COMBINED TREATMENT WITH ATROPINE AND DEFOCUS LENSES FOR CHILDHOOD MYOPIA PROGRESSION

Abstract

Introduction: Childhood myopia has been recognized as a major refractive condition on the rise globally, characterized by excessive elongation of the eyeball and progressive impairment of distance vision. Rapid progression of myopia during childhood has been linked to an increased risk of future ocular complications, including retinal detachment, glaucoma, and macular changes. Scientific studies have shown that controlling myopic progression relies on interventions capable of modulating axial eye growth, notably the use of low-concentration atropine and ophthalmic lenses featuring peripheral defocus technology. Combining these therapeutic strategies has yielded promising results by targeting complementary mechanisms, thereby reducing refractive progression and axial elongation in children and adolescents. This systematic literature review aimed to analyze scientific evidence regarding combined treatment with atropine and defocus lenses to reduce childhood myopia progression, evaluating clinical effects, therapeutic benefits, and relevance in preventing disease progression. Methodology: The review was conducted in accordance with PRISMA checklist recommendations, utilizing scientific articles published over the last 10 years in the PubMed, SciELO, and Web of Science databases. The following descriptors were used: “Childhood myopia,” “Atropine,” “Defocus lenses,” “Myopia control,” and “Axial length.” Included studies comprised clinical trials, scientific reviews, and research involving children diagnosed with myopia undergoing combined treatment. Duplicate articles, studies unrelated to childhood myopia control, and publications lacking relevant clinical data were excluded. Results: The analyzed studies demonstrated that low-dose atropine significantly reduced myopic progression, primarily by curbing axial eye growth with a lower incidence of adverse effects. Peripheral defocus lenses contributed to modifying the retinal optical stimulus, thereby reducing signals associated with excessive eye growth. The combination of therapies demonstrated greater control over progression compared to the use of each intervention in isolation, particularly in children with rapidly progressing myopia. Conclusion: Scientific evidence indicated that combined treatment with atropine and defocus lenses represented an effective and safe approach for controlling progressive childhood myopia. Combining these strategies enhanced the reduction of refractive progression and ocular axial elongation, demonstrating clinical importance in preventing complications associated with high myopia and preserving visual health during childhood development.