Antimuscarinic — Cycloplegic / Myopia Control Pregnancy: Safety for use in pregnancy and lactation has not been established; use only when directed by a physician.

Atropine Eye Drops 1% / 0.01%

Brand names: Minims Atropine, Atropine Sulfate Eye Drops

Atropine eye drops are a long-acting antimuscarinic used for cycloplegia and mydriasis (for example in uveitis and refraction) and, at low concentration, to slow the progression of childhood myopia.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Uveitis / iritis: one or two drops of atropine 1.0% w/v eye drops instilled into the eye(s)

Route: Topical ocular (eye drops, 1.0% w/v) - for external use only

Frequency: Up to a maximum of 4 times daily (uveitis / iritis)

Max: Maximum 4 times daily in adults (uveitis / iritis)

STRENGTH SCOPE: the SPC fetched is 'Atropine Eye Drops BP 1.0% w/v / Vistatropine Eye Drops 1.0% w/v'. It contains NO posology for the low-dose 0.01% strength used for paediatric myopia control, so that regimen is not covered here - clinician to source it separately. Other indication in the same SPC - Refraction (adults): one or two drops instilled into the eye(s) one hour before refracting. Children (as stated in the SPC, not weight-based) - Refraction: one drop into each eye twice daily for 1-3 days prior to the examination; Uveitis / iritis: one drop into each eye to a maximum of 3 times daily. Elderly: mydriatics and cycloplegics should only be used with caution in the elderly and others who may have raised intraocular pressure. The depth of the angle of the anterior chamber should be assessed before the product is used. The drops contain benzalkonium chloride - soft contact lenses must not be worn during the period of use. Patients should be warned that antimuscarinic eye drops will temporarily impair vision, should wash their hands after use, and great care should be taken to avoid getting the product into the mouth. Use with great caution when the ambient temperature is high or the patient has a fever (risk of hyperpyrexia) and in conditions characterised by tachycardia. A darkly pigmented iris is more resistant to pupillary dilation - take care to avoid overdosage. Discard the eye drops 4 weeks after first opening.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substance or to any of the excipients
Closed angle glaucoma
Narrow angle between the iris and the cornea (may raise intraocular pressure and precipitate an acute attack of closed angle glaucoma)

Side effects

Photophobia while the pupils are dilated (protect the eyes from bright light)
Local irritation, transient stinging, hyperaemia, oedema and conjunctivitis with prolonged use
Increase in intraocular pressure, especially in patients with closed angle glaucoma
Hypersensitivity to atropine (not uncommon) - skin rash or conjunctivitis
Systemic antimuscarinic toxicity, especially in infants and the elderly - severe ataxia, restlessness, excitement, hallucinations, dry mouth with difficulty swallowing and talking, flushing and dry skin, transient bradycardia followed by tachycardia, palpitations and arrhythmias, urinary urgency and retention, constipation; occasionally confusion (particularly in the elderly), nausea, vomiting and giddiness

Interactions

Other drugs with antimuscarinic properties - the effects of atropine may be enhanced
Solutions of higher osmolarity - absorption of atropine sulphate appears to be delayed

Clinical monograph

How it works

It blocks muscarinic receptors in the iris sphincter and ciliary muscle, producing pupil dilation and paralysis of accommodation; the mechanism of myopia control is incompletely understood.

Prescribing in practice

Avoid in primary angle-closure (narrow-angle) glaucoma, as mydriasis can precipitate an acute angle-closure attack.
Press on the inner corner of the eye after instillation to limit systemic absorption and antimuscarinic effects, especially in children.
Effects on pupil size and accommodation are prolonged and can last several days.

Monitoring

Monitor for systemic antimuscarinic effects (such as flushing, dry mouth and tachycardia) and, where relevant, intraocular pressure and refractive progression.

Counselling the patient

Expect blurred near vision and light sensitivity, which can persist for days; sunglasses may help.
Do not drive while vision is affected.
Report a red, painful eye with reduced vision urgently.

Evidence & guidelines

Low-concentration atropine is supported by the ATOM and LAMP studies for slowing myopia progression in children, and atropine is long-established for cycloplegia and uveitis.

Reference: ATOM1/ATOM2 Trials (Singapore Myopia Control); RCOphth Uveitis Guidelines; MHRA Atropine Paediatric Safety; SPC Atropine Eye Drops; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways