Atropine eye drops for refraction

Why does my child need atropine eye drops?

Atropine has been prescribed to your child to let an eye care specialist to check the back of your child’s eyes and to see if they need glasses. Atropine drops or ointment may be used when:

• a child has particularly dark irises (the coloured part of the eye).
• a child’s eyes have not dilated enough with cyclopentolate drops used in the clinic.
• there are recurring problems when giving drops in the clinic.

What do the drops do?

Blurred vision

The dilating drops affect your child’s ability to focus and causes blurred vision which may last up to 7 days or more.

Any activity needing hand eye co-ordination will be difficult such as writing, colouring, eating and so on. Your child should not use play on climbing frames, cycle or skate. Your child may temporarily lose the ability to judge depth, making steps, stairs and kerbs hard to judge. This means they will need close supervision until their vision returns to normal.

Sensitive to light

The dilating drops also stop the pupil (the black bit of the eye) from controlling the amount of light entering the eye.

This will cause your child to be sensitive to light. Wearing sunglasses or a peaked cap may help the discomfort. Do not worry, will be no damage to the eye if your child refuses to wear sunglasses or a cap. The effect lasts as long as your child’s pupil is large which may be up to 14 days. This does not affect their vision but they will find bright lights uncomfortable until their pupil size returns to normal.

Keep all medicines out of the reach of children.

⚠ Atropine is poisonous if taken internally.

How can I help prepare my child for having eye drops?

It is vitally important that you have a positive approach in preparing your child for eye drops. If you are negative in any way, you can affect your child’s cooperation.

For eye drops to be give to your child, they only have to sit still for a few seconds looking up or lie down with their eyes closed.

When should I use the drops?

You will be given 3 packets of drops. Please use a new packet for each of the following:

• 1 drop in the morning, 1 day before your hospital appointment
• 1 drop in the evening, 1 day before your hospital appointment
• 1 drop in the morning, on the day of your hospital appointment before you come to hospital.

Please note that 1 drop to each eye from the packet is enough to help with dilation. You do not need to use all the drop from the packet.

It is important that you:

• Do not use the atropine after the expiry date.
• Do not re-use it after it has been opened.
• Store the atropine in a dry place, away from strong light and below 25 degrees Celsius.

How do I give my child the eye drops?

There are 2 methods you can use:

Closed eye method

The closed eye method is the recommended technique by the Sheffield Paediatric ophthalmic team to minimise distress and maximise cooperation for further testing.

1. Wash your hands thoroughly, peel the over-wrap apart and take out the drops
2. Twist off the cap
3. Tilt your child’s head back or lay them flat on their back, with their eyes closed
4. Avoid touching the dropper against your child’s eyelids or eyelashes
5. Gently squeeze until a drop of liquid falls onto the corner of the closed eye nearest the nose
6. Do not ask the child to open their eyes
7. Ask your child to keep their eyes closed until the eyelashes are wet, then dab off the excess liquid with a tissue, but do not completely dry the lashes
8. Your child can then open their eyes and blink 3 times you may then dry their lashes completely
9. Repeat with the other eye
10. Always wash your hands and your child’s hands after using the drops to avoid it being accidentally taken internally
11. Throw away the rest of the drops when you have finished, even if there is some solution left

Open eye method

The open eye method is suitable for very cooperative or older children.

1. Wash your hands thoroughly, peel the over-wrap apart and take out the drops
2. Twist off the cap
3. Tilt your child’s head back or lay them flat on their back. You may need someone else to help them keep still and in a safe and comfortable position, maybe with a blanket.
4. Gently pull down the lower eyelid of one of the eyes with your finger, ask your child to look upwards

5. Avoid touching the dropper against your child’s eye, eyelashes or any other surface
6. Gently squeeze until a drop of liquid falls into the gap between the eyeball and lower eyelid
7. You can also gently press on the inner corner of the eye for 30 seconds, this will help to stop the eye drop solution draining away into the nose and throat
   

8. Repeat with the other eye
9. Always wash your hands and your child’s hands after using the drops to avoid it being taken internally
10. Throw away the rest of the drops when you have finished, even if there is some solution left

Are there any side effects I should look out for?

Immediately stop the atropine and seek medical advice if your child:

• has a sore throat
• becomes irritable
• feels hot
• has a rash
• has headaches
• is feeling or being sick

Should my child return to school after the eye test?

If your child’s teacher is happy to provide the necessary supervision to make sure they are safe, then they can return to school or attend nursery after having eye drops. However, they should not take part in PE and games lessons until the blurred vision has worn off completely.

Can my child go to sports classes after?

Again, this would depend on individual teachers accepting responsibility for your child while their vision is still blurred.

Can my child go swimming later?

Because of the dangers of water, it would probably be wise not to go swimming unless you are totally happy about the level of supervision provided.