Can Eye Drops Treat Childhood Myopia? [Part 3: Myoguard] - St. Mary's Jin Eye Center Pediatric Clinic (Dr. Jin-Hyoung Park, MD, PhD)

Hello, I am Dr. Jin-Hyoung Park, Chief Director of St. Mary's Jin Eye Center.

In the previous episodes, we looked into two types of lenses used to manage pediatric and adolescent myopia: Dream Lens (orthokeratology) and MiSight.

Today, I would like to introduce an eye drop treatment known for its effectiveness in slowing down myopia progression:

Myoguard.

Myoguard is a single-use ophthalmic solution formulated with atropine—traditionally used for mydriasis and cycloplegia—diluted to a concentration of 0.125%.

It is approved for use in children aged 4 and older.

Looking at the research data above, you can see that the efficacy of myopia progression suppression varies with the concentration of atropine.

While higher concentrations of atropine demonstrate greater inhibition of myopia progression, even low-dose 0.01% atropine shows significant results without a drastic gap in efficacy compared to high-concentration formulas over time.

Moreover, combining Myoguard with contact lens options such as Dream Lens or MiSight produces a substantially greater myopia-suppressing effect.

Why is the concentration of atropine so critical?

As shown in the illustration, atropine causes the pupils to dilate.

Consequently, children may experience photophobia (glare) and blurry near vision after instillation.

Because higher concentrations cause the medication's effects to last longer, clinical studies have focused heavily on identifying the optimal dosage balance.

Analysis of findings from the ATOM2 and LAMP2 studies demonstrates that even when atropine is diluted down to 0.01%, it still provides a meaningful reduction in myopia progression.

Minimizing your child's discomfort during treatment is essential.

When administering Myoguard, we recommend instilling 1 drop of artificial tears first, followed immediately by 1 drop of Myoguard, and then 2 to 3 additional drops of artificial tears to naturally dilute the solution in the eye.

Recent studies also suggest that using Myoguard every other day in both eyes can achieve comparable progression suppression. Such adjustments should be decided after a comprehensive evaluation with your attending ophthalmologist.

Additionally, clinical studies show that discontinuing Myoguard abruptly can trigger a rebound effect, causing previously suppressed myopia to accelerate rapidly again.

Therefore, it is crucial to continue using Myoguard consistently throughout the child's active growth period without arbitrary interruptions.

In conclusion, Myoguard is an evidence-based medical treatment that can be combined synergistically with Dream Lens or MiSight to manage pediatric myopia.

If you are concerned about your child's deteriorating eyesight, visit St. Mary's Jin Eye Center—where all specialists are clinical adjunct professors from Seoul St. Mary's Hospital—for a precise assessment and personalized care!

St. Mary's Jin Eye Center Faculty Specialists from Seoul St. Mary's Hospital: Presbyopia & Cataract Surgery, Retina Care, Dry Eye IPL, Vision Correction jineye.co.kr

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Frequently Asked Questions

From what age can children start using Myoguard?

It can be used in children starting from 4 years of age. Myoguard is a single-use eye drop containing diluted atropine, prescribed after a comprehensive examination by an eye specialist to slow down myopia progression during growing years.

Why does Myoguard cause glare or light sensitivity after instillation?

Atropine causes the pupil to dilate. As the pupil enlarges, temporary light sensitivity (photophobia) and difficulty focusing on near objects may occur. Higher concentrations can cause these symptoms to persist longer.

Is there a way to minimize discomfort when applying Myoguard?

Yes, diluting it with artificial tears is very effective. Apply 1 drop of preservative-free artificial tears first, immediately followed by 1 drop of Myoguard, and then add another 2 to 3 drops of artificial tears. This significantly reduces stinging, glare, and discomfort.

Can Myoguard be combined with Dream Lens or MiSight?

Yes, combining them is not only safe but also yields synergistic results. Studies demonstrate that using Myoguard alongside myopia control lenses such as Dream Lens or MiSight produces a greater slowing effect on myopia progression.

Is it safe to stop Myoguard treatment midway?

Stopping arbitrarily is not advised. Abrupt cessation can cause a rebound effect, leading to an accelerated progression of myopia. It is best to maintain consistent usage throughout the child's active growth phase under medical supervision.