Atropine eye drops
Atropine eye drops have been used since 1970s to treat myopic progression. We have used it for over 20 years at the Singapore National Eye Centre.
Low dose Atropine (0.01%, 0.025% and 0.05%) | Cost: SGD$15-30/mth Efficacy: 30-60% 20-30% started on 0.01% may benefit from higher dose, especially in younger children and high-risk families. |
Cons: Generally well tolerated but some children may experience near blur/glare. |
Moderate dose Atropine (0.125%) | Cost: SGD$15-30/mth Efficacy: 30-60% |
Cons: Generally well tolerated but some children may experience near blur/glare with higher doses. Treatment should not be stopped suddenly. |
High-dose Atropine (1%) | Cost: SGD$15-30/mth Efficacy: 60-80%, although 10% may still respond poorly |
Cons: Often need glasses with reading add and tint as children may experience near blur/glare. Treatment should not be stopped suddenly. |
Glasses
Different glasses options have been tried over time. In general, myopia-control glasses are
Progressive glasses have a graduated reduction in degree in the lower segment of lens. Similar to reading glasses used in older people. | ![]() |
Cost: SGD$400 onwards (brand dependent) Efficacy: 0-10% Cons: Well tolerated in children but may have some blur/magnification when looking down (e.g., walking down steps). |
Bifocal glasses have a separate area of lower degree at the lower segment of the lens with a definite line seen between the 2 segments. | ![]() |
Cost: SGD$400 onwards Efficacy: 0-20% Cons: Obvious line in glasses with blur/magnification when looking down. |
Peripheral defocus glasses with a clear rim of higher plus in the outer ring. | ![]() |
Cost: SGD$400 onwards Efficacy: No effect Cons: Some blur/distortion when looking off center |
Simultaneous myopic retinal defocus glasses with lenslets or microlenses creating myopic defocus or volume of defocus, and clear zones in between lenslets offer distance vision correction | ![]() |
Cost: SGD$550 onwards Efficacy: 50-67% Cons: Some blur when off center. 10% may have a poor response. May be less effective in younger children or in those have eye misalignment. Effect unknown in children with high myopia/astigmatism. |
Note: there is no evidence that 'pin-hole' glasses or 'blue light blocking' glasses slow myopic progression
Contact lenses
Contact lens (CL) are corrective lens placed onto the surface of the eye and are worn to correct refractive errors instead of glasses or refractive surgeries. Contact lenses can have two main function in myopia: refractive correction and myopia control.
Day time multifocal CL (with or without toric) have rings of increase plus within the lens. Daily disposable CL are generally safer, especially for long-term use in children. | ![]() |
Cost: estimated SGD$170 -200/month or SGD$2000/year for daily disposable CL Efficacy: 50%. 10% may have a poor response. Works better in children aged ≥ 9 years old Cons: Limited refractive correction range |
Night time wear orthokeratology CL (OrthoK lens or OK lens) are worn at night and works by reshaping the cornea so that glasses are not needed in the day. | ![]() |
Cost: estimated SGD$2500 per pair Efficacy: 30-50% over 3-5 years. 10% may have a poor response Cons: - Limited refractive range - Highest infection risk because of overnight wear - Rebound may occur when stopped |
Note: please refer to page on proper care of contact lenses for more details on that subject
Combination therapy
Atropine can be used in combination with myopia control spectacle glasses, multifocal soft contact lenses or Ortho K lenses to supplement myopia control effect.
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