Translational changes: evidence for low-dose atropine and myopia control

Myopia control, as opposed to myopia correction, is emerging as the new standard of care for clinical management of paediatric myopia by optometrists. The prevalence of myopia, and high myopia, is increasing worldwide, while the prevalence of pathologies associated with myopia increases with increasing axial length. With increasing global prevalence, preventing the axial elongation and pathologies associated with higher levels of myopia is therefore of paramount importance. Pharmacological management with atropine is one of the key myopia control options available to practitioners. Management with 1% atropine shows positive control effects but induces significant visual side effects in paediatic patients due to cycloplegia and mydriasis. The initial studies on the efficacy of low-dose atropine (<0.1%) have led to a significant increase in both publications (50% of all atropine myopia control papers having been published in the past 4 years) and practitioner prescribing. In this review, the advantages and disadvantages of low-dose atropine are explored to provide practitioners with an evidence-based approach to use in their practice.