Effectiveness of low-dose atropine in pediatric myopia management: insights from NIO and H, Dhaka

Background: Myopia, the most common refractive error, is becoming a significant public health challenge due to its rising incidence and associated risks of vision impairment and ocular complications. Low-dose atropine (0.01%) is a promising intervention hypothesized to slow myopia progression by modulating retinal and scleral signaling and reducing axial elongation. Unlike higher concentrations, it has fewer side effects, making it suitable for long-term use in children. Methods: This prospective comparative study was conducted at the National Institute of Ophthalmology and Hospital in Dhaka, Bangladesh, from June 2023 to July 2024. Fifty-six myopic children aged 6–14 years were divided into two equal groups: one received atropine 0.01% eye drops (Atropine group), while the other received no atropine (Control group). Refractive status (RS) and axial length (AL) were assessed over 12 months using SPSS 26 for data analysis. Results: Forty-six participants (92 eyes) completed the study. Children aged 6–10 years in the atropine group showed significantly less myopia progression (-0.04±0.09 D vs. -0.38±0.23 D, p<0.0001) and axial length elongation (0.03±0.02 mm vs. 0.21±0.05 mm, p<0.0001). In the 11–14 years subgroup, axial length growth was significantly slower in the atropine group (0.04±0.05 mm vs. 0.20±0.05 mm, p<0.0001), though refractive error differences were not statistically significant. Temporary photophobia was reported in 4.5% of atropine users, with no other adverse effects. Conclusions: Atropine 0.01% eye drops effectively slow the progression of myopia and axial length growth in children aged 6–14 years.