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Atropine 0.01% Eye Drops for Myopia Control in American Children: A Multiethnic Sample Across Three US Sites
G Luke Larkin1, Alifiya Tahir2, K David Epley3
1Northeast Ohio Medical University & US Acute Care Solutions, 525 East Market Street, PO Box 2090, Akron, OH, 44309, USA.
Insights
Low-concentration atropine 0.01% eye drops effectively slowed myopia progression in US children. This treatment significantly reduced the worsening of myopia over two years with no major safety concerns.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Myopia Control
Background:
- Previous studies in East Asia indicated that low-concentration topical atropine eye drops can slow myopia progression.
- This research investigated the efficacy of atropine 0.01% eye drops in managing myopia progression within a diverse pediatric population in the United States.
Purpose of the Study:
- To evaluate the effect of adding nightly atropine 0.01% eye drops to standard care on myopia progression in children aged 6-15 years.
- To assess the rate of myopia progression and the incidence of clinically significant myopia worsening in a multiethnic cohort.
Main Methods:
- A multicenter retrospective case-control study involving 198 children (ages 6-15) with myopia.
- Children treated with atropine 0.01% nightly for at least one year were compared to age- and baseline refraction-matched controls.
- Primary endpoint: average spherical equivalent refraction (SER) progression at 1, 1.5, and 2 years; Secondary endpoint: percentage of subjects with SER increase > -0.75 D.
Main Results:
- Atropine group (n=100) and control group (n=98) had similar baseline SERs ( -3.1±1.9 D vs -2.8±1.6 D).
- The atropine group showed significantly less SER increase at year 1 (-0.2±0.8 D vs -0.6±0.4 D) and year 2 (-0.3±1.1 D vs -1.2±0.7 D) (p<0.001).
- At year 2, 37% of the atropine group experienced significant myopia worsening (> -0.75 D) compared to 80% in the control group (p<0.001). No major safety issues were reported.
Conclusions:
- Topical atropine 0.01% eye drops demonstrated significant efficacy in reducing myopia progression in a US pediatric cohort over two years.
- Findings are consistent with previous research from East Asian studies, supporting atropine 0.01% as a viable myopia control option for diverse populations.
Introduction:
Topical atropine eye drops at low concentrations have been shown to slow myopia progression in East Asian studies. This study explored the effect of atropine 0.01% eye drops on controlling myopia progression in a multiethnic cohort of children in the USA.
Methods:
A multicenter retrospective case-control study (n = 198) quantified the effect of adding nightly atropine 0.01% eye drops to treatment as usual on the progression of childhood (ages 6-15 years) myopia. Cases included all children treated with atropine for at least 1 year. Controls were matched to cases on both age (± 6 months) and baseline spherical equivalent refraction (SER) (± 0.50 diopters, D) at treatment initiation. The primary endpoint was the average SER myopia progression after 1, 1.5, and 2 years of therapy. A secondary outcome was the percentage of subjects with a clinically significant worsening of myopia, defined as a greater than - 0.75 D SER increase in myopia.
Results:
The average baseline SERs for the atropine (n = 100) and control (n = 98) groups were similar (- 3.1 ± 1.9 D and - 2.8 ± 1.6 D, respectively) (p = 0.23). The average SER increase from baseline was significantly less for the atropine group than the control group at year 1 (- 0.2 ± 0.8 D compared with - 0.6 ± 0.4 D, p < 0.001) and at year 2 (- 0.3 ± 1.1 D compared with - 1.2 ± 0.7 D, p < 0.001). Secondary analysis at year 2 revealed that 80% of the control group vs. 37% of the atropine group experienced clinically significant worsening myopia of at least - 0.75 D (p < 0.001). There were no major safety issues reported in either group.
Conclusion:
Similar to results reported in Asia, atropine 0.01% eye drops significantly reduced myopia progression in a cohort of US children over 2 years of treatment.
Funding:
Nevakar, Inc. Plain language summary available for this article.
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