CCLS MYOPIA MANAGEMENT GUIDE
It’s the standard of care for our young myopic patients and in New Zealand we are lucky to have a lot of options.
Management Options
Atropine therapy
Eikance 0.01% Eye Drops (Atropine 0.01%)
Eikance 0.01% eye drops are indicated as a treatment to slow the progression of myopia in children aged from 4 to 14 years. Eikance is a preservative-free, ophthalmic solution containing 100 micrograms of atropine sulfate in 1 mL (0.01%) available in single-dose ampoules of 0.3mL, pack size 30. Eikance 0.01% is an unfunded Prescription Only Medicine that patients can obtain from their pharmacy with a prescription.
Current Based Evidence 'Rules of Thumb' - 0.01% atropine is an effective dual therapy treatment with OrthoK. (Meta-Analysis 2021 Wang et al.). 0.01% atropine has emerging research and clinical application as a dual therapy with other optical options. 0.01% atropine is generally not recommended as an effective monotherapy. (LAMP, ATOM2 and further emerging studies).
It is exciting to have a non-compounded option for 0.01% atropine in New Zealand. Although other concentrations are more often recommended, particularly monotherapy treatment, the availability of this drop is an important first step for increased access to atropine for myopia control in New Zealand.
Compounded Atropine Sulphate is also an option at the percentage of your choosing (e.g. 0.01%, 0.02%) by prescription only to a Compounding Pharmacy.
The pharmacy needs prescription and patient contact details (phone and email, to arrange delivery and payment).
Optimus Health pharmacist@optimushealth.co.nz
Typically, allow 7-10 days for delivery
Auckland Central Pharmacy ph: (09) 2151636. akcentralpharmacy@gmail.com.
Patients can either pick it up from the Auckland pharmacy or choose to courier it to their address in any city in NZ.
Delivery to North Island is usually 1-2 working days. Delivery to South Island is usually 1-3 working days.
Each bottle has a month's supply; expiry would be three months from the dispensing date (which will be clearly written on the label). This is a lubricant-based eye drop. Each bottle costs $47.5.
orthokeratology Contact Lenses
EyeSpace Forge OrthoK Lenses, Corneal Lens Corp.
Paragon CRT OrthoK, Ophthalmic Instrument Company
BE OrthoK, Capricornia Contact Lenses
Brighten Optix Ortho-K, Corneal Lens Corp.
Estimation of Axial Length
While precise measurement of axial length by ocular biometry is recommended for monitoring eye growth and myopia management, you can make an estimation of axial length using the table below if you have cycloplegic refractive error (SER, D) and average keratometry values for the child (K, mm).*
*The 95 % limits of agreement of using this formula to generate an estimate of axial length compared to ’real’ axial length measures from the NICER study were −0.73 to +0.99 mm (an average of ± 3.7 %).