Low concentration atropine eye drops are a safe and effective treatment for short-sightedness (myopia) in UK children, although the effects are small, according to a clinical trial published by The BMJ on June 11. Researchers said the drops led to small but significant reductions in myopia progression compared with placebo, and are "a worthwhile addition to currently available optical interventions for the treatment of myopia in children in the UK."
Rates of myopia in children are increasing worldwide and are linked to higher healthcare costs and long-term eye-related complications. Atropine eye drops are used globally to treat myopia in children but are not currently available through the National Health Service, so their effectiveness and safety among UK children has been uncertain.
To address this knowledge gap, researchers recruited 289 children with myopia aged 6-12 years from five NHS hospital eye services and academic institutions between June 2019 and February 2022. All participants wore standard spectacles for vision correction. Of these, 192 received daily 0.01% atropine eye drops while 97 received placebo over two years, alongside their regular spectacles. Myopia progression, eye growth, safety, and tolerability were monitored every six months.
Final results were available for 230 participants: 151 who received atropine and 79 who received placebo. After accounting for factors such as age, ethnicity, and family history of myopia, those treated with atropine experienced a small decrease in both myopia progression and eye growth compared with those given placebo drops.
Specifically, atropine treatment led to an average reduction of 0.38 diopters in refractive error and a decrease of 0.14 mm in central axial length—two key measures of short-sightedness—compared with placebo. Pupil diameter was also greater by an average of 0.36 mm among those using atropine; no differences were seen between groups regarding adverse events or tolerability measures such as sore eyes or blurry vision.
Researchers acknowledged several limitations, including questions about how well results generalize outside a clinical trial setting as well as potential influences from the covid-19 pandemic during the study period. Nevertheless, they concluded: "The findings suggest that a low concentration atropine eye drop product would be a worthwhile addition to currently available optical interventions for the treatment of myopia in children in the UK." They added that these results will help inform policymakers.
