When your child’s glasses prescription keeps changing, it is natural to ask what might help slow the change. Low dose atropine is a prescription eye drop treatment used in childhood myopia management. It aims to slow progression, but does not correct existing blur or replace the need for suitable glasses or contact lenses.
Understanding the evidence, side effects and follow up matters more than choosing a concentration from an online description. The right plan depends on your child’s eyes and how their myopia is changing.
Contents
What does atropine do?
Myopia often progresses as the eye grows longer. Atropine can reduce the rate of this progression, although its precise mechanism in myopia control is not fully established. It is not a permanent cure, and some progression can occur during treatment. 1
A child who sees clearly through glasses may still have progressing myopia. Treatment response therefore needs to be measured over time, rather than judged by how clear their vision feels.
What does the research show?
Concentration can affect the result
The first-year LAMP randomised trial compared nightly atropine at 0.05%, 0.025% and 0.01% with placebo in children in Hong Kong. Average eye-length growth was 0.20 mm with 0.05%, compared with 0.41 mm with placebo. The 0.05% group had the strongest effect of the concentrations tested. 2
That result does not make 0.05% the automatic choice for every child. Response, tolerability and the child’s progression risk all need consideration. A study average cannot predict an individual outcome.
Results are not identical across studies
In a US randomised trial, 0.01% atropine did not slow progression compared with placebo over two years. 3 Differences between study populations and formulations matter; “low dose atropine” should not be treated as one treatment with one reliable percentage benefit.
The International Myopia Institute reviews atropine alongside optical treatments. Its guidance supports matching treatment to the child and monitoring the actual response, rather than assuming that a prescribed drop will provide enough control. 1
What is the difference between Eikance and compounded atropine?
Registered atropine products
Eikance is a brand of atropine eye drops registered in Australia at 0.01%, 0.025% and 0.05%. The current TGA indication covers slowing myopia progression when treatment is started in children aged 4–14 years. It allows initiation when annual progression reaches at least 0.50 dioptres, or eye length increases by 0.20 mm per year. 4
These are product indication criteria, not a self-treatment checklist. A clinician still needs to establish suitability and discuss the intended treatment. Decisions outside the registered indication require an individual prescribing discussion.
Individually compounded preparations
A compounded medicine is prepared for an individual patient when an approved ready-made medicine is unsuitable or unavailable. Compounded preparations are not evaluated by the TGA for safety, quality and efficacy before supply, and should not be described as TGA approved or automatically equivalent to a registered product. 5
If compounding is proposed, ask why the registered options do not meet your child’s needs, and confirm the concentration, storage instructions and expiry with the pharmacist.
What does treatment involve day to day?
Follow the prescription and instructions for the exact product supplied. Eikance’s product information specifies one drop in each eye at night. The clinician or pharmacist should demonstrate administration; gentle pressure over the tear duct for one minute helps reduce absorption into the body. Single use containers are discarded after the dose, even if liquid remains. 6
Choose a routine that the supervising adults can maintain. Tell the clinician about missed doses or difficulties, so they can interpret the progress measurements accurately.
What side effects should parents watch for?
Light sensitivity and difficulty focusing at near can occur, with greater pupil and focusing effects seen at higher concentrations in LAMP. 2 Mention reading difficulties or discomfort in sunlight at review; treatment should not make schoolwork unnecessarily difficult.
Eye irritation, redness, swelling or itching also need advice. Serious symptoms such as a rapid or irregular pulse, fever, hot dry skin or unusual behaviour require urgent medical assessment. For suspected overdose or accidental ingestion, call the Poisons Information Centre on 13 11 26. 6
How is progress monitored?
Monitoring combines prescription measurements, usually with drops to relax focusing when appropriate, and axial length, a measure of eye length. The results are interpreted together with age, previous progression and how consistently treatment is used.
There should be an early review for tolerance, followed by regular monitoring, commonly at six monthly intervals. Faster change, symptoms or a treatment adjustment may require additional visits.
If progression remains faster than expected, the clinician should reassess the measurements, adherence and treatment choice. Changing concentration or adding another treatment should follow that assessment.
How long does treatment continue?
