Atropine Drops and Myopia-Control Glasses

At Reimbold Eye Group, our first choices for slowing a child's nearsightedness are contact lens treatments: DreamSculpt ortho-K overnight lenses and MiSight 1 day soft lenses. This page covers two other tools we use in Alpharetta and when we use them: myopia-control glasses, a good starting point while your family decides which contact lens option fits best, and low-dose atropine drops, which we add only when contact lens treatment needs extra help.

Myopia-control glasses: a good place to start

Myopia control glasses for children at Reimbold Eye Group in Alpharetta

Myopia-control glasses look like regular glasses. The center of each lens corrects your child's vision. Around the center, a pattern of tiny lens areas changes how light focuses on the edges of the retina, the signal that seems to slow eye growth.

Glasses are easy to start, need no lens handling, and can begin right away. That makes them a good bridge while you and your child think about DreamSculpt or MiSight.

Why we still prefer contact lenses for most children

  • They move with the eye. A contact lens stays centered on the eye wherever your child looks, so the treatment zone is always in the right place. Glasses stay still on the face, so the treatment pattern lines up properly only when your child looks straight through the lens.
  • Real life gets in the way of glasses. Kids look over their glasses, push them down their nose, and take them off for sports.
  • Daily wear is required. The glasses only help while they are on, so they need to be worn most of the waking day, every day.

In our experience, these real-world limits make glasses less effective than contact lens options for most children.

Low-dose atropine: an add-on, never our first step

Illustration of a low-dose atropine 0.01% eye drop bottle used for myopia control

Atropine is a powerful medicine that acts on the nervous system. It blocks acetylcholine, a chemical messenger the body uses to control the pupil, the eye's focusing muscle and many functions outside the eye. In very small doses, atropine eye drops appear to slow how fast a child's eye grows longer.

We use low-dose atropine only when a child is already in contact lens myopia control and still progressing. It is never our first step.

Atropine is not FDA-approved for myopia. No atropine eye drop is approved by the FDA to slow myopia in the United States. Low-dose atropine is made by a compounding pharmacy and prescribed off-label. In October 2025 the FDA declined to approve one low-dose atropine product; it is under review again.

The strengths doctors use

Low-dose atropine is usually given as one drop in each eye at bedtime. The common strengths are:

  • 0.01%: the lowest and gentlest. It has the fewest side effects, and in the largest study its effect on eye growth was small.
  • 0.025%: a middle strength, with more effect and slightly more light sensitivity and near blur.
  • 0.05%: the strongest of the low doses. In the LAMP study of children it slowed progression the most in the first year, and it also enlarged the pupil and weakened near focusing the most.

Older studies used 0.1%, 0.5% and 1%. These caused more light sensitivity and near blur. When they were stopped, the eyes "rebounded" faster: in the ATOM2 study, 68% of children on 0.5% needed treatment again after stopping, compared with 24% on 0.01%. That is why higher strengths are rarely used today.

We choose the strength for each child, and we see them regularly to check the effect and any side effects.

Atropine with contact lenses

Research supports adding low-dose atropine to ortho-K. A review of studies in 341 children found a small extra slowing of eye growth when 0.01% atropine was added to ortho-K, mostly in the first 6 to 12 months. A study that added atropine to soft multifocal lenses found no significant extra benefit. These results are part of why we treat atropine as an add-on for specific children, not a routine first step.

Side effects of atropine

In the eyes

  • Light sensitivity, because the pupil is larger (sunglasses help)
  • Blurry near vision, because focusing up close is weaker
  • Stinging, eye pain or dry eyes

Allergic reaction: call us right away

  • Red, itchy eyes
  • Swollen eyelids or inflamed skin
  • Shortness of breath

Too much atropine in the body: call us or a doctor right away

  • Dry or flushed skin
  • A fast or irregular heartbeat
  • Confusion, unusual behavior, or seeing or hearing things that are not there

Safety at home

  • Atropine drops are dangerous if swallowed. Keep the bottle out of reach of children, never put drops in the mouth, and wash hands before and after use.
  • If drops are swallowed, call Poison Control at 1-800-222-1222 or 911 right away.
  • When atropine is stopped, myopia can speed up again (rebound). We plan the timing of stopping together.

Talk with us

Every child's eyes are different. At your myopia consultation in Alpharetta, we measure your child's eye length and prescription, explain the options, and build a plan together: DreamSculpt, MiSight, glasses, and atropine only if it is needed. Read more on our myopia management page.

Book a myopia consultation Call 770-776-9000