How to lie to my eye doctor regarding atropine drops?

Dear fellow members,

my son got atropine drops prescribed. According to our optometrist, it is supposed to be a “miracle” which stops progressive myopia. We all know what the deal is and there is no way Im gonna administer this “miracle” into my son´s eyes.

My son has been given glasses of -1D sphere and -1D cylinder 2 years ago. He is overprescribed because he sees 20/30 or even 20/25 without glasses, so his real myopia would be something around -0.5D and some astigmatism. But I have been getting him to practise AF, astigmatism exercises and peripheral vision exercises and I do measure his eyes quite often and according to my measurement, his astigmatism seems to be around -0.25D. He has improved tremendously since I got him to stare at the app to do astigmatism exercises.

Here comes the issue - we are supposed to see our optometrist in July. She then wants to know, how my son goes with his atropine drops etc. She is also not the friendliest person out there, I must say. My son will of course not receive these atropine drops from me. I will get him to do AF and astigmatism exercises instead. When we see the optometrist again, I wanna tell her that my son takes these drops in order to prevent any discussions with her. I always pretend that I agree with everything she says and do my own thing with my son. My issue is - when we see her in July, will she be able to tell that Im not giving my son the drops although I claim that I do? Is there any way she might be able to see through my lie?

I still want her to check his eyes and tell me if he has improved. I will do plenty of exercises with my son till July so that he could really have some improvements but I dont want her to think that my son has not taken even a single atropine drop.

Or would it work for me to drop his eyes with atropine the night before we go to the optometrist, so to play along with her idea that I do give him the drops very diligently? But then when she measures his eyes and he will improve, this improvement could be then influenced by me giving him the atropine drops before hand, is that right? Is there any way she could tell his eyes have not been receiving the drops the whole time? Is there any sustainable effect the drops create so that she could easily tell if Tim really takes these drops or not?

Do you have any ideas?

Thanks in advance!

Michaela

If you feel you can’t be honest with your optometrist then I think you should look for another one who is maybe a bit more open minded and/or more friendly. Anyway, your optometrist can’t force you to do anything. It’s up to you decide what treatment you want for your son. If your optometrist doesn’t respect that or you feel you can’t have an honest conversation with her about this, then I think you should stop seeing her.

8 Likes

thats true, the only trouble is that I might not be able to find another optometrist easily. Most optometrist are “old-school” and they go by the books according to what they learned in the university.

I could try to contact one opthalmologist whom I found on Internet, so that might be a solution. But if even this lady is not going to be understanding of my wishes, then Im afraid there is no alternative optometrist around and I just have to stick with the traditional inflexible optometrists and basically just lie to them.

1 Like

I can’t believe that all optometrists would suggest using atropine drops, I think that’s quite rare.
Change so at least you get rid of that part. With the other things you already know how to deal with by altering the suggested full over prescription.

I’m with @mbassano on this one, if you feel you have to outright lie to this individual, cancel the appointment! It is one thing that most of us omit what we are doing because most optos don’t want to hear it, but I think it is going too far to lie about putting chemicals in your son’s eye’s. And I certainly don’t think you should give him the drops to avoid a potential confrontation. It is your right to make choices for your son rather they are in line with the “professional” advice or not; and you should set an example for him by advocating for the fact that you believe you are doing the right thing.

6 Likes

Yes, I realize it’s not easy to find one that’s supportive. But even if they’re old-school and close minded, they still need to respect your rights and your choices. So I would advise simple honesty, and see how that turns out. What’s the worst that could happen? They may think you’re crackpot but will that prevent them from checking your kid? I don’t think so. This optometrist gave you an advice and you didn’t follow it. Big deal… If she checks your boy and finds he has improved, it might actually help her to become a bit more open minded. And if it really doesn’t work out, then you can still try the ophthalmologist. In any case you shouldn’t feel compelled to lie because you’re afraid of her reaction. You have the right to refuse a treatment you don’t agree with, and she knows that. OK, you probably should have objected right away when she prescribed the drops, but what’s done is done. And like I said you get to make your own choices. Don’t give them any power over you just because they’re in a position to prescribe stuff.

4 Likes

guys you are right, Im being too weak here… Im probably a bit afraid to stand my grounds and tell the doctor I did not follow her treatment as Im afraid of the confrontation. But I sent an email to that ophtalmologist, so I will see where will it lead to. Thank you guys for your courage!

4 Likes

One more question: wasn’t your son just at the opto? Why are you going back again so soon anyways? This is a lot of stress for you and your son to keep returning so often, especially considering you can do your measurements at home… Maybe just take a beat and keep working on what you are doing. My biggest concern is that he is getting a habit for squinting, it would be better if he had enough correction (and reminding) that you could nip that in the bud but other wise don’t doubt yourself so much. You don’t want him to start doubting you so you need to show confidence here; even if you are only faking it for the moment, you will gain confidence in time and he needs to not have his confidence in you shaken in the mean time.

Confrontation is rough but if it comes to it tap into that mama bear because your son needs you to be his advocate.

My son was at the optometrist couple of days ago and they want to see him im July to see how he is getting on with the atropine drops. I think they probably wanna measure if the drops work and if they stopped his myopia. I would like to tell them that there are different ways how to stop myopia from progression, but I dont think they would agree with me :-DDD.

You are right, he needs to see that I know what Im doing. I cannot wait for his normalised to come. As soon as it comes, he will wear it and hopefully will unlearn his squinting. I keep reminding him to stop doing it but I cannot control it when he is in his preschool :-(.

