Low‐Dose Atropine for Myopia Control in Children: A Comprehensive Review With Indian Evidence

ABSTRACT

Myopia is an increasingly prevalent public health concern in India, particularly among school‐aged children in urban and academically demanding environments. Early‐onset myopia is associated with rapid progression and an increased lifetime risk of vision‐threatening complications such as retinal detachment, myopic maculopathy, glaucoma, and early cataract. Low‐dose atropine has emerged as an effective pharmacological intervention for controlling myopia progression; however, the applicability of global evidence to Indian pediatric populations requires careful evaluation. This structured narrative review synthesized evidence from randomized controlled trials, prospective studies, retrospective multicentric cohorts, and real‐world clinical investigations evaluating low‐dose atropine (≤ 0.05%) for myopia control in Indian children. Literature searches were conducted in PubMed, Scopus, Web of Science, Google Scholar, and the Indian Journal of Ophthalmology archive for studies published between January 2005 and October 2025. Study quality was assessed using Joanna Briggs Institute critical appraisal tools, and findings were synthesized narratively due to heterogeneity in study designs and outcome measures. Indian studies consistently demonstrate that 0.01% atropine reduces myopia progression by approximately 50%–65% with minimal adverse effects. Higher concentrations such as 0.05% atropine provide greater efficacy but are associated with slightly increased mild ocular side effects. These findings align with major international trials, including Atropine for the Treatment of Myopia (ATOM) and Low‐Concentration Atropine for Myopia Progression (LAMP). Low‐dose atropine, particularly 0.01%, is an effective and safe therapy for controlling myopia progression in Indian children and represents a practical strategy for national myopia‐control programs.