Western Australia Atropine for the Treatment of Myopia (WA-ATOM) study: Rationale, methodology and participant baseline characteristics

Samantha S.Y. Lee, David A. Mackey, Gareth Lingham, Julie M. Crewe, Michael D. Richards, Fred K. Chen, Jason Charng, Fletcher Ng, Ian Flitcroft, James J. Loughman, Augusto Azuara-Blanco, Nicola S. Logan, Christopher J. Hammond, Audrey Chia, Tan Tai Truong, Antony Clark*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Importance: Atropine eyedrops are a promising treatment for slowing myopia progression in East Asian children. However, its effects on children in Australia, including those of non-Asian background, have not been well-studied. Background: The Western Australia Atropine for the Treatment of Myopia (WA-ATOM) study aims to determine the efficacy and long-term effects of low-dose atropine eyedrops in myopia control. This paper describes the study rationale, methodology and participant baseline characteristics. Design: Single-centre, double-masked, randomized controlled trial. Participants: Children (6-16 years) with spherical equivalent ≤−1.50 D in each eye, astigmatism ≤1.50 D and myopia progression by ≥0.50 D/year. Methods: Enrolled children were randomly assigned 2:1 to receive 0.01% atropine or placebo eyedrops. Participants are examined every 6 months during first 3 years of the study (2-year treatment phase followed by a 1-year washout phase), and then at a 5-year follow-up (2 years after the end of the washout phase). Main Outcome Measures: Annual progression rate of myopia and axial length, tolerability to eyedrops and incidence and severity of unwanted effects. Results: Out of 311 children who were referred, 242 were suitable for study participation, and 153 were subsequently enrolled. The baseline characteristics of enrolled participants are presented. Conclusions and Relevance: Outcomes of the WA-ATOM study will inform on the efficacy, tolerability, safety and long-term effects of low-dose atropine eyedrops in myopia control in Australian children. The impact of ocular sun exposure, iris colour and parental myopia on the efficacy of low-dose atropine will also be assessed.

Original languageEnglish
Pages (from-to)569-579
Number of pages11
JournalClinical and Experimental Ophthalmology
Issue number5
Early online date26 Feb 2020
Publication statusPublished - 08 Jul 2020

Bibliographical note

Funding Information:
We would like to thank all participants of the WA-ATOM study and their families. We additionally acknowledge the referring optometrists and ophthalmologists from the following practices in Western Australia: SpecSavers Australia, OPSM, Laubman and Pank Optometrists, Spectrum Family Eyecare, Bullcreek Optometrists, Eye5 Optometrists, Options Optometrists, The Optical Superstore, Eyes at Australind, Specs 241, Northam Optical, Cooper and Lourie Optometrists, Crystal Vision Optometrists, Abernethy Owens Optometrists, Future Vision Optometrists, Opticentre, Dr Richard Gardner, Vision Care Centre, Vision West Optometrists, Mr B the Optometrist, Eyecare Centre Carine, Armadale Eyewear, Dr Philip House, Dr Neil Sinclair (Bunbury and Busselton Eye Doctors), Bupa Optical, Dr David de la Hunty, Angelo Street Optical, Eye Focus Optometrists and EyesWest. We would especially like to thank Ms Nicola Seed, Mrs Magdelena Blaszkowska, Ms Katie Dyer, Dr Feroza Jeewa, Mr Nick Stafford-Bell, Dr Maria Franchina, and Dr Adrian Koay for assisting in participant recruitment and/or testing.

Publisher Copyright:
© 2020 Royal Australian and New Zealand College of Ophthalmologists

Copyright 2020 Elsevier B.V., All rights reserved.


  • atropine eyedrop
  • myopia
  • myopia control
  • myopia treatment

ASJC Scopus subject areas

  • Ophthalmology

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