Low-Dose Atropine for Treatment of Myopia

Inclusion Criteria: * Age 5 years to \<13 years at time of enrollment. Children within 4 weeks of their 13th birthday are not eligible. * Refractive error meeting the following by cycloplegic autorefraction: * Myopia -1.00D to -6.00D spherical equivalent (SE) in both eyes * Astigmatism \<=1.50D in both eyes * Anisometropia \<1.00D SE * Gestational age ≥ 32 weeks. * Birth weight \>1500g. * Parent understands the protocol and is willing to accept randomization to atropine or placebo. * Is willing to participate in a 2 to 4 week run-in phase using daily artificial tear eyedrops. * Able to return in 2 to 4 weeks for possible randomization. * Parent has a phone (or access to phone) and is willing to be contacted by Investigator's site staff. * Relocation outside of the area of an active PEDIG site within next 32 months is not anticipated. Exclusion Criteria: * Current or previous myopia treatment with atropine, pirenzepine or other anti-muscarinic agent. * Current or previous use of bifocals, progressive-addition lenses, or multi-focal contact lenses. * Current or previous use of orthoK, rigid gas permeable, or other contact lenses being used to reduce myopia progression. * Known atropine allergy. * Abnormality of the cornea, lens, central retina, iris or ciliary body. * Current or prior history of manifest strabismus, amblyopia, or nystagmus. * Prior eyelid, strabismus, intraocular, or refractive surgery. * Down syndrome or cerebral palsy. * Females who are pregnant, la…