Atropine's Trade-Off

Systematic review investigates dose-dependent effects of atropine on accommodative and binocular visual function

July 6, 2026
3 min

The Ophthalmologist

Overview

A systematic review and meta-analysis evaluated the effects of varying concentrations of atropine on accommodative amplitude and binocular visual function in children and adolescents. The findings show a dose-dependent relationship, with lower concentrations showing minimal impact on visual function, while higher concentrations resulted in accommodative impairment.

Background

The management of myopia in children involves the use of atropine as a treatment option. Understanding the balance between myopia control and visual function is crucial for clinicians, as higher doses of atropine can lead to reductions in accommodative ability.

Data Highlights

No specific numerical data provided in the source material.

Key Findings

Atropine's effects on accommodation and binocular vision are dose dependent.
0.01% atropine resulted in less than one diopter reduction in accommodative amplitude with no significant impact on other visual measures.
0.05% atropine consistently reduced accommodative amplitude by around two diopters.
Higher concentrations (0.1% and above) led to accommodation losses exceeding 9 diopters.
Intermediate doses (0.02–0.03%) showed variable effects.
Routine assessments of accommodation and binocular vision are recommended when prescribing atropine.

Clinical Implications

Clinicians should carefully consider the concentration of atropine prescribed for myopia control, balancing efficacy with potential impacts on visual function. Monitoring visual performance and discussing symptoms with patients and parents can help optimize treatment outcomes.

Conclusion

The study emphasizes the need for individualized treatment plans in myopia management, highlighting that there is no universally ideal atropine dose. Clinicians must weigh the benefits of myopia control against the preservation of functional vision.