Fighting myopia, 1 eye drop a night

SINGAPORE - Doctors say a simple eye drop could be the best solution to fighting short-sightedness, which afflicts eight in 10 people here by the time they are adults.

"We think we have found the answer to reducing the progression of myopia in children," said Professor Donald Tan, chairman of the Singapore Eye Research Institute (Seri), who led the latest study.

"There is reasonable evidence that reducing near-work activities such as reading and playing computer games may slow it down, but not by such a huge margin as the eye drops."

Seri has tried battling myopia on several fronts - using computer software to exercise the brain and an eye gel, for example - but nothing has proven as successful as the latest eye drops.

They contain a very dilute solution of the chemical atropine, which has been proven to slow myopia, but can cause problems such as glare and the loss of near vision in higher concentrations.

"We were extremely pleased to find that the children had almost no side effects and the drug was absolutely safe," said Prof Tan of the latest study.

Singapore is the myopia capital of the world, where 7 per cent of five-year-olds are short-sighted and more than 60 per cent are myopic by the time they are in Primary 6.

High myopia rates mean more individuals have severe myopia, said Dr Audrey Chia, an adjunct clinician investigator at Seri, adding that they are also at risk of developing potentially blinding eye conditions such as retinal holes, retinal detachment and even glaucoma.

With the new eye drops, myopia in an average child increased at only half the usual rate, so a child who might have had a short-sightedness level of 1,000 degrees in one eye might have a level of just 500, she added.

Such eye drops generally do not work on adults as their myopia, if any, would be fully developed.

Myopia occurs when the eyeball grows longer than normal, making it unable to focus on distant objects, and atropine works by slowing this growth.

Seri's study was the first in the world to fine-tune the dosage. At a 0.01 per cent concentration - 100 times lower than previously used - the solution worked well with no side effects.

"We feel we have finally arrived at an ideal therapy in 0.01 per cent atropine eye drops," said Prof Tan. "No other approach seems to be as effective and safe."

The five-year trial that ended last year involved 400 children, aged six to 12, who applied a single drop every night.

Anglo-Chinese School (Independent) student Nikhil Daniel Angappan was 10 when he joined the study. At the time, he was moderately short-sighted, with 225 degrees in the left eye and 250 degrees in the right.

Now 16, his short-sightedness has stopped at 150 degrees in his left eye and 175 degrees in his right.

"This really was a fantastic programme," said Nikhil, who likes to play rugby. "There was a reduction in myopia and I was still able to have an active lifestyle."

The eye drops are expected to be available to all children here by the middle of next year.

At the same time, a further study involving up to 600 children will begin, said Prof Tan. This will fulfil drug registration requirements and test the new eye drop's performance in a real world setting.

OTHER BREAKTHROUGHS

Ocular drug delivery system

Researchers at the Singapore Eye Research Institute (Seri) have found a way to inject slow-releasing drugs into the eyeball.

This could free people with glaucoma from having to use eye drops daily or risk a worsening of their condition, which could lead to blindness.

Designed to mimic cell membranes in the human body, the special particles developed at Seri can stay in the eye for up to four months, slowly releasing the medication.

If trials show the injection treatment works, it could benefit the 10,000 people who go to the eye centre for glaucoma treatment every year.

Corneal surgery

A new laser treatment to correct short-sightedness may be able to reverse it later in life, when patients develop presbyopia, or long-sightedness, instead.

Unlike conventional Lasik surgery that vaporises corneal tissue, the new surgery removes a lens-shaped piece of the cornea without destroying it. The piece of corneal tissue, called a lenticule, can be stored and later retrieved to treat the same patient's presbyopia.

It can even be donated to corneal transplant patients.

This procedure is not unlike cord blood banking, where an infant's cord blood, stored at birth, may be used years later to treat immune system and blood-related disorders.

achern@sph.com.sg

Get a copy of The Straits Times or go to straitstimes.com for more stories.