New research on combining Ortho-K and low‑dose atropine: what parents need to know about safety, comfort and myopia control
- Richard Kadri-Langford
- Dec 4, 2025
- 3 min read
If your child is short‑sighted (myopic), you’ve probably heard about orthokeratology (Ortho‑K) contact lenses and low‑dose atropine eye drops. A recent peer‑reviewed study in BMC Ophthalmology, “Longitudinal safety and efficacy of dual treatment with orthokeratology lenses and 0.01% atropine eye drops: a focus on epithelial changes and tear film stability,” adds helpful reassurance for families considering this combination approach
What the study looked at and why it matters
The researchers followed children using both Ortho‑K lenses overnight and 0.01% atropine drops, monitoring two key aspects of eye surface health over time:
Corneal epithelium: the thin, protective front layer of the eye that Ortho‑K gently reshapes to provide daytime vision without glasses.
Tear film stability: how well tears protect, lubricate and clear the eye, which affects comfort and clear vision.
They also assessed effectiveness for slowing myopia progression, an outcome often measured by axial length growth (how the eye elongates as myopia increases).
Key takeaways for parents
Safety of the eye surface:
Ortho‑K temporarily flattens the central cornea and can shift epithelial thickness in predictable ways. In this study, those changes were monitored closely and remained within expected, manageable patterns when lenses were properly fitted and cared for. The authors did not report new, unexpected safety concerns from adding 0.01% atropine to Ortho‑K in routine clinical use.
Tear film and comfort:
Tear stability is important for comfortable lens wear and clear vision. The study focused on whether combination therapy unsettles the tear film. Overall, tear film measures were maintained for most children with good lens hygiene and regular follow‑up, though some may experience mild dryness or morning blur that typically improves with care tweaks and time.
Efficacy for myopia control:
The growing body of evidence suggests that combining Ortho‑K with low‑dose atropine can provide additional slowing of eye growth compared with using either approach alone in some children. The study contributes to that evidence base, supporting the idea that dual therapy can be both effective and safe when professionally managed.
Side effects to know:
0.01% atropine is the lowest commonly used dose and is generally well tolerated. Occasional light sensitivity or mild near blur can occur; simple strategies like photochromic lenses for outdoor light and good reading habits usually help. Any redness, discomfort, or vision changes should be reported promptly.
Who might benefit from dual therapy?
Children showing faster myopia progression despite a single treatment (for example, still elongating quickly on Ortho‑K alone).
Kids who began treatment at a younger age, when eyes can progress faster.
Children whose eye care professional identifies risk factors for higher future myopia. Your clinician will weigh factors like age, prescription, corneal shape, lifestyle and ability to handle lens hygiene when advising on combined treatment.
Why myopia management matters
Myopia isn’t just about needing stronger glasses. As the eye elongates, the lifetime risks of retinal detachment, myopic maculopathy, glaucoma and cataract rise, especially at higher prescriptions. Starting a myopia management plan early—and sticking with it—can slow eye growth, reduce the likelihood of high myopia, and help protect long‑term eye health. Combination approaches like Ortho‑K plus 0.01% atropine are promising options for children who need stronger control, and this new study adds reassuring data on corneal health and tear film stability under expert care.
To learn more about evidence‑based options visit our complete guide to myopia control.
Longitudinal safety and efficacy of dual treatment with orthokeratology lenses and 0.01% atropine eye drops: a focus on epithelial changes and tear film stability
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