Eye Drops

Author: Jason Higginbotham
BSc (Hons) MCOptom Prof Cert Glau Prof Cert Med Ret Prof Cert LV FBDO MBCLA

Atropine 0.01% eye drops

Up until now, atropine for myopia control in the UK has only been available as an unlicensed “special”, usually at 0.01%. However, in late 2025, a new formulation and drop, Ryjunea has been approved. Families and practitioners will soon have access to a fully licensed, clinically tested option supported by long-term evidence.

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When you're talking to your optician or eye care professional, you might hear them mention using Atropine for myopia management. Atropine 0.01% are eye drops that have been shown to help reduce eyeball growth (axial elongation) in myopia management. Atropine has been used in eye care for many years, particularly to conduct what we call a cycloplegic refraction, where the child’s eyes are temporarily partially paralysed in order to relax them to get a more accurate measure of their true spectacle prescription.

However, in myopia management, the dosage is about one-hundredth of that normally used. This means the child’s vision is less affected or blurred. Also, the child doesn’t usually suffer any adverse eye reactions like redness, soreness, or watering, for example. Sources do however also suggest that Atropine 0.02% or even a fraction higher may be more effective still, whilst keeping side effects at a minimum.

The exact mechanism that is being affected is not entirely fully understood, but it is believed that one of the driving forces behind axial elongation is during near work. When we focus on near objects, there are muscles in the eye which facilitate the change in the shape of the lens just behind the pupil.

This process is known as accommodation and the mechanical tension of prolonged muscular contraction seems to be partly responsible for the impetus to make the eyeball grow in length.

Atropine should be available to UK patients in 2026, alongside being available from specialist ophthalmologists who currently have access to the drops.

TL;DR Key Points

Atropine 0.01% eye drops are used for myopia management, reducing eyeball growth.
Originally used for cycloplegic refraction, now used at a much lower dosage for myopia control.
Low dosage minimises vision blurring and adverse eye reactions in children.
Mechanism not fully understood, but near work and prolonged muscle contraction may drive axial elongation.
As of 2025, the low-dose atropine eye drop Ryjunea (0.1 mg/ml) has gained MHRA approval, becoming the first licensed treatment for childhood myopia progression in the UK

FOCUS
POINT

Atropine 0.01% is now considered a safe and reliable therapy for myopia management , but for many, it is still not considered the best option available.

Ryjunea: A New Licensed Option for Childhood Myopia

Ryjunea, from Santen, is the first MHRA-approved low-dose atropine treatment for slowing myopia progression in children. This marks an important shift for families in the UK, who until now have only had access to unlicensed atropine “specials”.

Licensed for children aged 3 to 14 with myopia between –0.50 D and –6.00 D and documented progression of ≥0.50 D per year, Ryjunea provides a regulated, clinically tested option backed by long-term data from the STAR study. As a prescription-only medicine, it can currently be prescribed by independent prescribers such as IP optometrists and ophthalmologists.

Ryjunea is expected to become available in the UK in Q2 2026, offering families a consistent, evidence-based treatment that reflects the growing recognition that childhood myopia requires active management, not just stronger glasses each year.

Early trials of Atropine used high dosages (1%) typically designed for very short-term use, and the side effects were blurring (especially for near work), glare, eye-strain, headaches and sore/watery eyes.

Later trials used smaller doses (0.5%, 0.3% and 0.01%) and compared their efficacy and side effects. It became clear that 0.01% had a notable effect on slowing the growth of the eyeball, whilst the side effects were very minimal indeed.

Other Drops and drugs

At present, there are a range of experimental myopia management drops and even systemic drugs being trialled to see if they can effectively and safely reduce the growth of the eyeball in progressive myopia.