Ongoing research already provided some insights into molecular pathways underlying myopia and could be expected that it will soon produce new drug targets and drugs for treatment of myopia. In the meantime, children who have high-risk factors (myopia first noted around 4 or 5 years. with aggressive progression and parental myopia) should probably be started with 1% atropine. One might consider the prophylactic use of atropine 0.01% in children with a strong risk of development of myopia, that is, 2 parents being myopic and decreasing hyperopia of 0.5 D/year. On the other hand, children who become myopic after the age of 8 can be treated with 0.01% atropine, soft multifocal contact lenses or OK. In addition, patients with more than 6 diopters of myopia can wear soft multifocal contact lenses or a combination of OK contact lenses and glasses to obtain an effective treatment result.241 Because soft multifocal contact lenses, OK and low dosage of atropine seem to be equally effective,242 patient concerns and compliance may help guide treatment selection.
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