My 8-Year-Old's Myopia Increased by 100 Degrees in One Year — Why We Chose Low-Dose Atropine
One Year, 100 Degrees More Myopia
Mia was 8 years old. Last year, she was found to have 150 degrees of myopia. Her family arranged defocus spectacle lenses and tried to make sure she spent at least one hour outdoors every day, although two hours was difficult because of homework.
One year later, her follow-up examination showed 250 degrees of myopia — an increase of 100 degrees.
Her parent worried that if the progression continued at this pace, Mia could become highly myopic before finishing primary school.
They brought her to Dr. Li from Pediatric Ophthalmology. After listening to the history, Dr. Li suggested that they could consider low-dose atropine.
Fast progression · Defocus glasses already used · Outdoor time limited by homework · Low-dose atropine considered
What Is Low-Dose Atropine?
Atropine was originally used at higher concentrations, such as 0.5% to 1.0%, to help control myopia progression. However, side effects such as light sensitivity and near-vision blur were often difficult for children to tolerate.
Later, lower concentrations such as 0.01% to 0.05% were found to retain myopia-control effects while causing fewer side effects for many children.
The exact mechanism is still being studied, but one possible explanation involves dopamine signaling in the retina. By influencing the eye's growth signals, low-dose atropine may help slow axial elongation and reduce the speed of myopia progression.
"Low-dose atropine is not a miracle cure. It cannot reverse myopia, and it cannot replace glasses. But it may help slow progression in suitable children."
Who May Be Suitable — And Who Should Avoid It?
- Children mainly aged 6–12 years
- Myopia around 100–400 degrees
- Progression faster than 50 degrees per year
- May be combined with OK lenses or defocus glasses
- Use only after ophthalmology evaluation
- Atropine allergy
- Eye redness, swelling, or itching after use
- Glaucoma or glaucoma tendency
- Unexplained eye pain or pressure symptoms
- Self-purchased use without doctor supervision
Dr. Li emphasized that low-dose atropine should not be purchased and used casually. A doctor should evaluate the child's refractive status, eye pressure, eye health, and progression pattern before starting treatment.
How to Use It — And Why Habits Still Matter
The usual approach described by Dr. Li was one drop in each eye every night before sleep. Parents should wash their hands, gently pull down the lower eyelid, place the drop into the conjunctival sac, and press the inner corner of the eye for 2–3 minutes to reduce systemic absorption.
The bottle tip should not touch the eye. After opening, many eye drops should generally not be used for more than four weeks. If other eye drops are needed, they should usually be separated by at least 15 minutes.
Most side effects are mild and may become more tolerable with time. The most common is light sensitivity, so sunglasses or a hat may help outdoors. Some children may experience near-vision blur, and rare symptoms such as eye pain, headache, nausea, or suspected eye pressure increase require immediate medical evaluation.
Mia's myopia increased by 100 degrees in one year despite glasses and some outdoor time.
Low-dose atropine may be used nightly under ophthalmologist supervision with regular review.
Outdoor activity, visual habits, glasses, and follow-up remain essential for myopia control.
"Medication can help apply the brakes, but you cannot keep pressing the accelerator and expect the brakes to do everything."
— Dr. Li
Dr. Li repeatedly emphasized that medication is only one part of myopia control. Children still need appropriate glasses, regular follow-up, outdoor activity, the 20-20-20 rule for near work, and good reading and writing posture.