to be treated with medications, the child is randomly assigned to one of two groups:
1. Child is treated with 0.125% atropine in addition to spectacle correction
2. Child is treated with 0.25% atropine in addition to spectacle correction
All children are followed up for the next 12 months.
Primary outcome measure
Myopia and its progression: with autorefractometer and manifest refraction by experienced technician. Assessed at baseline and then every 3 months for next 12 months.
Secondary outcome measures
IOP measurement: with pneumatic tonometer by experienced technician. Assessed at baseline and then every 3 months for next 12 months.
Overall trial start date
Overall trial end date
Reason abandoned (if study stopped)
Participant inclusion criteria
1. Children in Northern Taiwan aged between 6 to 12 years.
2. Patients with a refractive error less than -3.0 diopters (D)
Target number of participants
Participant exclusion criteria
1. Congenital eye disorder
2. Any disease influence the cornea, lens or retina
3. Best correct visual acuity<20/25 using the Snellen chart
4. Primary intraocular pressure above 21mmHg
5. Atropine application within 6 months before enrollment
6. Patients who could understand the details of this study or could not adhere to the follow up schedule
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
Chang Gung Memorial Hospital
Chang Gung Medical Research Foundation
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
This manuscript has been submitted to BMC Ophthalmology and currently under consideration for publication. If possible, we expected it will be published within 3 months. The dissemination targets are those who are interested in myopia control and concern about side effects of mydriatics, including professional Ophthalmologists, public health researchers and the general public.
Intention to publish date
Participant level data
Not expected to be available
Basic results (scientific)