Atropine eye drops for myopia control are a low concentration (0.01% to 0.05%) with much fewer side effects. Spectacles or contact lenses are still needed to correct the blurred vision from myopia, as atropine only acts to slow myopia progression. Although studies since 2005 have found that Low-Dose Atropine can slow down myopia progression with few side effects, the FDA has not officially approved it for this use. Therefore, the use of Low-Dose Atropine for Myopia Management is considered off-label.

Risks and safety

The risks and side effects of atropine are as follows:

• Potential side effects of increased sensitivity to light due to larger pupil size, which is typically resolved with light-sensitive glasses or sunglasses. One study found around a third of children requested these types of glasses, but this was the case even in the placebo (untreated) group.

• Problems with close-up focusing, which is typically resolved with glasses providing a stronger power for reading. One study found this only occurred in 1-2% of children treated with low-concentration atropine.

• Eye irritation or mild allergy, which can occur in 2-7%, although this can depend on the formulation of the atropine. 

Atropine can be toxic and even fatal to small children if it is ingested in high quantities by mouth, but high quantity absorption via the eye is unlikely. Medication safety in the home is extremely important. 

Benefits

Atropine eye drops are typically used at nighttime, before sleep, so are only utilized in the home environment. They are also ideal if the effective spectacle or contact lens options for myopia control are not suitable or not available for your child.