The Asia-Pacific Journal of Ophthalmology

Asia-Pacific Journal of Ophthalmology:

Issue 6, November/December 2016 Review Article

Topical Atropine in the Control of Myopia

Tan, Donald; Tay, Su Ann; Loh, Kai-Lyn; Chia, Audrey

Author Information

From the *Singapore National Eye Centre; †Singapore Eye Research Institute; ‡Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore; and §Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore. 

Reprints: Donald Tan, FRCS, Singapore National Eye Center, 11 Third Hospital Ave, Singapore 168751. E-mail:


Efforts to reduce myopia progression in childhood are driven by the increasing incidence of high myopia and its attendant health risks. Interventional approaches to reduce myopia progression in childhood have included the use of spectacles, contact lens, and pharmacological methods, of which the latter appear to be most promising. We review the use of topical atropine eye drops in the retardation of myopia progression in children and discuss the efficacy and safety profiles when used at different concentrations (1.0%, 0.5%, 0.1%, and 0.01%). Topical atropine reduces myopia progression and axial elongation in children in a dose-related manner, but a rebound phenomenon occurs with higher doses. Its use has been shown to be safe, but higher doses cause pupil dilation, loss of accommodation and near vision. Atropine 0.01% has the best therapeutic index, with clinically insignificant amounts of pupil dilation, near vision, and accommodation loss but remains as effective as higher doses.

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