Introduction to Atropine

•   The drop/ointment is inserted into the good eye only.
•   Wash your hands.
•   Gently pull down the lower eyelid of the good eye with your
     finger.
•   Ask your child to look up if possible.
•   Place (put) one drop or squeeze a little ointment into the area
     between the eyeball and the lower eyelid.
•   If you think the drop did not go into the eye, you can repeat the
     process but do not try more than twice.
•   Release the eyelid and ensure you wash your hands after
     instillation. Try not to let your child rub their eyes or the atropine
     may go in both eyes.
•    Atropine does not usually sting.

The blurring effect of atropine can last 7 days or more and the pupil
may remain dilated for up to 14 days after the last instillation. As
your child’s pupil will be dilated they will be more sensitive to bright
light therefore it will help if they wear sunglasses or a sunhat when
outdoors. If your child is at school, please notify their teacher.

Side effects are rare, but may include a hot flushed appearance,
a sore red eye, stomach upset, rash, headaches, dry mouth, or
nausea. If your child experiences any side effects, stop using the
drops/ointment immediately and seek medical advice by phoning
the Orthoptic department on Blackpool 953457 or your own GP if
outside of normal working hours.

If your child is seen by another healthcare professional you must tell
them that your child is using atropine drops / ointment.

Very occasionally the amblyopia (weak eye) can reverse (6%
chance, refer to references below). The previously better seeing-eye
then becomes the weaker eye. Therefore, regular monitoring of your
child’s vision is important at the instruction of your Orthoptist.

It may be stored at room temperature. Keep out of the reach of
children.

Please dispose of opened medication responsibly. Unwanted
or unused drops can be taken back to a pharmacy, or bring
them back to the clinic for disposal.

It is very important to keep all arranged follow up appointments
as these form a vital part of the treatment. Failure to attend an
appointment will mean the treatment must be stopped as regular
supervision is essential. If you cannot attend please phone 01253
953457 and inform us. We will give you another appointment and
advice on the continued use of the atropine.

Name of child:__________________________________________
Instillation instructions:____________________________________
_____________________________________________________
Review appointment made and agreement to attend: Yes / No
Information sheet given: Yes / No
Parents/Guardian Signature to confirm they have been given the
information and understand the treatment plan:
Signature:_ ____________________________________________
Date:_ ________________________________________________

Arch Ophthalmol 2002;120(3):268-78

Pediatric Eye Disease Investigator Group (PEDIG). A randomised
trial of atropine vs. Patching for treatment of moderate amblyopia
in children. (‘Atropine and patching produce improvement of similar
magnitude, and both are appropriate modalities for the initial
treatment of moderate amblyopia in children aged 3 to less than 7
years.’)

Ophthalmology 2004: 11(11):2076-85.

Pediatric Eye Investigator Group. A randomised trial of atropine
regimes for treatment of moderate amblyopia in children.(‘Weekend
atropine provides an improvement in Visual Acuity of a magnitude
similar to that of the improvement provided by daily atropine in
treating moderate amblyopia in children 3 to 7 years old.’)

J AAPOS 2009; 13(3):258-63.

Pediatric Eye Investigator Group. Treatment of severe amblyopia
with weekend atropine: results from 2 randomised trials. (‘Weekend
atropine can improve visual acuity in children 3 to 12 years of age
with severe amblyopia. Improvement may be greater in younger
children.’)

Binocul Vis Strabismus Q. 2009; 24(1):25-31.

Reverse amblyopia with atropine treatment. (Discusses the risk of
atropine causing a reversal of poor vision from the weak eye to the
better seeing-eye. The risk is low).