Atropine 0.01% as a Potential Myopia Prevention in Children with Dosage Effectivity Comparison: a Literature Review

Ignatius Ivan, Maureen Miracle Stella, Mariani Santosa


Myopia (long-sightedness) is one of the many problems of vision disorder occurring around the world and being 1 in 5 eye conditions that becoming a priority at the World Health Organization's Global Intitiative for the Elimination of Avoidable Blindness. Many methods of preventing myopia development have been sought. Atropine is an alkaloid derived herbal plant Atropa belladonna which acts as a muscarinic acetylcholine receptor antagonist that has a strong nonselective competitive affinity on the five types of muskarinic acetylcholine receptors (M1-M5) that weaken the muscles of the ciliary and iris and causes the reduction of accommodation and the occurrence of pupil dilation. Recent research found that with the use of low dose atropine (0.01%), in addition to the side effects inflicted more minimal, effectiveness in the long time period shows better results. Until now, the  mechanism of atropine is still experiencing debate whether working on an accommodating or non-accommodating pathway. But recent research suggests the possibility of working mechanism of this drug is through a non-accommodating pathway i.e. on GABAergic, dopaminergic as well as involving nitric oxide (NO) role to help inhibit the progression of myopia. In research and advanced scientific studies, it can be researched regarding the pathways of atropine mechanism and its advantages and disadvantages at any dose of atropine given to myopia sufferers using the latest literature sources.


atropine; myopia; accommodation


Arumugam, B., McBrien, N.A., 2012. Muscarinic Antagonist Control of Myopia: Evidence for M 4 and M 1 Receptor-Based Pathways in the Inhibition of Experimentally-Induced Axial Myopia in the Tree Shrew. Investig. Opthalmology Vis. Sci. 53, 5827.

Barathi, V.A., Chaurasia, S.S., Poidinger, M., Koh, S.K., Tian, D., Ho, C., Iuvone, P.M., Beuerman, R.W., Zhou, L., 2014. Involvement of GABA Transporters in Atropine-Treated Myopic Retina As Revealed by iTRAQ Quantitative Proteomics. J. Proteome Res. 13, 4647–4658.

Berntsen, D.A., Barr, C.D., Mutti, D.O., Zadnik, K., 2013. Peripheral Defocus and Myopia Progression in Myopic Children Randomly Assigned to Wear Single Vision and Progressive Addition LensesPeripheral Defocus and Myopia Progression in Children. Invest. Ophthalmol. Vis. Sci. 54, 5761–5770.

Berntsen, D.A., Mutti, D.O., Zadnik, K., 2010. Study of Theories about Myopia Progression (STAMP) Design and Baseline Data: Optom. Vis. Sci. 87, 823–832.

Brenner, R., 1985. Further observations on use of atropine in the treatment of myopia. Ann. Ophthalmol. 17, 137—140.

Carr, B.J., Stell, W.K., 2016. Nitric Oxide (NO) Mediates the Inhibition of Form-Deprivation Myopia by Atropine in Chicks. Sci. Rep. 6.

Chia, A., Chua, W.-H., Cheung, Y.-B., Wong, W.-L., Lingham, A., Fong, A., Tan, D., 2012. Atropine for the Treatment of Childhood Myopia: Safety and Efficacy of 0.5%, 0.1%, and 0.01% Doses (Atropine for the Treatment of Myopia 2). Ophthalmology 119, 347–354.

Chia, A., Chua, W.-H., Wen, L., Fong, A., Goon, Y.Y., Tan, D., 2014. Atropine for the Treatment of Childhood Myopia: Changes after Stopping Atropine 0.01%, 0.1% and 0.5%. Am. J. Ophthalmol. 157, 451-457.e1.

Chia, A., Lu, Q.-S., Tan, D., 2016. Five-Year Clinical Trial on Atropine for the Treatment of Myopia 2. Ophthalmology 123, 391–399.

CHOU, A.-C., SHIH, Y.-F., HO, T.-C., LIN, L.L.-K., 1997. The Effectiveness of 0.5% Atropine in Controlling High Myopia in Children. J. Ocul. Pharmacol. Ther. 13, 61–67.

Chua, W.H., 2014. Atropine for the treatment of childhood myopia: An article review.

Chua, W.-H., Balakrishnan, V., Chan, Y.-H., Tong, L., Ling, Y., Quah, B.-L., Tan, D., 2006. Atropine for the Treatment of Childhood Myopia. Ophthalmology 113, 2285–2291.

Chung, K., Mohidin, N., O’Leary, D.J., 2002. Undercorrection of myopia enhances rather than inhibits myopia progression. Vision Res. 42, 2555–2559.

Clark, T.Y., Clark, R.A., 2015. Atropine 0.01% Eyedrops Significantly Reduce the Progression of Childhood Myopia. J. Ocul. Pharmacol. Ther. 31, 541–545.

Feltz, A., Large, W.A., Trautmann, A., 1977. Analysis of atropine action at the frog neutromuscular junction. J. Physiol. 269, 109–130.

Foster, P.J., Jiang, Y., 2014. Epidemiology of myopia. Eye 28, 202–208.

Hammond, D.S., Wallman, J., Wildsoet, C.F., 2013. Dynamics of active emmetropisation in young chicks - influence of sign and magnitude of imposed defocus. Ophthalmic Physiol. Opt. 33, 215–226.

