Atropine Eye Drops 1% / 0.01%

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.