Changes in accommodation and vergence parameters with topical use of 0.025% and 0.05% atropine in myopes aged between 7 and 17 years.

OBJECTIVE

To evaluate the vergence and accommodation parameters of myopic children in the use of 0.025% and 0.05% atropine.

METHODS

In total, 34 schoolchildren aged between 7 and 17 years were randomly divided into 2 groups: atropine 0.025% (n = 18) and atropine 0.05% (n = 16). The authors evaluated the parameters of accommodation and vergence before (baseline) and after the instillation of 1 drop of medication for 14 nights, on the 15th day in the morning. The accommodative parameters were near point of accommodation (NPA), accommodation amplitude (AA), negative relative accommodation (NRA), positive relative accommodation (PRA), accommodative facility (AF), accommodative lag (AL), and pupillary diameter. The vergence parameters were near point of convergence (NPC), accommodative convergence/accommodation (AC/A) ratio, positive fusional vergence (PFV), and negative fusional vergence (NFV).

RESULTS

There were significant changes in the accommodative parameters: NPA from 5.85 ± 1.75 cm to 11.33 ± 4.58 cm (atropine 0.025%) and from 5.23 ± 1.31 to 14.94 ± 9.36 cm (atropine 0.05%); reduction of AA from 18.58 ± 5.62D to 11.07 ± 6.99D (atropine 0.025%) and from 20.23 ± 5.11 to 9.40 ± 5.32D (atropine 0.05%); reduction of PRA in absolute terms (modulus) from -3.72 ± 1.90 to -2.12 ± 0.79 and from -4.31 ± 1.88 to -2.02 ± 0.98 (atropine 0.05%); reduction of AF from 10.56 ± 3.50 cpm to 5.00 ± 5.59 cpm (atropine 0.025%) and from 11.56 ± 2.16 to 1.94 ± 3.82 cpm (atropine 0.05%); and increase in pupillary diameter from 4.16 ± 0.90 mm to 5.44 ± 0.97 mm (atropine 0.025%) and from 4.04 ± 0.50 mm to 6.69 ± 0.62 mm (atropine 0.05%). In the vergence parameters, only the Near PFV with 0.025% atropine and changes in Far PFV with both 0.025% and 0.05% atropine showed significant differences compared to baseline.

CONCLUSIONS

Under the conditions of this study, the use of atropine at concentrations of 0.025% and 0.05% induced significant disturbances in the accommodative system, causing visual discomfort.