Huang, J., Wen, D., Wang, Q., McAlinden, C., Flitcroft, I., Chen, Haisi, Saw, S.M., Chen, Hao, Bao, F., Zhao, Y., Hu, L., Li, X., Gao, R., Lu, W., Du, Y., Jinag, Z., Yu, A., Lian, H., Jiang, Q., Yu, Y., Qu, J., 2016. Efficacy Comparison of 16 Interventions for Myopia Control in Children. Ophthalmology 123, 697–708.

Jones, D., Luensmann, D., 2012. The Prevalence and Impact of High Myopia: Eye Contact Lens Sci. Clin. Pract. 38, 188–196.

Kemenkes, R., 2014. Situasi Gangguan Penglihatan dan Kebutaan.

Kothari, M., Rathod, V., 2017. Efficacy of 1% atropine eye drops in retarding progressive axial myopia in Indian eyes. Indian J. Ophthalmol. 65, 1178.

Li, S.-M., Wu, S.-S., Kang, M.-T., Liu, Y., Jia, S.-M., Li, S.-Y., Zhan, S.-Y., Liu, L.-R., Li, H., Chen, W., 2014. Atropine slows myopia progression more in Asian than white children by meta-analysis. Optom. Vis. Sci. 91, 342–350.

Lim, S.A., Park, Y., Cheong, Y.J., Na, K.S., Joo, C.-K., 2016. Factors Affecting Long-term Myopic Regression after Laser In Situ Keratomileusis and Laser-assisted Subepithelial Keratectomy for Moderate Myopia. Korean J. Ophthalmol. 30, 92.

Luft, W.A., Ming, Y., Stell, W.K., 2003. Variable effects of previously untested muscarinic receptor antagonists on experimental myopia. Invest. Ophthalmol. Vis. Sci. 44, 1330–1338.

McBrien, N.A., Moghaddam, H.O., Reeder, A.P., 1993. Atropine reduces experimental myopia and eye enlargement via a nonaccommodative mechanism. Invest. Ophthalmol. Vis. Sci. 34, 205–215.

McBrien, N.A., Stell, W.K., Carr, B., 2013. How does atropine exert its anti-myopia effects? Ophthalmic Physiol. Opt. 33, 373–378.

Näreoja, K., Kukkonen, J., Rondinelli, S., Toivola, D., Meriluoto, J., Näsman, J., 2011. Adrenoceptor activity of muscarinic toxins identified from mamba venoms: Adrenoceptor toxins from mambas. Br. J. Pharmacol. 164, 538–550.

Pineles, S.L., Kraker, R.T., VanderVeen, D.K., Hutchinson, A.K., Galvin, J.A., Wilson, L.B., Lambert, S.R., 2017. Atropine for the Prevention of Myopia Progression in Children. Ophthalmology 124, 1857–1866.

Ramamurthy, D., Lin Chua, S.Y., Saw, S.-M., 2015. A review of environmental risk factors for myopia during early life, childhood and adolescence: Environmental risk factors for myopia Ramamurthy, Chua and Saw. Clin. Exp. Optom. 98, 497–506.

Schmid, K.L., Strasberg, G., Rayner, C.L., Hartfield, P.J., 2013. The effects and interactions of GABAergic and dopaminergic agents in the prevention of form deprivation myopia by brief periods of normal vision. Exp. Eye Res. 110, 88–95.

Shih, K.C., Chan, T.C.-Y., Ng, A.L.-K., Lai, J.S.-M., Li, W.W.-T., Cheng, A.C.-K., Fan, D.S.-P., 2016. Use of Atropine for Prevention of Childhood Myopia Progression in Clinical Practice: Eye Contact Lens Sci. Clin. Pract. 42, 16–23.

SHIH, Y.-F., CHEN, C.-H., CHOU, A.-C., HO, T.-C., LIN, L.L.-K., HUNG, P.-T., 1999. Effects of Different Concentrations of Atropine on Controlling Myopia in Myopic Children. J. Ocul. Pharmacol. Ther. 15, 85–90.

Stone, R.A., Lin, T., Laties, A.M., 1991. Muscarinic antagonist effects on experimental chick myopia. Exp. Eye Res. 52, 755–758.

Tong, L., Huang, X.L., Koh, A.L.T., Zhang, X., Tan, D.T.H., Chua, W.-H., 2009. Atropine for the Treatment of Childhood Myopia: Effect on Myopia Progression after Cessation of Atropine. Ophthalmology 116, 572–579.

Vasudevan, B., Esposito, C., Peterson, C., Coronado, C., Ciuffreda, K.J., 2014. Under-correction of human myopia – Is it myopigenic?: A retrospective analysis of clinical refraction data. J. Optom. 7, 147–152.

Wu, P.-C., Yang, Y.-H., Fang, P.-C., 2011. The Long-Term Results of Using Low-Concentration Atropine Eye Drops for Controlling Myopia Progression in Schoolchildren. J. Ocul. Pharmacol. Ther. 27, 461–466.

YOUNG, F.A., 1965. THE EFFECT OF ATROPINE ON THE DEVELOPMENT OF MYOPIA IN MONKEYS. Am. J. Optom. Arch. Am. Acad. Optom. 42, 439–449.



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