Slowing Myopia: Glasses, Atropine and Where They Fit
Bolt Eye Group's doctors build each child's myopia plan around contact lens treatment first: overnight DreamSculpt™ Ortho-K or daytime MiSight soft lenses. Two more tools can play a part. Glasses are a practical place to begin. Atropine drops are a backup we add only when lenses alone are not holding progression back.
Myopia-control glasses
How they work. Each lens has a clear center for sharp vision, surrounded by a ring of small focusing zones. Those zones send a "slow down" signal to the outer retina. Myopia-control contact lenses use the same idea.
Where they fit in our plan. Glasses are simple: nothing goes in the eye, and a child can start right away. Many families begin with glasses while they decide between DreamSculpt Ortho-K and MiSight.
Why lenses usually do more
- Lining up. The treatment zones work best when the eye looks straight through them. Glasses stay still while the eyes move, and kids peek over the top or let glasses slide down. A contact lens rides on the eye, so it stays lined up no matter where your child looks.
- Wear time. Glasses only work while they are on, so they must be worn most of the day, every day.
In practice, glasses usually give less control than the contact lens options.
Low-dose atropine
What it is. Atropine is a strong medicine that works on the nervous system by blocking acetylcholine, a signaling chemical used throughout the body. Used as a very weak eye drop at bedtime, it can slow eye growth in some children.
How our doctors use it. Only as an add-on to contact lens myopia control when progression continues. It is not a first-line treatment at Bolt Eye Group.
Common strengths
| Strength | What to know |
|---|---|
| 0.01% | Lowest strength and fewest side effects. In the largest trial (LAMP), its effect on eye length was small. |
| 0.025% | Middle strength, with a moderate effect and moderate side effects. |
| 0.05% | Strongest of the low doses. It worked best in the LAMP study's first year, but it also caused the most light sensitivity and blurry close-up vision. |
| 0.1% to 1% | Older, higher strengths. They cause more side effects and a stronger rebound when stopped; in the ATOM2 study, about two-thirds of children on 0.5% needed treatment again after stopping. |
Drops are usually used once a night, one drop per eye. Your doctor picks the strength and checks progress at regular visits.
Atropine combined with lenses
Studies combining 0.01% atropine with DreamSculpt Ortho-K found a modest extra slowing of eye growth, mostly in the first year. Combining it with soft multifocal lenses did not show a significant extra benefit. Our doctors take this into account when deciding whether atropine makes sense for your child.
Possible side effects of atropine
Common, eye-related
- Glare and light sensitivity
- Blurry reading vision
- Stinging, eye pain or dryness
Signs of an allergic reaction
- Itchy red eyes
- Puffy eyelids or a skin rash
- Trouble breathing
Signs of too much atropine in the body
- Flushed, dry skin
- A racing or irregular heartbeat
- Confusion, behavior changes or hallucinations
Call your Bolt Eye Group office or a doctor right away if you see any of these. For trouble breathing, call 911.
Keep it safe at home
- Atropine can be poisonous if swallowed. Store it out of children's reach, wash hands after each drop, and never put it in the mouth.
- If a child swallows atropine, call Poison Control at 1-800-222-1222 or 911.
- Stopping atropine can lead to faster progression for a while, so stop only on your doctor's plan.
Get a plan for your child
Bolt Eye Group offers myopia consultations at our Canton, East Cobb, Lawrenceville, Riverdale and Johnson City offices. DreamSculpt Ortho-K is available at every office except Riverdale. We measure your child's eyes, explain the options and build a plan with you. Glasses are an easy place to start, contact lenses are our main treatment, and atropine is added only if needed. Learn more about myopia management.