NICE draft decision on low-dose atropine: what practices need to know

NICE has issued draft guidance recommending that low-dose atropine eye drops should not be routinely funded by the NHS for slowing myopia progression in children aged 3 to 14.

For practices, the key point is not that myopia management has been dismissed, but that NICE wants greater certainty before committing NHS resources to this specific intervention. The committee noted the potential scale of childhood myopia and the impact wider access could have on NHS budgets, saying it needed to be more certain about the evidence to avoid decision error.

FODO’s policy team is advising members that the evaluation is focused on low-dose atropine eye drops only. NICE did not assess myopia-control spectacle lenses or contact lenses as part of this appraisal, and the draft decision relates to NHS funding and cost-effectiveness rather than self-funded care.

The practical takeaway is that practitioners should continue to discuss myopia management options in a balanced way, making clear the distinction between clinical effectiveness, regulatory status, NHS funding and privately funded care. The draft guidance is open for consultation until 19 August 2026, with final NICE guidance currently expected later in the year.