Low-dose atropine is an option eye care providers may consider when managing myopia (nearsightedness) in children. A compounded formulation, such as atropine sulfate 0.05%, is prescribed when a provider feels a specific strength better fits a child’s needs. Avrio Pharmacy compounds atropine 0.05% ophthalmic drops with a valid patient-specific prescription.
Understanding low-dose atropine
Low-dose atropine has been studied for its potential role in slowing myopia progression in children. Providers may consider it based on how quickly a child’s prescription is changing, their age, and how they tolerate daily eye drops.
The LAMP Study and low-dose atropine
The LAMP (Low-Concentration Atropine for Myopia Progression) study is one of the most commonly referenced studies in this space. Researchers followed children using atropine at concentrations of 0.05%, 0.025%, and 0.01% over multiple years.
The study looked at three concentrations: 0.05%, 0.025%, and 0.01%. Higher concentrations (0.05% and 0.025%) showed more slowing of myopia progression, with 0.05% showing the strongest effect of the three doses studied in the LAMP study. Atropine 0.05% tends to hit the balance where it is effective enough to show meaningful results in the data, yet manageable enough for a nightly routine. The lower concentrations still showed benefits compared to no treatment, though the effect was smaller.
Researchers also tracked pupil size, focusing ability, and day-to-day visual function throughout. Tolerability was generally good across all groups.
Why a compounded option may be prescribed
Higher doses, like atropine sulfate 1%, have been used historically, but pupil dilation, difficulty focusing up-close, and a rebound effect when stopping treatment are all things providers consider before writing a prescription. Low-dose atropine was researched to see whether a lower concentration could show results with more manageable side effects- LAMP data supported that, particularly for atropine sulfate 0.05% concentration.
Compounding makes it possible to prescribe that exact concentration when the commercially available option isn’t the right fit for a particular patient.
This might come up when:
- a provider prefers a specific concentration, like atropine sulfate 0.05%, which is supported by research
- a provider wants to minimize the risk of side effects associated with higher concentrations, like with commercial atropine sulfate 1%
- a child is sensitive to certain inactive ingredients
- a simpler nightly routine might help with consistency/patient adherence
What Avrio Pharmacy provides
When prescribed for a specific patient, Avrio Pharmacy can compound:
- This is packaged in a 3.5 mL multi-dose droptainer
- Typically prescribed for use once nightly in each eye, but follow the specific directions written by your provider
Quality standards
Avrio Pharmacy sources all ingredients used in compounding from FDA-registered facilities. Each ingredient comes with a certificate of analysis (COA) to verify the identity, quality, and purity of each ingredient sourced. Our pharmacists review each COA prior to using any ingredient in making compounded medication at Avrio. Additional product testing may include product sterility, potency, method suitability, antimicrobial effectiveness testing, and container closure integrity, along with stability data to support beyond-use dating.
What Families May Expect With Low-Dose Atropine
Some kids adjust to eye drops quickly, whereas others take a little longer. Light sensitivity or temporary changes in near vision can happen, and providers usually walk families through what to expect with treatment ahead of time.
At a concentration, for compounded atropine sulfate, of 0.05%, side effects are generally mild and well tolerated.
Some things parents might notice in their child could be:
- Some light sensitivity, usually mild at this concentration
- Slightly blurry near vision right after the drop goes in, which typically clears
- Occasional stinging on application, especially at first use
- Redness or irritation is possible but not super common at this dose
What normally isn’t an issue at 0.05% low-dose atropine:
- The dramatic dilation you’d see at higher doses
- Needing sunglasses constantly
- Significant reading difficulty
Questions during treatment? Both the prescribing optometrist/ophthalmologist and Avrio Pharmacy can be great resources.
Resources:
- National Institutes of Health. Low-Concentration Atropine for Myopia Progression (LAMP) Study: A Randomized, Double-Blinded, Placebo-Controlled Trial of 0.05%, 0.025%, and 0.01% Atropine Eye Drops in Myopia Control. Available at: https://pubmed.ncbi.nlm.nih.gov/30514630/
- American Academy of Ophthalmology. Five-Year Clinical Trial of the Low-Concentration Atropine for Myopia Progression (LAMP) Study. Available at: https://www.aaojournal.org/article/S0161-6420(24)00190-8/abstract
- American Optometric Association. Atropine 0.05% over 0.01% in Myopia Control: Study. Available at: https://www.aoa.org/news/clinical-eye-care/diseases-and-conditions/atropine-in-myopia-control
- American Academy of Ophthalmology. Continued Use of 0.05% Atropine Over Time May Help Stall Myopia Progression. Available at: https://www.aao.org/education/editors-choice/continued-use-of-0-05-atropine-over-time-may-help-
- Eyes On Eyecare. A Guide to Compounding Pharmacies: Basics for Ophthalmologists. Available at: https://eyesoneyecare.com/resources/guide-to-compounding-pharmacies-basics-for-ophthalmologists/
Disclaimer: This content is for informational purposes only and is not a substitute for professional medical advice. Compounded low-dose atropine sulfate 0.05% may be prescribed when a provider determines a personalized formulation is appropriate for their specific patient. Compounded medications are prepared pursuant to a valid prescription from a licensed healthcare provider. Dosage, administration, and suitability depend on the patient’s specific condition, size, and health status. Always consult with a licensed provider before starting, stopping, or changing any treatment. Avrio Pharmacy provides compounded medications only with a valid prescription. Compounded medications are not approved by the FDA and have not been studied for safety, quality, and efficacy.
