Atropine Drops

Low-Dose Atropine Eye Drops
Usage
Low-dose atropine eye drops are a compounded ophthalmic preparation used primarily for the management of myopia (short-sightedness) progression in children. At very low concentrations, atropine has been shown to help slow the progression of myopia over time.
It may be prescribed for:
• Control of progressive myopia in paediatric patients
• Myopia management programmes under ophthalmologist or optometrist supervision
• Occasionally for other ophthalmic indications as directed by a specialist
Treatment should be initiated and monitored by an eye care professional.

Dosage
Dosage should be determined by the prescribing practitioner (ophthalmologist or optometrist) based on the patient’s age and clinical response.
Typical dosing considerations include:
• Commonly used concentrations: 0.01% to 0.05%
• Instil one drop into each affected eye once daily, usually in the evening
• Treatment is typically long-term, often continued for several years with periodic review
Patients and caregivers should follow the prescriber’s instructions carefully.

Mechanisms of Action
Atropine is a muscarinic receptor antagonist (anticholinergic agent).
At low doses, its exact mechanism in myopia control is not fully understood, but proposed actions include:
Inhibition of muscarinic receptors in ocular tissues
Atropine blocks muscarinic receptors in the retina and sclera, which may influence eye growth.
Reduction of axial elongation
It is thought to slow elongation of the eyeball, a key factor in myopia progression.
Minimal effect on accommodation (at low dose)
Low concentrations are designed to minimise effects on pupil dilation and focusing ability, improving tolerability compared with higher doses.

Contraindications
Low-dose atropine eye drops should not be used in patients with:
• Hypersensitivity to atropine or other anticholinergic agents
• Narrow-angle glaucoma or risk of angle-closure glaucoma
• Allergy to any component of the formulation

Precautions
Use with caution in patients with:
• Light sensitivity, as mild pupil dilation may occur
• Pre-existing eye conditions, including glaucoma or ocular hypertension
• Young children, where monitoring is required
Additional precautions include:
• May cause mild photophobia (light sensitivity) or blurred near vision
• Use caution when performing activities requiring clear vision, especially initially
• Avoid touching the dropper tip to the eye or surrounding surfaces to prevent contamination
• Systemic absorption is minimal but can be reduced by nasolacrimal occlusion (gentle pressure on the tear duct) after instillation
Patients should seek medical advice if they experience persistent eye irritation, vision changes, or signs of allergic reaction.

Storage
• Store as directed by the pharmacy, typically below 25°C or refrigerated (2–8°C) depending on formulation
• Keep the bottle tightly closed when not in use
• Protect from light
• Do not freeze
• Discard after the recommended in-use period (as advised on the label)
• Keep out of reach of children
Patients should follow the specific storage and expiry instructions provided on the dispensing label.