Myopia Control: Ortho-K vs. Low-Dose Atropine

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Myopia Control: Ortho-K vs. Low-Dose Atropine

Wednesday, November 19 2025 | 08 h 41 min | Vision Science

Based on: JAMA Ophthalmology, 2025 – Randomized Clinical Trial

At a Glance

Population: Children & adolescents with progressing myopia
Interventions: Orthokeratology lenses, atropine 0.04%, atropine 0.01%
Duration: 2 years
Key outcomes: Axial length change, refractive progression, safety

Summary
A two-year randomized trial compared orthokeratology and two doses of atropine in slowing myopia progression. Researchers tracked axial elongation and refractive error in several hundred children across Asia.

Results showed both ortho-k and low-dose atropine provided clinically meaningful slowing of myopia, with higher-dose atropine (0.04%) showing stronger effect than 0.01%. Orthokeratology performed comparably in efficacy but carried the known practical considerations of fitting, adherence, and infection risk.

Practice Considerations

Both ortho-k and low-dose atropine remain effective options for pediatric myopia control.
Atropine 0.04% may provide greater impact, but even 0.01% delivers measurable slowing for hesitant families.
Matching treatment to family readiness, patient age, and lifestyle is essential.
Combination therapy could be promising but requires further evidence.

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