Atropine and Myopia Management: Current Evidence, Mechanisms, and Clinical Implications

Abstract

Myopia, especially in children and young adults, has become a serious global public health issue. The increasing prevalence of high myopia and its associated ocular complications has prompted interest in pharmacological interventions aimed at slowing axial elongation. Of these, the non-selective muscarinic antagonist atropine has shown notable effectiveness in slowing the progression of myopia.  This review summarizes current evidence on the use of low-dose atropine in myopia management, elucidates its proposed mechanisms of action, evaluates dosage-dependent outcomes, and discusses clinical implications for optometric practice. Low-dose atropine (0.01–0.05%) has been proven to be a safe and effective treatment option with few adverse effects by recent large-scale studies like the ATOM and LAMP trials. Despite ongoing debates regarding the optimal concentration, rebound effects, and long-term safety, atropine remains the most widely studied pharmacologic agent for myopia control. Understanding its clinical application, pharmacodynamics, and integration with optical interventions offers valuable insight for eye care practitioners striving to combat the global myopia epidemic.