5094 E. Los Coyotes Diagonal
Long Beach, CA 90815

Tel: 562-597-3100
Fax: 562-597-5055

Low-Dose Atropine Drops and Myopia Control

Atropine sulfate is a safe eye drop that has been used in eye care for almost a century.

1% atropine is typically used (and is FDA-approved) for achieving a very effective and long-lasting dilation. It has also been shown to have a very stabilizing effect on myopia, but the side effects (severe light sensitivity and very blurry near vision) at this high concentration were not tolerable. However, at much lower concentrations (0.01%, 0.025%, 0.05%), it still helps to slow the elongation of the eyeballs in young, developing eyes, with minimal side effects. Thus, it slows the progression of myopia. The exact mechanism is not entirely understood, but it is believed that atropine causes a thickening of the choroidal tissue in the back of the eyes, and this has a stabilizing effect. By reducing myopic progression now, we reduce the risk of developing potentially serious eye diseases later on in life, such as myopic maculopathy, glaucoma, cataracts, and retinal detachments.

Possible Side Effects

Though the side effects are negligible for most patients, the following side effects may occur: stinging upon instillation, pupillary dilation, light sensitivity, and a reduction in accommodation (ability to focus at near). Additionally, there is a low risk (<1%) of developing an allergic reaction (itching/burning) over time. If any of these side effects occur to the point of concern, Dr. Ryan would reduce the concentration to a more tolerable level, or potentially look at alternative options for myopia control.

‘Off-Label’ Use

Because atropine is not currently approved by the FDA specifically for ‘Myopia Control’, it is considered ‘off-label’. For this reason, we require a parent/guardian to sign a waiver giving authorization for us to prescribe it to their child. Also, because of this ‘off-label’ designation, atropine is not covered under most insurance plans, but would likely be covered by a personal health savings account (HSA) or an employer-based flexible spending account (FSA).

The research and development are moving fast in this space. There are currently at least 2 pharmaceutical companies going through FDA trials to approve using low-dose atropine for myopia control. It appears their approval will happen within the next 1-2 years.

What is the Next Step?

Dr. Ryan treats each myopic child/teen individually, taking all factors into account to determine the appropriate treatment plan. If he feels that atropine will help a myopic child, he will discuss it with the parents at length so they can agree on a management plan with which everyone is on board. Dr. Ryan is one of the only eye doctors in Long Beach prescribing atropine for myopia control.

Please call our office at 562-597-3100 if you have any questions about atropine and myopia control.