Friday 20 December 2013

Eye-drops for kids with severe myopia

Drug which slows down condition available only at SNEC for now
By Salma Khalik, The Straits Times, 18 Dec 2013

CHILDREN who suffer from rapidly deteriorating myopia can now turn to a new treatment offered by the Singapore National Eye Centre (SNEC).

Its low-dose atropine eye-drops, which cost less than $20 for a month's supply, can slow down short-sightedness by as much as 60 per cent, said Professor Donald Tan, the SNEC's medical director. "It would be fantastic if a child who would normally end up with myopia of 800 degrees is able to keep it to 400 degrees or less," he added.

The SNEC will provide the drops to as many children here as possible. But if its paediatric clinics cannot cope with the expected high demand, Prof Tan said the centre will open more clinics.

About one in six children here suffer from severe myopia of 600 degrees of more by the time they are in their late teens. This puts them at risk of getting cataract at an early age as well as other eye problems like macular degeneration and retinal detachment.

SNEC's five-year trial of 400 children, which began in 2006, found that the daily use of low-dose atropine showed no noticeable side effects.

Instead the drops, which retard the elongation of the eyeballs which leads to myopia, proved a success in slowing down the condition. For some children, it even arrested the short-sightedness from getting any worse.

Prof Tan's wish is to see the drug became widely accessible, but there are regulatory hurdles to overcome.

The SNEC tried to interest pharmaceutical companies to produce the eye-drop, but with no success. Prof Tan said this is because the company would need to carry out expensive trials to get regulatory approval.

But because it is an old drug that is no longer under patent, once a company has obtained approval, others could simply produce and sell similar eye-drops.

SNEC finally decided to pay a company to make the eye-drops. But until large-scale trials are conducted to meet regulatory demands, these drops can be dispensed only by SNEC's pharmacy, and all patients have to be logged.

Prof Tan hopes to be able to conduct trials that will satisfy health regulators within a few years - together with eye centres in other Asian countries facing a high incidence of myopia, such as China.

When that happens, the eye- drops can then be dispensed by any doctor. Until then, SNEC will be the only place supplying these eye-drops to patients in general to prevent worsening of myopia.

About 85 per cent of teens here are myopic, with the condition generally starting when a child is five or six years old.

Usually, the fastest deterioration occurs between the ages of seven and nine years. Prof Tan stressed that while the drops can slow the progression of myopia, they cannot cure it.

Parents can call 6227-7266 for an appointment, or e-mail

Those who want subsidised treatments need a referral from a polyclinic.

Parents should bring along proof of their child's deteriorating myopia, such as the need for a new pair of spectacles every few months.

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