Atropine Eye Drops for Myopia Control

Low-dose atropine eye drops are a nightly medicine that can slow the growth of the eye in children. By relaxing the focusing muscle, the drops signal the eye to grow more slowly, helping to keep nearsightedness (myopia) from getting worse. Studies show that three years of 0.05 % atropine can cut yearly prescription change nearly in half.[1] The landmark LAMP trial found similar benefits last at least three years with few side effects at bedtime doses.[3]

Your eye-care provider prescribes a custom bottle (usually 5–10 mL) from a compounding pharmacy. The most common strengths are 0.05 %, 0.025 %, and 0.01 %. One drop goes in each eye before bed; blinking spreads the medicine across the front of the eye, where it soaks in overnight. The drop’s effect wears off through the next day, so daytime vision stays clear. FDA-approved 1 % atropine is available, but low-dose formulas are used “off-label” for myopia control because they reduce light sensitivity and blurry near vision.[5] Providers may adjust strength over time; higher doses slow myopia more but also enlarge pupils slightly.[3]

Children ages 4–17 with progressive myopia (typically –0.50 D to –6.00 D) gain the most. Kids who add a half-diopter or more per year, or whose parents are highly myopic, are strong candidates. Eye health must be normal—no active inflammation, glaucoma, or narrow angles. Adults with accommodative spasm or jobs needing large focusing range may use low-dose atropine too, though research is mainly in kids.[1] A 2020 meta-analysis confirms that benefit is dose-dependent, with 0.05 % showing the best balance of effect and comfort.[4]

Low-dose atropine is not sold in retail pharmacies, so a compounding pharmacy prepares it. In the United States, prices average $75–$120 for a 5–10 mL bottle (about a three-month supply). One example lists a 10 mL bottle at $95.[6] Insurance rarely covers the drops because the use is considered off-label, although flexible spending and health savings accounts can help. Commercial 1 % atropine costs less per bottle but usually needs to be diluted under sterile conditions, which raises total expense.[5]

Benefits: Average slowing of eye growth by 40 – 60 %, easy nightly dosing, and reversible effects after stopping. In LAMP, the 0.05 % group showed the greatest cut in axial length without major light sensitivity complaints.[3] Limitations: Very low doses such as 0.01 % may give little to no protection; a National Eye Institute-funded U.S. trial found 0.01 % no better than placebo over two years.[2]

Vision usually stays normal the morning after the first drop. Mild pupil enlargement or near blur may last an hour in some children, then fades. Follow-up visits are scheduled every 6–12 months to check eye length and prescription. Treatment often continues until eye growth slows naturally—around age 14–16—then is tapered. Parents should store bottles in the refrigerator, discard after 90 days, and wash hands before each use.[1][5]

Five-year LAMP data show continued benefit with flexible retreatment for fast growers, suggesting long-term safety.[3] Meta-analyses now explore combining atropine with orthokeratology or multifocal soft lenses, hinting at additive effects of up to 70 % slower progression.[4]

If your child’s glasses get stronger every year, book an eye exam. A pediatric ophthalmologist or optometrist trained in myopia management can measure eye length and discuss whether atropine drops fit your family’s routine. You can connect with the right specialist on Kerbside for a medical-education consult—no physician-patient relationship will be created.[1][6]