A 16-year-old myope with increasing spectacle prescription is being considered for myopia control. Which intervention has the STRONGEST evidence for reducing myopia progression in children?
- A Under-correction of myopia with spectacles
- B Single-vision soft contact lenses
- C Atropine 0.01% eye drops once nightly ✓
- D Bi-focal spectacle lenses
Explanation
Low-dose atropine 0.01% nightly has the strongest evidence for myopia progression control, with the ATOM2 study showing approximately 50–60% reduction in axial elongation with minimal photophobia and accommodation loss at this concentration compared to higher doses. The exact mechanism is not fully established but is thought to involve non-accommodative retinal mechanisms (M1 and M4 muscarinic receptors). Under-correction of myopia is contraindicated as it may accelerate progression. Single-vision contact lenses offer no myopia control benefit. Bifocal spectacles have minimal benefit compared to specialized peripheral defocus optics (e.g., MiyoSmart DIMS lenses).
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.