Atropine occlusion: Instillation of drops

Why has my child been prescribed atropine?

Atropine drops may be used as an initial treatment of amblyopia (lazy eye) or when patching treatment is not working. The main aim of atropine occlusion is to blur the vision in the good eye (when viewing close objects) to promote the vision in the weaker eye.

What are the effects of atropine?

Atropine has two effects when instilled in the eyes:

• Dilates the pupil (makes the black part of the eye larger).
• Stops the eye from focusing properly which blurs the child’s near (or close-up) vision.

How often should I instil the eye drops?

To be deleted as appropriate by your healthcare professional:

• Once a week OR Twice a week
• Other……………………………………………………….…(to be completed by health care professional if appropriate)
• LEFT EYE OR RIGHT EYE
• The drops can be instilled whilst your child is asleep if this is preferred.

How long do the effects of the atropine last?

Atropine will cause blurred vision which may last up to seven days or more after using it. The pupil may also remain dilated for up to 14 days

Are there any side-effects?

• It will make the dilated eye sensitive to light so avoid bright light. Wearing a sun hat or sunglasses may help.
• The child may feel a little discomfort when the drops are initially instilled, although the drops do not sting.
• Tell your ophthalmologist or orthoptist if your child is taking any other medication.
• If your child becomes hot and complains of a sore throat, becomes irritable or develops any of the following symptoms: a rash, headaches, nausea/ vomiting, stop using the atropine and seek medical advice immediately.

It is important that you:

• Do not use atropine if your child suffers from heart problems or has a high fever.
• Do not use the atropine beyond the expiry date.
• Do not use it after it has been opened for four weeks.
• Store the atropine upright in a dry place, away from strong light and below 25°C (room temperature).
• Do not continue using atropine if you have missed an appointment as this may induce unwanted effects.
• Keep all medicines out of the reach of children.
• Attend follow up appointments to monitor effect of atropine occlusion on vision.
• Warning: atropine is poisonous if taken internally.
• Do not instil atropine if your child has a known allergy (or has had a severe reaction) to it.
• If you should run out of atropine eye drops contact the orthoptist, paediatric ophthalmology nurses or ophthalmologist for a further prescription.

How should I instil the atropine drops?

• Wash your hands.
• Gently pull down the lower eyelid of the good eye with your finger.
• Instil one drop of atropine into the area between the eyeball and the lower eyelid.
• Release the eyelid.
• Gently press on the inner corner of the eye for one minute. This will avoid the solution draining away into the back of the nose and being swallowed, and then absorbed systemically.
• Always wash your hands and your child’s hands after using the drops to avoid it being taken internally.
• Continue instilling as instructed until and including the day of your next appointment.
• Any remaining medication that is no longer needed or has expired should either be taken to your local pharmacy or brought to your clinic appointment for safe disposal.

For further information, or if you have any concerns, please contact:

The Orthoptic Department
Clinic 3, Box 41,
Outpatients Department,
Addenbrookes Hospital,
Hills Road, Cambridge,
CB2 0QQ

Telephone number: call 01223 216528

Consultant Paediatric Ophthalmologist
Department of Ophthalmology,
Clinic 3, Box 41,
Addenbrooke’s Hospital,
Cambridge University Hospitals NHS Foundation Trust,
Hills Road, Cambridge,
CB2 0QQ

Secretary: call 01223 216700

Paediatric Ophthalmology Nurses
Department of Ophthalmology,
Clinic 3, Box 41,
Addenbrooke's Hospital,
Cambridge University Hospitals NHS Foundation Trust,
Hills Road, Cambridge,
CB2 0QQ

Tel: call 01223 596414

If no response is gained please contact the clinic nurses: call 01223 217778