Advances in Low-Concentration Atropine and Optical Interventions for Myopia Control

Myopia has become a global public health challenge, with its prevalence reaching epidemic proportions in recent decades, particularly in East Asian countries. This comprehensive review synthesizes recent evidence from clinical studies and meta-analyses to examine the efficacy and safety of low-concentration atropine and optical interventions for controlling myopia progression in children and adolescents. We show that low-concentration atropine (specifically 0.01%, 0.025%, and 0.05%) effectively slows myopia progression with a favorable safety profile. Furthermore, we evaluate optical interventions including orthokeratology (Ortho-K), Defocus Incorporated Multiple Segments (DIMS) spectacles, and peripheral progressive addition lenses. Emerging evidence suggests that combination therapy, integrating low-concentration atropine with an optical intervention, may yield superior effects compared to either modality alone. This review also discusses key issues such as treatment personalization, long-term adherence, and future research directions, providing evidence-based insights for clinicians managing childhood myopia.