Published online Sep 12, 2026. doi: 10.5318/wjo.121730
Revised: April 27, 2026
Accepted: June 23, 2026
Published online: September 12, 2026
Processing time: 163 Days and 10.8 Hours
Children’s eyes are under siege. Pediatric myopia is escalating into one of the defining public health crises of this generation with mounting rates of high myopia that bring catastrophic sequelae including retinal detachment, glaucoma and irreversible myopic maculopathy. Low-dose atropine has stepped forward as a compelling pharmacological countermeasure. Yet an enormous evidence gap persists. Middle Eastern populations remain dramatically underrepresented in the literature. Lebanon has no published data whatsoever.
To investigate the efficacy of nightly 0.01% atropine eye drops in controlling myo
This retrospective cohort study enrolled 70 eyes from 36 pediatric patients (mean age 7.89 ± 2.59 years; 50% female; all Lebanese nationals of Arab ethnicity). Thirty-five eyes received nightly 0.01% atropine. Thirty-five eyes received standard spectacle correction alone. Follow-up extended across 24 months. Cycloplegic retinoscopy using cyclopentolate 1% determined refraction at every visit. The primary outcome was change in spherical equivalent refraction. Secondary outcomes included best-corrected visual acuity (logMAR) and adverse effects in the atropine group. Repeated measures analysis of variance via SPSS v26 con
Both groups showed myopic progression throughout the follow-up window. The atropine cohort demonstrated significantly slower spherical equivalent refraction advancement at 6 months [0.26 ± 0.29 diopters (D) vs 0.51 ± 0.46 D; P = 0.008] and at 18 months (0.18 ± 0.25 D vs 0.37 ± 0.32 D; P = 0.009) relative to controls. Inter-period differences at 12 months (P = 1.00) and 24 months (P = 0.071) did not reach statistical significance. Best-corrected visual acuity held steady across both cohorts. No adverse effects were documented in the atropine arm.
Nightly 0.01% atropine was associated with significantly slower myopic progression at multiple timepoints in Lebanese children. The tolerability profile was exemplary. These findings extend support for low-dose atropine as a viable myopia management approach in the Middle Eastern pediatric population. Prospective randomized studies remain essential to consolidate these results.
Core Tip: This is the first study to evaluate nightly 0.01% atropine for myopia control in Lebanese children. Over 24 months atropine-treated eyes demonstrated statistically significantly slower myopic progression than spectacle-only controls at multiple timepoints. No adverse effects were recorded. These findings extend existing evidence to the underrepresented Middle Eastern region. They support low-dose atropine as a safe, accessible and effective option for pediatric myopia management in Lebanon.