Many parents ask whether their children should be on both atropine and ortho K to control myopia. There were small studies, some showing better result with the combo treatment. There was also a small scale study that I talked about that showed when ortho k failed to control myopia progression, additional atropine did not help.

Now a new research that analyzed 5 clinical studies involving 341 children revealed that ortho K + low dose atropine worked better than ortho K alone in controlling myopia progression [1]. On average, using the combo treatment results in 0.25 mm axial length elongation compared to about 0.35 mm in ortho K alone after 12 months of treatment. This is a small, but statistically significant finding.  

I think having this data is helpful. When a child has sub-optimal control with ortho K alone, I can recommend adding atropine. If a child has fast progressing myopia and parents are anxious, I can recommend starting with both treatments to maximize the control.

Would you be interested in seeking both treatments together right from the beginning?

Reference:

[1]https://journals.lww.com/claojournal/Fulltext/2021/02000/The_Efficacy_of_Atropine_Combined_With.7.aspx