I tried to call the ophtalmologist but she does not take any new patients at the moment, so I will need to find someone else.

2 Likes

If the appointment was only for a follow up on the drops then you can cancel it for sure since you aren’t using them. And your son was just to the opto so you have time to find a better opto without stressing :smiley:

3 Likes

I’m going to take another side; atropine works. I don’t fully understand what the consensus (if any) on atropine eye drops is on this forum, but a whole host of studies and meta-analyses (ATOM1, ATOM2, etc) have shown the effectiveness of low-dose (0.01-0.05) atropine in retarding myopic progression, and it is a very promising, minimally invasive treatment. I don’t think that we need to reject the science on that. As I understand, we on this forum essentially believe that myopia can slowly improve, even once the eyes have stopped growing from hyperia to (ideally) emmetropia, in response to mild myopic defocus, not that we fear chemicals or reject all other methodologies.

But that is just my humble opinion, and ultimately you should do what you think is best for yourself/your son.

1 Like

For the most part the consensus on this forum is less chemical more natural, that extends to atropine drops. That is not to say there is no one on the forum who uses them, everyone here certainly makes their own (hopefully well informed) choices, but on the whole we look for long term results by addressing causality rather than treating symptoms.

4 Likes
1 Like

My question is why are you going to go back to see the Dr. At all? If you are going along your way then just cancel until you have a concern and then no need to even have confrontation.

5 Likes

They essentially prevent correct accomodation, because they inhibit the ciliary muscle. I would not call that “minimally invasive”, although it’s definitely that category compared to other procedures.

The only thing it does as I mentioned before, is that it hinders accommodation. Because there is a link of too much accommodation and myopia progression, sure they do something. But that’s like to put a cast on your leg to prevent muscle soreness.

2 Likes

Also it’s always good to check side effects and contraindications:

4.3 Contraindications
The product should not be used in patients with closed angle glaucoma.
It is also contraindicated in patients with narrow angle between the iris and the cornea since it may raise intra-ocular pressure and precipitate an acute attack of closed angle glaucoma.

4.7 Effects on ability to drive and use machines
May cause transient blurring of vision on instillation. Warn patients not to drive or operate hazardous machinery until vision is clear.

4.8 Undesirable effects
Patients may experience photophobia and eyes should be protected from bright light while the pupils are dilated.
Prolonged use of atropine eye drops may lead to local irritation, transient stinging, hyperaemia, oedema and conjunctivitis. An increase in intra-ocular pressure may occur, especially in patients with closed angle glaucoma.
Hypersensitivity to atropine is not uncommon and may appear as a skin rash or conjunctivitis.
Systemic toxicity may be produced by the instillation of the eye drops especially in infants and the elderly. Reported symptoms include severe ataxia, restlessness, excitement and hallucinations.
Other adverse effects may include a dry mouth with difficulty in swallowing and talking, flushing and a dry skin, transient bradycardia followed by tachycardia, palpitations and arrhythmias, reduced bronchial secretions, urinary urgency and retention and constipation.
Side effects that occur occasionally include confusion (particularly in the elderly), nausea, vomiting and giddiness.

Yeah, sounds like a good idea to put that into your child’s eye.

2 Likes

I strongly disagree with Jake on this, and I’m quite disappointed. It seems like he’s

  1. Conflating the side-effects of high dose atropine (1%) with low dose (0.01-0.05%) (greater accomodative impairment, photophobia, regression after discontinuing atropine)

  2. Disregarding the >50% efficiency in retarding myopic progression. The data is in the literature (and consensus, not that that matters too much), why does Jake claim that we should read the literature then?

I don’t want to get banned from here simply because of a single point of disagreement, so I’ll just leave you all with that.

Sources: ATOM1 ATOM2, 5 year

1 Like

Atropine for the treatment of childhood myopia: safety and efficacy of 0.5%, 0.1%, and 0.01% doses (Atropine for the Treatment of Myopia 2)

Atropine 0.01% had a negligible effect on accommodation and pupil size, and no effect on near visual acuity. Allergic conjunctivitis and dermatitis were the most common adverse effect noted, with 16 cases in the 0.1% and 0.5% atropine groups, and no cases in the 0.01% group.
Conclusions: Atropine 0.01% has minimal side effects compared with atropine at 0.1% and 0.5%, and retains comparable efficacy in controlling myopia progression.

And I don’t think it’s fair or realistic to judge some medicinal substance based on the list of reported side-effects, disregarding the studies on its safety and efficacy. The decision to use it or not should be informed and based on reality, not fear. The reason I’m saying this is because I’d like to avoid us going down the same rabbithole as mainstream optometry, dismissing any and all other methods of treating or slowing myopia.

1 Like

I think most people who advise against atropine drops are basically advising against keeping bad habits and compensating with long term use of the drops. I’d also be worried about developing photophobia.
In my opinion, experimenting with this (at your own risk!) may bring you an experience you couldn’t achieve by usual eye relaxation techniques, but as said the biggest worry is using the smart phones and tablets as babysitters and then give daily drops… Focus should be on eliminating bad habits in my opinion. Instead of quick fixes.

3 Likes

Definitely agree with you there. Bad habits are the cause and key to reversal of myopia. Just a note on the photophobia caused by too-high doses of atropine, it is entirely temporary.

The higher concentrations of atropine such as 1% or 0.5% have been shown to be very effective in retarding myopia progression, but the high rate of photophobia side-effect (in up to 100%) has been associated with high dropout rate (16–58%) [57, 58].

This is basically what I meant by distinguishing between high and low-dose.

1 Like