Low-Dose Atropine for Myopia Progression in North Indian Children: A Study from a Tertiary Care Hospital in Bihar

Background: Myopia is a rapidly growing global public health concern, particularly among children, due to its increasing prevalence and associated risks of developing high myopia and related complications. Low-dose atropine has emerged as an effective intervention for myopia progression, but data on its efficacy and safety in Indian populations remain limited. Aim: To evaluate the efficacy and safety of 0.01% atropine eye drops in controlling myopia progression among North Indian children attending a tertiary care hospital in Bihar. Methods: This prospective interventional study involved 140 children aged 5–15 years with documented progressive myopia. Participants received 0.01% atropine eye drops once daily for 12 months. Changes in spherical equivalent and axial length were assessed at baseline and follow-up visits using cycloplegic refraction and optical biometry. Adverse effects were documented. Data were analyzed using paired t-tests and chi-square tests with SPSS version 23.0, and p < 0.05 was considered significant. Results: Over 12 months, the mean spherical equivalent decreased from 3.50 D to 3.10 D, reflecting an 11.4% reduction in myopia progression (p < 0.001). Axial length increased by an average of 0.30 mm, significantly lower than typical untreated progression (p < 0.001). Adverse effects were reported in 10% of participants, with photophobia (5.7%) and eye irritation (4.3%) being the most common, but were mild and transient. Conclusion: Low-dose atropine (0.01%) significantly slowed myopia progression with minimal side effects, demonstrating its efficacy and safety in North Indian children. These findings support its role as a viable option for myopia management in this demographic. Recommendations: Routine use of 0.01% atropine is recommended for managing progressive myopia in children. Further research is suggested to explore optimal concentrations and long-term outcomes across diverse populations.