Study Finds No Clear Benefit from Adding Atropine to HAL Lens Wear for Myopia

No significant difference was observed in axial elongation over one year between the monotherapy and combination therapy groups in myopic children, showing that there doesn’t seem to have been much added benefit from adding 0.01% atropine to highly aspherical lenslet spectacle lens wear in this study. Photo: Essilor; Getty Images. Click image to enlarge. As the myopia prevalence continues to grow and has become a global public health concern, having the most effective treatment to control the condition is more important than ever before. Chinese researchers of a recent study posed the question: is combination therapy more effective than monotherapy? Specifically, they compared one-year myopia control effects of spectacle lenses with highly aspherical lenslets (HAL) and HAL with 0.01% atropine use in children with moderate to high myopia. The results showed  no significant difference, with both treatment arms providing similar results. The findings were reported in BMC Ophthalmology.This retrospective cohort study analyzed 175 myopic children aged eight to 12. Participants were divided into three groups based on treatment: monotherapy (n=62), combination therapy (n=55) and single-vision spectacle lenses (n=58). Changes in axial length and spherical equivalent refraction under non-cycloplegic conditions were compared.Children aged eight to 10 showed no significant differences among groups. Across all treat­ments, younger children exhibited faster myopia pro­gression and axial elongation, consistent with findings from previous myopia control trials, the authors noted. This sug­gests that, in younger children with moderate to high myopia, the addition of 0.01% atropine may not provide substantial added benefit.“According to the two-year results of the LAMP study, similar myopia control efficacy was achieved when six-year-old children used 0.05% atropine, eight-year-olds used 0.025% atropine and 10-year-olds used 0.01% atropine, indicating that younger children may require higher concentrations (e.g., 0.05%) to achieve equivalent myopia control as older children using lower concentrations (0.01%),” the authors wrote in their paper. “Therefore, in younger chil­dren with moderate to high myopia who do not respond well to the combination of HAL lenses and 0.01% atropine, increasing the atropine concentration may be worth considering.”Combination therapy appears to offer similar efficacy to monotherapy for older children (ages 11 and 12) as well. In such cases, where treat­ment response is favorable, monotherapy may be the preferred option, the authors noted. “Given the concentration-dependent nature of low-dose atropine in slowing myopia progres­sion, combining HAL lenses with higher concen­trations of atropine in cases of moderate to high myopia may result in greater efficacy than monotherapy,” they wrote.Click here for the journal source. Tang Y, Song J, Huang Y, Mao Y. Comparison of the effects of spectacle lenses with highly aspherical lenslets combined with atropine for moderate to high myopia control in children. BMC Ophthalmology. December 22, 2025. [Epub ahead of print.] This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.