Atropine for Myopia: 0.01% vs 0.05% – What Parents and Clinicians Need to Know

Is 0.05% Atropine actually better than 0.01% for slowing childhood myopia? The answer isn't about the number on the bottle—it's about the formulation inside the bottle. In this video, Dr. Robert Clark, a Pediatric Ophthalmologist, breaks down the "Atropine Paradox." While recent studies like the LAMP trial suggest 0.05% is superior to 0.01%, we compare data from the landmark ATOM2 trial to reveal why a preserved 0.01% formulation may actually be the "Goldilocks" dose for your patients – balancing maximum efficacy with minimum side effects. Timecodes 0:00 - Intro 0:58 - Formulation Matters 1:44 - Preserved versus Preservative Free 3:19 - ATOM2 versus LAMP 4:20 - Two-Week Wash-In Pharmacodynamics 5:24 - Two-Year Treatment Outcomes 6:55 - Atropine Nonresponders 7:43 - Goal - Minimum Effective Dose 9:39 - Clinical Approach to Atropine in US Children Key Literature Discussed: ATOM2 Study (The Preserved Benchmark) – Chia A, et al. Atropine for the Treatment of Childhood Myopia: Safety and Efficacy of 0.5%, 0.1%, and 0.01% Doses (Atropine for the Treatment of Myopia 2). Ophthalmology. 2012;119(2):347-354. LAMP Study (The Preservative-Free Benchmark) – Yam JC, et al. 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. Ophthalmology. 2019;126(1):113-124. Yam JC, et al. Two-Year Clinical Trial of the Low-Concentration Atropine for Myopia Progression (LAMP) Study: Phase 2 Report. Ophthalmology. 2020;127(7):910-919. Side Effects in Non-Asian Populations Joachimsen L, et al. A Pilot Study on the Efficacy and Safety of 0.01% Atropine in German Schoolchildren with Progressive Myopia. Ophthalmol Ther. 2019;8(3):427-433. Joachimsen L, et al. Side effects of topical atropine 0.05% compared to 0.01% for myopia control in German school children: a pilot study. Int Ophthalmol. 2021;41(6):2001-2008. Cooper J, et al. Maximum atropine dose without clinical signs or symptoms. Optom Vis Sci. 2013;90(12):1467-72.