Differential impact of 0.01% and 0.05% atropine eye drops on visual performance in young adults

Abstract Purpose The onset and progression of myopia can occur during adulthood, suggesting that myopia should be managed in young adults. Low‐concentration atropine eye drops have shown promising efficacy in myopia control. This study aimed to evaluate the impact of 0.01% and 0.05% atropine eye drops on the visual performance of university students. Methods Twenty‐six myopic students aged 18–30 years received 0.01% and 0.05% atropine in random order. Atropine eye drops were administered once a night in both eyes for 14 days, with a minimum 14‐day washout period between concentrations. Visual assessments, including the modulation transfer function (MTF) cut‐off, Strehl ratio (SR), objective scattering index, contrast sensitivity (CS) and glare disability, were conducted 1, 2, 7 and 14 days after atropine administration and corresponding time points after cessation. A questionnaire was used to evaluate ocular and general symptoms. Results After 1 day of treatment with 0.05% atropine, the MTF cut‐off ( β = −8.75, p < 0.001) and SR ( β = −0.05, p < 0.001) decreased significantly to their lowest levels. The area under the log CS function also decreased significantly (all p < 0.05) during administration of the 0.05% eye drops, especially in the mesopic with glare condition, and reached its lowest point 1 day after administration ( β = −0.20, p < 0.001). However, all parameters returned to baseline levels 2 weeks after 0.05% atropine was stopped (all p > 0.05). Additionally, 40.91% of the young adults reported experiencing excessive daytime sleepiness and nocturnal glare during 0.05% atropine use. Treatment with 0.01% atropine had minimal effects on both visual performance and subjective symptoms. Conclusions Administration of 0.05% atropine had a significant but temporary effect on the visual performance of young adult myopic patients, whereas 0.01% atropine had a minimal effect.