UH, OSU researchers secure $25 million for trial assessing atropine drops and myopia management

Researchers at the University of Houston (UH) and The Ohio State University have received 2 grants totaling $25 million from the National Institutes of Health’s National Eye Institute to aid in testing daily drops of low concentration atropine as a nearsightedness preventative therapy in children aged 6-11.¹ The Delaying the Onset of Nearsightedness Until Treatment (DONUT) study will be the first of its kind in the US to examine whether atropine eye drops can delay the onset of nearsightedness in young children and lessen its progression over the child’s life, according to a news release.

David Berntsen, OD, PhD, co-principal investigator on the grants and Golden-Golden Professor of Optometry at UH, will be co-leading the study alongside Jeffrey Walline, OD, PhD, associate dean for research at The Ohio State University College of Optometry, and Lisa Jordan, MS, PhD, research professor and director of the Data Coordination and Analysis Center at Ohio State.¹

“The more nearsighted, or myopic, someone becomes, the greater their risk of sight-threatening complications later on as an adult including myopic degeneration, retinal detachment, glaucoma,” Berntsen said in the release. “Our goal is to ultimately decrease how myopic someone becomes to hopefully reduce their risk of complications later in life.”

The clinical trial will be conducted at UH, Ohio State, and 12 additional centers in the US. Over 600 children are planned to be enrolled in the study and will be randomly assigned to receive nightly drops of either 0.05% low-concentration atropine or placebo for 2 years. The timing of the onset of nearsightedness of patients will then be compared between patients who receive the drug and those who receive placebo. Any child in the placebo arm of the trial who are diagnosed with myopia during the study will begin receiving the drops, in addition to receiving an annual voucher for corrective lenses.¹

“We’ve shown that kids can handle treatments from a very young age, and so we’re just applying a different treatment now,” Walline said in an Ohio State news release.² “If they become nearsighted during our study, we will also give them the option of wearing contact lenses.”

The researchers predict that the atropine drops will reduce the proportion of children who become nearsighted from 20% in the placebo group to 10% in the treatment group. Additionally, they estimate that atropine will slow pre-myopic eye growth by 30% over the course of the study.¹

Berntsen, Walline, and Jordan are seasoned experts in running similar studies, having previously co-led trials showing that multifocal contact lenses can effectively slow the progression of nearsightedness, according to the release.¹ Specifically, their 2020 BLINK randomized clinical trial and follow-up study demonstrated that lenses with a high add power significantly slowed the progression of myopia in nearsighted children as young as 7 years old.³

“In this 3-year multicenter, randomized, double-masked clinical trial, commercially available center-distance soft multifocal contact lenses with a high add power slowed myopia progression by 0.45 D and eye growth by 0.23 mm compared with single-vision contact lenses, and slowed myopia progression by 0.29 D and eye growth by 0.16 mm compared with medium add power multifocal contact lenses,” the study authors stated.³

In 2025, the researchers found that those benefits also lasted after the treatment ended.¹

“Our previous work has shown that young children are very successful with treatments to slow the progression of myopia. This new study will now look to see if we can delay when a child first becomes myopic,” Berntsen said in the release.

Walline noted in the release that high myopia ultimately limits the options for refractive surgery, contact lenses, and glasses, which underscores the importance of managing myopia quickly and early.¹

“The more nearsightedness you have, the more at risk you are as an older adult of sight-threatening complications – retinal detachments, atrophy at the back of the eye, glaucoma and macular degeneration,” said Walline in the Ohio State release.² “So anything we can do to reduce the amount of myopia reduces your risk of those complications. And that’s our goal, ultimately.”

“The number of myopic individuals in the world is projected to increase to 50% by the year 2050, and over one third of the US populations is myopic. Anything that we can do to delay the onset of myopia in children has the potential to have a significant impact on this growing problem,” Berntsen said in the release.

References:

1. Fickman L. University of Houston co-leads $25 million NIH-funded grant to study the delay of nearsightedness in children. University of Houston. September 18, 2025. Accessed September 23, 2025. https://www.uh.edu/news-events/stories/2025/september/09182025-berntsen-atropine-drops-study.php

2. Taking aim at nearsightedness in kids before it’s diagnosed. The Ohio State University. News release. September 18, 2025. Accessed September 18, 2025. https://optometry.osu.edu/news/taking-aim-at-nearsightedness-in-kids-before-its-diagnosed

3. Walline JJ, Walker MK, Mutti DO, et al; BLINK Study Group. Effect of high add power, medium add power, or single-vision contact lenses on myopia progression in children. JAMA. 2020;324(6):571-580. doi:10.1001/jama.2020.10834