Treatment often continues for years. The decision to reduce or stop it depends on age, progression and tolerance, with monitoring afterwards because progression may accelerate again. 7
In the five year LAMP follow-up, 87.9% of children in the cessation and re-treatment group needed to restart treatment under the study protocol. This supports planning follow up after stopping; it does not mean every child needs indefinite treatment. The continuing groups all received 0.05% in years four and five, so the study was not a five year comparison of three unchanged concentrations. 7
Do not change or stop treatment without discussing the plan with the prescriber. A taper may be considered, but it should not be presented as a guarantee against rebound.
What other options are available?
Myopia-control spectacle lenses, suitable soft contact lenses and OrthoK are other approaches. Combination treatment can be appropriate in selected cases, but evidence varies by combination. Research supports an additional effect from combining OrthoK with 0.01% atropine; that finding should not be extended automatically to every lens and drop combination. 1
Ask how the options compare for your child’s age, prescription, daily routine and ongoing costs. Our comparison of myopia control treatments is a useful starting point.
Before a myopia review
These details help the clinician make sense of your child’s progress.
- Bring current glasses and previous prescriptions, axial length results or eye reports.
- Bring the eye drop packaging or an accurate record of its name and concentration.
- List medicines, allergies and relevant medical or eye conditions, including a personal or family history of glaucoma.
- Note missed doses, reading difficulties, light sensitivity or other symptoms.
- Ask about review timing, medicine and consultation costs, and how treatment success will be assessed.
Discuss childhood myopia treatment in Camberwell
Vision Camberwell Optometrists is at 784 Burke Road, Camberwell VIC 3124, in Melbourne’s inner east. We welcome families from Camberwell, Hawthorn, Balwyn, Kew, Canterbury and across Melbourne. Consultations with Jue Wang are available in English and Mandarin. Read more about our approach to myopia management or our parent’s guide to childhood myopia.
To discuss whether atropine may be appropriate for your child, call (03) 9882 5666 or contact our team.
Questions parents often ask
Will drops mean my child no longer needs glasses?
No. Myopia control drops and vision correction have different purposes. Appropriate glasses or contact lenses remain necessary for clear vision.
What if we miss a dose?
Follow the supplied medicine leaflet or ask your pharmacist. Do not give a double dose to make up for a missed one. 6
Does a stronger drop always mean a better choice?
No. LAMP found a concentration dependent effect, but stronger concentrations also affected pupil size and near focusing more. The useful choice balances progression control with tolerability. 2
Is a stable glasses prescription enough to stop treatment?
Not on its own. Review the prescription and eye length trend, age and treatment history with the clinician, and agree on follow up if treatment changes.
References
- Bullimore MA, Saunders KJ, Baraas RC, et al. IMI—Interventions for Controlling Myopia Onset and Progression 2025. Investigative Ophthalmology & Visual Science. 2025;66(12):39. doi:10.1167/iovs.66.12.39.
- Yam JC, Jiang Y, Tang SM, et al. Low-Concentration Atropine for Myopia Progression (LAMP) Study: A Randomized, Double-Blinded, Placebo-Controlled Trial of 0.05%, 0.025%, and 0.01% Atropine Eye Drops in Myopia Control. Ophthalmology. 2019;126(1):113–124. doi:10.1016/j.ophtha.2018.05.029.
- Repka MX, Weise KK, Chandler DL, et al. Low-Dose 0.01% Atropine Eye Drops vs Placebo for Myopia Control: A Randomized Clinical Trial. JAMA Ophthalmology. 2023;141(8):756–765. doi:10.1001/jamaophthalmol.2023.2855.
- Therapeutic Goods Administration. EIKANCE (Aspen Pharmacare Australia Pty Ltd). Prescription medicine registration information. Accessed 10 September 2026.
- Therapeutic Goods Administration. Compounded medicines. Accessed 10 September 2026.
- Australian Commission on Safety and Quality in Health Care. Eikance. Medicine Finder: product information and consumer medicine information. Accessed 10 September 2026.
- Zhang XJ, Zhang Y, Yip BHK, et al. Five-Year Clinical Trial of the Low-Concentration Atropine for Myopia Progression (LAMP) Study: Phase 4 Report. Ophthalmology. 2024;131(9):1011–1020. doi:10.1016/j.ophtha.2024.03.013.
Reviewed by Dr Shonit Jagmohan, B.Optom (Hons), FIAOMC, IACMM, Ophthalmic Medicines Prescriber, Fellowship Chair for the International Academy of Orthokeratology and Myopia Control (Oceania). Last reviewed October 2026.
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