Management of progressive school myopia with topical atropine eyedrops and photochromic bifocal spectacles.

Purpose: To report our results of medical management of myopia, and add these to the prior literature supporting this practice.

Method: Retrospective review of the medical records of 35 patient-subjects offered this treatment with adequate followup over a five year period. Treatment consisted of prescription of photochromic gray extra lenses incorporating full myopic correction with a +3.00 bifocal addition, and atropine 1% ophthalmic drops, one in each eye, each night at bedtime. Compliance was monitored based upon mydriasis and cycloplegia.

Results: The mean change in refractive error per year was +0.07 diopters for the always compliant group, that is, a decrease in the amount of myopia; -0.18 diopters per year for the sometimes compliant group; and -0.17 diopters for the never compliant group, an increase in the degree of myopia. Statistical comparison of our always compliant group with each of the other two groups using the t-test, yielded a P value of P<.10 in each case, considered to be "medically/clinically significant". Comparison of the mean annual change in refractive error of our always compliant group (+0.07 D/yr) with the mean annual change in re-fractive error in the general population aged 8-15 years (-0.24 D/yr) shows an absolute difference of 0.31 D/yr. This difference is "statistically significant" (t-test) with a P <.02.

Conclusion: Atropine and bifocals are an appropriate, effective, and safe management for progressive school myopia; and probably also for pathological myopia.