Editing Atropine (section)

=== Eyes ===
[[Ophthalmic drug administration|Topical]] atropine is used as a [[cycloplegic]], to temporarily paralyze the [[accommodation reflex]], and as a [[mydriatic]], to dilate the [[pupil]]s.<ref name="pmid29132914"/> Atropine degrades slowly, typically wearing off in 7 to 14 days, so it is generally used as a therapeutic [[mydriatic]], whereas [[tropicamide]] (a shorter-acting [[cholinergic]] antagonist) or [[phenylephrine]] (an α-adrenergic agonist) is preferred as an aid to [[Ophthalmology|ophthalmic]] examination.<ref name="pmid29132914">{{cite journal | vauthors = Yazdani N, Sadeghi R, Momeni-Moghaddam H, Zarifmahmoudi L, Ehsaei A | title = Comparison of cyclopentolate versus tropicamide cycloplegia: A systematic review and meta-analysis | journal = Journal of Optometry | volume = 11 | issue = 3 | pages = 135–143 | date = 2018 | pmid = 29132914 | pmc = 6039578 | doi = 10.1016/j.optom.2017.09.001 }}</ref>

In refractive and accommodative [[amblyopia]], when occlusion is not appropriate sometimes atropine is given to induce blur in the good eye.<ref>{{cite journal | vauthors = Georgievski Z, Koklanis K, Leone J | year = 2008 | title = Fixation behavior in the treatment of amblyopia using atropine | journal = Clinical and Experimental Ophthalmology | volume = 36 | issue = Suppl 2| pages = A764–A765 }}</ref> Evidence suggests that atropine penalization is just as effective as occlusion in improving visual acuity.<ref>{{Cite journal |date=2019-12-05 |title=A patch or eye drops are similarly effective for the treatment of "lazy eye" in children |url=https://evidence.nihr.ac.uk/alert/a-patch-or-eye-drops-are-similarly-effective-for-the-treatment-of-lazy-eye-in-children |journal=NIHR Evidence |type=Plain English summary |publisher=National Institute for Health and Care Research |doi=10.3310/signal-000849 |s2cid=243130859 |access-date=2022-09-16 |archive-date=2024-05-26 |archive-url=https://web.archive.org/web/20240526050121/https://evidence.nihr.ac.uk/alert/a-patch-or-eye-drops-are-similarly-effective-for-the-treatment-of-lazy-eye-in-children/ |url-status=live }}</ref><ref>{{cite journal | vauthors = Li T, Qureshi R, Taylor K | title = Conventional occlusion versus pharmacologic penalization for amblyopia | journal = The Cochrane Database of Systematic Reviews | volume = 8 | pages = CD006460 | date = August 2019 | issue = 8 | pmid = 31461545 | pmc = 6713317 | doi = 10.1002/14651858.CD006460.pub3 }}</ref>

Antimuscarinic topical medication is effective in slowing myopia progression in children; accommodation difficulties and papillae and follicles are possible side effects.<ref>{{Cite journal|vauthors=Walline JJ, Lindsley KB, Vedula SS, Cotter SA, Mutti DO, Ng SM, Twelker JD|date=13 Jan 2020|title=Interventions to slow progression of myopia in children|journal=Cochrane Database Syst Rev|volume=1|issue=9|pages=CD004916|doi=10.1002/14651858.CD004916.pub4|pmid=31930781|pmc=6984636}}</ref> All doses of atropine appear similarly effective, while higher doses have greater side effects.<ref name="Gong2017">{{cite journal | vauthors = Gong Q, Janowski M, Luo M, Wei H, Chen B, Yang G, Liu L | title = Efficacy and Adverse Effects of Atropine in Childhood Myopia: A Meta-analysis | journal = JAMA Ophthalmology | volume = 135 | issue = 6 | pages = 624–630 | date = June 2017 | pmid = 28494063 | pmc = 5710262 | doi = 10.1001/jamaophthalmol.2017.1091 }}</ref> The lower dose of 0.01% is thus generally recommended due to fewer side effects and potential less rebound worsening when the atropine is stopped.<ref name="Gong2017" /><ref>{{cite journal | vauthors = Fricke T, Hurairah H, Huang Y, Ho SM | title = Pharmacological interventions in myopia management | journal = Community Eye Health | volume = 32 | issue = 105 | pages = 21–22 | date = 2019 | pmid = 31409953 | pmc = 6688412 }}</ref>