Using low-dose atropine in control of intermittent exotropia

Clin Exp Optom. 2026 May;109(4):720-731. doi: 10.1080/08164622.2025.2594706. Epub 2026 Feb 24.

ABSTRACT

CLINICAL RELEVANCE: There are a variety of non-surgical methods to control and correct intermittent exotropia. Identifying the effectiveness of an alternative method that carries minimal risk and ocular symptoms can guide clinicians in optimising patient care.

BACKGROUND: The aim of this work is to evaluate the efficacy of 0.05% atropine eye drops on exotropia control in children with intermittent exotropia.

METHODS: This parallel-group, controlled, randomised clinical trial was conducted on children aged 2-8 years with intermittent exotropia who had been admitted at the Paediatric Ophthalmology and Strabismus Clinic of Rasoul Akram Hospital, Tehran, Iran. Participants were randomly assigned in a 1:1 ratio to the low dose (0.05%) atropine or overminus lens groups and followed for 3 months. Deviation control was evaluated using 3-point and 6-point control scales.

RESULTS: A total of 21 participants in each group (mean (SD) age, 5.1 (2.34) years; 14 males [33.3%]) were included in this study. According to both 3- and 6-point control scales, deviation control 1 and 3 months after the intervention was significantly better than before in each group (p < 0.05). According to the 3-point control scale, in the low-dose atropine group, the distance deviation control at 3 months was significantly improved than at 1 month (p = 0.031). According to the 6-point control scale, distance and near deviation controls at 3 months were significantly improved than at 1 month in the overminus lens group (p = 0.005 and p = 0.005, respectively). In the low-dose atropine group, near deviation control at 3 months was significantly better than at 1 month (p = 0.007).

CONCLUSION: Low dose atropine appears to have the same level of effectiveness as overminus lenses, and induces good control in intermittent exotropia. Therefore, it may be an efficient alternative to overminus lenses.

PMID:41734769 | DOI:10.1080/08164622.2025.2594706