Atropine (low-dose ophthalmic)

Also known as: low-concentration atropine eye drops, antimuscarinic

Other

In plain English

Low-dose atropine eye drops are used to slow the worsening of nearsightedness (myopia) in children. A tiny nightly dose helps limit how much the eye elongates over time, with far fewer side effects (like light sensitivity and blurry near vision) than the older high-dose drops. It slows progression rather than reversing existing myopia.

The science

Atropine is a nonselective muscarinic antagonist; its anti-myopia effect is thought to act on retinal/scleral muscarinic pathways to slow axial elongation rather than through accommodation. The ATOM2 randomized trials compared 0.5%, 0.1%, and 0.01% drops: while higher concentrations slowed progression more during treatment, rebound after stopping was greater, and over 5 years 0.01% gave the best overall balance of efficacy with minimal pupil dilation, accommodation loss, or near-vision impact.

References

• Chia A et al., atropine for treatment of childhood myopia (ATOM2), Ophthalmology 2012
• Chia A et al., five-year clinical trial on atropine for myopia (ATOM2), Ophthalmology 2016