Low-dose atropine is one of the most extensively studied pharmacological interventions for myopia control. The LAMP (Low-concentration Atropine for Myopia Progression) study series and ATOM2 trial have provided the most robust dose-response data, establishing that concentration selection involves a meaningful tradeoff between efficacy, side effects, and rebound risk.
| Concentration | AL Reduction vs Untreated | Photophobia Risk | Near Vision Impact | Rebound on Cessation |
|---|---|---|---|---|
| 0.01% | ~30% | Minimal | Minimal | Low |
| 0.025% | ~45% | Low–Moderate | Mild | Moderate |
| 0.05% | ~58% | Moderate | Moderate | Higher |
Note: ATOM2 compared 0.5%, 0.1%, and 0.01% — it did not include 0.025%. The LAMP study (Yam et al.) specifically introduced 0.025% as an intermediate concentration. These are distinct trials with different concentration ranges.
The ATOM2 trial compared 0.01%, 0.1%, and 0.5% atropine in 400 children over 5 years (including a 2-year washout phase). Counterintuitively, 0.01% showed the best net long-term outcome — despite lower short-term efficacy — because of significantly less rebound progression after cessation. Children on higher concentrations experienced accelerated progression after stopping treatment, partially offsetting initial gains.
The LAMP studies specifically compared 0.05%, 0.025%, and 0.01% against placebo in a Chinese pediatric cohort. Key findings:
Jurisdiction: Atropine for myopia is a prescription medication in the United States. It requires a DEA number, state prescribing licensure, and typically compounding pharmacy preparation at sub-therapeutic concentrations (0.01–0.05% are not commercially available in the US as of 2026). Availability varies significantly by jurisdiction.
Age considerations: Most RCT data is in children 6–12. Use in children under 6 is less studied. Older teenagers may have diminishing benefit as natural emmetropization slows progression independently.
Rebound management: Gradual tapering (rather than abrupt cessation) is commonly recommended at higher concentrations. Clinical decision on when to discontinue should account for the patient's proximity to the end of the active progression period (typically late teens).
Combination with optical interventions: Combination therapy (atropine + optical myopia control) is the highest-efficacy approach in current evidence. MyopiaTracker models combination therapy at a composite 68% AL reduction, representing the approximate aggregate of published combination data.
MyopiaTracker includes all three atropine concentrations (0.01%, 0.025%, 0.05%) as selectable treatment modalities with RCT-sourced efficacy values. Enter patient data to see projected AL at age 18 for each concentration — and compare against optical interventions — free, no login required.
Plot axial length against normative curves, compare treatment outcomes, and generate a parent-ready report — in under 30 seconds. Free, no login required.
Start with a Sample Patient →This page is provided for educational purposes. MyopiaTracker is a clinical decision support tool and does not constitute medical advice, diagnosis, or treatment. All efficacy values are population averages from published RCTs; individual patient outcomes vary. MiSight® is a registered trademark of The Cooper Companies, Inc. Stellest® is a registered trademark of Essilor International. MiyoSmart® is a registered trademark of Hoya Corporation.