Ryjunea is a preservative-free low-dose atropine 0.1% eye drop, given once nightly, that slows the progression of childhood myopia (short-sightedness) by reducing axial-length elongation of the growing eye. At Eye Surgery Clinic partner clinics, a consultant paediatric-ophthalmology Ryjunea programme costs from £95 per month, all-inclusive of the drops, cycloplegic refraction, axial-length biometry and four-to-six-monthly progress reviews. Treatment typically continues for 2–4 years, ending in the mid-teens when myopia progression naturally slows. Compared with no intervention, low-dose atropine reduces the rate of refractive progression by roughly 30–50% in the majority of children.
What is Ryjunea atropine 0.1%?
Ryjunea is the brand name for a 0.1% preservative-free atropine sulphate eye drop developed specifically for paediatric myopia control. It is the first low-dose atropine formulation to gain a regulatory licence for slowing the progression of myopia in children. The drop is supplied in single-use vials to avoid preservative-related ocular surface irritation in long-term daily use.
Childhood myopia is driven by excessive elongation of the eyeball during growth. As the eye becomes longer than the focusing system was designed for, distance vision blurs. Higher myopia in adulthood carries a meaningfully increased lifetime risk of myopic maculopathy, retinal detachment, glaucoma and earlier cataract. The aim of low-dose atropine is to keep adult myopia lower than it would otherwise have been, reducing both spectacle dependence and the lifetime risk of myopic eye disease.
Ryjunea is one of three evidence-based myopia-control options used in UK private paediatric ophthalmology. The others are orthokeratology (overnight rigid contact lenses that reshape the cornea) and specialist daily soft contact lenses (dual-focus or defocus-incorporated multi-segment designs). Low-dose atropine is the easiest of the three to start, has the lowest day-to-day burden and combines well with the others where progression is rapid.
Who is Ryjunea for?
- Children aged 3–17 with progressing myopia (typically more than 0.5 dioptres of progression in 12 months)
- Ages 6–12 see the largest benefit — the window where eye-growth is most responsive
- One or both parents with high myopia, and the child showing earlier-than-expected myopia onset
- Children where contact-lens-based myopia control is impractical or has been declined
- As an adjunct to orthokeratology or dual-focus soft contact lenses where progression remains rapid on monotherapy
Is your child's prescription getting stronger each year? A consultant paediatric-ophthalmology myopia assessment includes cycloplegic refraction, corneal topography and axial-length biometry — the only objective way to track progression.
Book a child myopia assessmentAtropine concentration options
Three concentrations are used in UK paediatric practice, ranging from very-low-dose specials to the licensed Ryjunea formulation. Your consultant will choose the right starting concentration based on progression speed, age and side-effect tolerance.
Many children start on 0.01% and step up to Ryjunea 0.1% if progression is not adequately controlled at six-to-twelve months. The combination of Ryjunea with orthokeratology or dual-focus soft contact lenses is the strongest evidence-based option for rapidly progressing high myopia.
How a Ryjunea myopia programme works
A Ryjunea programme is medical, not surgical — the only intervention is the once-nightly drop and the structured monitoring around it. Here's how the consultant pathway runs at Eye Surgery Clinic partner clinics:
- Initial paediatric-ophthalmology consultation — full ocular history, family history of myopia, cycloplegic refraction, slit-lamp examination, corneal topography and an axial-length biometry scan to establish the baseline.
- Treatment decision — the consultant explains progression rate, projected adult prescription without treatment, and the right starting concentration. Side-effects are discussed with the child and parents.
- First Ryjunea prescription — the drop is supplied in single-use preservative-free vials. One drop is instilled to each eye at bedtime by a parent.
- 4–6 monthly reviews — repeat cycloplegic refraction and axial-length biometry. Treatment is continued, stepped up, or combined with optical myopia control depending on response.
- Step-down at mid-teens — myopia progression naturally slows in late adolescence. Treatment is tapered over six-to-twelve months to reduce the risk of rebound.
What to expect during treatment
Ryjunea is well-tolerated by most children. There is no recovery period — the drop is started straight away after the consultation and reviewed objectively at every visit.
Night one
First drop instilled at bedtime. Some children notice mild stinging for a few seconds; this settles within a week.
Week 1
Mildly larger pupils and slightly more light sensitivity outdoors are common. Photochromic or polarised lenses are advised on bright days.
Weeks 2–4
Most children settle fully. Reading and screen vision are unaffected for the vast majority on the 0.1% concentration.
Month 6 review
Repeat cycloplegic refraction and axial-length scan to confirm response. Treatment continued, stepped up or combined with optical myopia control.
Years 2–4
Treatment continues with six-monthly reviews. Once progression has clearly slowed and the child is past peak growth, treatment is tapered to avoid rebound.
Cost & insurance
Our Ryjunea myopia-control programme prices are all-inclusive: consultant paediatric-ophthalmology consultations, cycloplegic refraction, corneal topography, axial-length biometry, the preservative-free drops themselves and the structured 4–6 monthly reviews. There are no hidden extras.
- Atropine 0.01% (UK special): from £75 per month, all-inclusive.
- Ryjunea atropine 0.1% (licensed): from £95 per month, all-inclusive.
- Atropine 0.5% (UK special, rescue): from £135 per month, all-inclusive.
- Initial consultation, refraction & axial-length scan: £295, redeemed against the first three months of treatment if a programme is started.
- Insurance: some private medical insurers cover paediatric myopia control where progression is documented. We handle pre-authorisation.
- Finance: the monthly programme fee is treated as a subscription — no finance is normally required.
If your child later needs adult refractive correction, the laser and lens treatments that low-dose atropine helps make more accessible are detailed on our laser eye surgery, EVO ICL for high myopia and SMILE Pro pages.