A five-year clinical trial, the results of which were presented at the American Academy of Ophthalmology annual meeting, suggests treating children with low doses of atropine could slow the progression of myopia by as much as 50%. 

Four hundred children ages six to 12 were randomly assigned a nightly dose of 0.5%, 0.1%, or 0.01% atropine for two years. After stopping treatment for one year, investigators started another round of 0.01% atropine for two more years for children who became more myopic during the year off. 

The results show that, after five years of treatment, children using the low-dose 0.01% atropine were the least myopic when compared with those treated with higher doses. They further mention an earlier study, which revealed 0.01% atropine eye drops slowed myopia progression by an estimated 50% compared with untreated children. 

While low doses of 0.01% atropine appear safe enough to use in children ages six to 12 for up to five years, the researchers stress the need for more study. Higher concentrations of atropine have been known to cause light sensitivity and blurry vision when looking at objects up close, and can also cause allergic conjunctivitis and dermatitis. These risks explain why atropine use for myopia is fairly uncommon in the United States, but the investigators suspect this trend could change now that much lower doses appear to offer a similar benefit in reducing nearsightedness progression, without the side effects. 

Chia A, Lu QS, Tan D. Five-year clinical trial on atropine for the treatment of myopia 2: myopia control with atropine 0.01% eyedrops. Ophthalmology. 2015 Aug 11. [Epub ahead of print].