The prevalence of myopia is rising dramatically and is expected to affect one in three people worldwide by 2020. The myopic eye is inherently compromised and vulnerable, evidenced by blindness rates attributable directly to myopia. Atrophic myopic maculopathy stands out as the only disease amongst the top-five causes of blindness that remains entirely untreatable. Despite its causal relationship with blindness and associated quality of life/socio-economic impacts, there is no current therapeutic approach to the control and prevention of myopia. This project will address significant research gaps that exist in relation to myopia control, the impact of low dose atropine on myopia progression and ocular growth, as well as advancing our understanding of myopia and our ability to predict those at risk. The overarching aim is to investigate new ways to prevent and control myopia progression in children and to deepen our understanding of myopia and its risks. We propose to evaluate, for the very first time in Western society, the safety and efficacy of atropine, a pharmacological intervention currently used in the treatment of amblyopia, and which has shown potential for effective myopia control in Asia. A randomised, placebo-controlled twoyear clinical trial will be conducted to investigate the capacity of atropine to reduce the rate of progression of myopia amongst eligible European children. As well as examining the efficacy, safety and acceptability of this treatment, the project will generate a unique myopia-specific ocular biometric dataset that may provide novel insights into the biological mechanisms of myopia development and allows us to predict those at risk. The investigators will work with government agencies, practitioners, parents, educators and children to ensure that the pioneering results generate maximum impact and contribute to the reform of clinical practice for myopia, better health outcomes, better quality of life and substantially reduced risk of avoidable blindness.
