A recent randomised controlled trial published in the British Journal of Ophthalmology has reported promising results for slowing myopia progression in children by combining low-dose atropine with defocus-incorporated multiple segments (DIMS) spectacle lenses.[1] The study, known as the 'Atropine and Spectacle lens Combination Treatment' (ASPECT) trial, offers new evidence supporting integrated myopia-control strategies in paediatric eye care.

Conducted at the Ophthalmology Service of Hospital Clínico San Carlos in Madrid, Spain, the ASPECT trial enrolled children aged 4-16 years with myopia ranging from –1.00 to –6.00 diopters and low astigmatism (≤ 2.00 D). Participants were randomly assigned to one of two groups:

  • Group A: 0.025% atropine eye drops plus single-vision spectacle lenses

  • Group B: 0.025% atropine eye drops plus DIMS spectacle lenses

The trial followed participants over 12 months to compare the effectiveness of the two interventions in slowing myopia progression and axial elongation, a key anatomical driver of vision deterioration. 

The study found that children treated with the combination of low-dose atropine and DIMS lenses exhibited slower axial elongation compared with those receiving atropine with standard single-vision lenses. Notably, around 39.6% of children in the combination group experienced no axial elongation over the 1-year period—more than three times the rate seen in the single-vision group (12.2%). These results suggest an additive benefit when optical defocus strategies are paired with pharmacological treatment. 

Although differences in spherical equivalent refraction (a measure of overall refractive error) between groups did not reach statistical significance within the 12-month timeframe, the trend favored combination therapy and supports its potential to enhance clinical outcomes.

Both low-dose atropine and DIMS spectacle lenses have independently demonstrated effectiveness in managing myopia progression in children by slowing axial elongation. This study is among the first randomized clinical trials to assess the efficacy of combined therapy in a controlled setting, offering evidence that the two approaches may work synergistically. 

The authors emphasize the need for longer-term follow-up and larger multicenter studies to confirm these findings and to refine treatment protocols based on age, baseline refractive error, and individual risk profiles. They also highlight the importance of further research to optimise atropine dosing and to explore how other combination approaches may influence visual outcomes.

Reference

1. Hernández-Verdejo, J. L., González-Méijome, J. M., Ruiz-Alcocer, J., et al. (2025). Atropine 0.025% combined with defocus-incorporated multiple segments spectacle lenses for myopia control in children: a randomised clinical trial (ASPECT). British Journal of Ophthalmology, 109(9), 1074–1081. https://doi.org/10.1136/bjo-2023-324580