Myopia (nearsightedness) is the most common developmental eye disorder in the first decades
of life. It is the biggest risk factor for sight threatening degenerative eye diseases later
in life, second only to age. Its prevalence is increasing worldwide in pandemic dimensions
affecting now > 80% in Asian and > 40% in Caucasian populations. Myopia is one of the five
eye diseases identified as immediate priorities by the WHO's global initiative for the
elimination of avoidable blindness. It usually develops during primary school and its onset
and progression are related to environmental factors such as near work and lack of day light
exposure, to a lesser degree to genetic factors. Therefore, retardation of myopia progression
is a major therapeutic goal. Clinical trials from Asia have shown that 0.01% atropine eye
drops can attenuate progression of myopia while inducing only little side effects such as
light sensitivity and reduced accommodation. However, it is unclear whether this therapy is
equally and sufficiently efficacious in a Caucasian population. Due to the increasing
prevalence also in Europe and an increasing demand from parents for means to retard myopia
progression, the trial is the first European large scale randomized clinical trial
investigating the safety and efficacy of 0.01% atropine eye drops in comparison to placebo
drops. Such a trial is mandatory to substantiate the increasing off-label prescriptions of
low-dose atropine in children and to develop clinical guidelines.