An Important Step Forward in Myopia Prevention: Low-Dose Atropine.

The article by Chia et al (see www.aaojournal.org/article/ S0161-6420(15)00675-2/fulltext) in this issue of Ophthalmology reports 5-year follow-up from the Atropine for the Treatment of Myopia (ATOM) 2 study. ATOM2 now covers a 2-year initial phase using 0.5%, 0.1%, and 0.01% atropine, a 1-year washout period, and a further 2 years of treatment with 0.01% atropine in those who progressed more than 0.5 diopters (D) in the washout year. The article shows that 0.01% atropine produces better reduction in progression than higher doses, with marked reductions in the short-term side effects that required the use of photochromic reading glasses with higher doses and with marked reduction in the rebound effect that is observed during washout after higher doses. Longer-term follow-up is still required, but this represents an important step forward. Control of myopia progression has become an important clinical goal because of concerns about the significantly increased risks of pathologic myopia in those with high myopia. It is clear there has been amajor increase in the prevalence