Ryjunea is a low-dose atropine eye drop (atropine 0.1 mg/ml, the same as 0.01%) licensed in the UK to slow short-sightedness (myopia) getting worse in children. The MHRA approved it in October 2025, making it the first licensed low-dose atropine treatment for childhood myopia here. It won’t reverse myopia or replace glasses; the aim is to slow how fast a child’s prescription gets stronger while their eyes are still growing.
What is Ryjunea?
Ryjunea is made by Santen. It contains atropine sulfate at 0.1 mg per ml, a small fraction of the strength of the atropine drops eye clinics use to widen the pupils. The UK summary of product characteristics (SmPC) says it comes in a multi-dose bottle and contains a preservative, benzalkonium chloride.
It’s a prescription-only medicine. The College of Optometrists says it can be prescribed by independent prescribers with the right scope of practice, including IP optometrists and ophthalmologists with competence in children’s myopia management, and that it’s available for private prescribing first.
Why slow myopia at all? Short-sightedness in children usually gets worse because the eye grows too long from front to back. Blue Fin Vision’s myopia page points out that every extra dioptre raises the lifetime risk of retinal detachment, myopic maculopathy, glaucoma and earlier cataract, which is why clinics try to slow it while a child is still growing.
Who is Ryjunea for?
The UK licence covers starting treatment in children who meet all three of these:
- aged 3 to 14
- myopia between −0.50 and −6.00 dioptres
- myopia getting worse by 0.50 dioptres or more a year
The SmPC says Ryjunea should only be started by an ophthalmologist or another healthcare professional qualified in ophthalmology. It isn’t for children with primary or angle-closure glaucoma, or with an allergy to atropine or to similar medicines such as ipratropium and tiotropium. Before starting, the prescriber should rule out rarer causes of worsening myopia, such as glaucoma or retinitis pigmentosa, which low-dose atropine isn’t meant to treat.
Blue Fin Vision’s children’s myopia service sees children aged six and above, and it says its first appointment can end with a decision to keep monitoring rather than treat straight away.
Other ways to slow myopia
Blue Fin Vision says it discusses four options at the first appointment: licensed low-dose atropine, myopia-control spectacles, myopia-control contact lenses, or structured monitoring without treatment for now. Our guides cover the main lens options: MiYOSMART spectacle lenses, Stellest spectacle lenses, MiSight 1 day contact lenses and Acuvue Abiliti contact lenses.
How the drops are used
The SmPC sets out how Ryjunea is used:
- one drop into each eye once a day, preferably at bedtime
- straight after each drop, press gently on the inner corner of the eye for a minute, to reduce how much reaches the rest of the body
- take contact lenses out first, and wait fifteen minutes before putting them back in
- leave at least fifteen minutes between Ryjunea and any other eye drops
- if a dose is missed, carry on with the next one as normal
Treatment is checked at regular reviews. Blue Fin Vision says it sees children every six months for the first two years, measuring vision, how well the drops are tolerated and the length of the eye (axial length) at each visit, then yearly once progression is slow or stable, with a full dilated examination at least once a year.
The SmPC says to consider tapering and stopping once myopia has stabilised during adolescence (less than 0.5 dioptres of change over two years) and to keep monitoring for a year after stopping. Myopia can speed up again when atropine stops, and treatment can be restarted if it does.
What the STAR trial found
Ryjunea’s licence rests on the STAR study, a double-masked trial described in the SmPC that randomised 852 children aged 3 to 14 to Ryjunea, a stronger atropine drop or a placebo drop. Among children who were already getting worse by 0.5 dioptres or more a year (the group the licence now covers), the average change in prescription after two years was −0.47 dioptres with Ryjunea and −0.86 dioptres with the placebo drop, a difference of 0.39 dioptres. After three years the difference was 0.43 dioptres, and the SmPC notes larger effects in younger children.
Two cautions. In a smaller group of children whose eye length was measured, the SmPC reports no statistically significant difference in axial length between Ryjunea and placebo at two years. And the College of Optometrists says most low-dose atropine trials compare it with an inactive drop, and describes the certainty of the evidence as low. Ask the prescriber what the drops can and can’t be expected to do for your child.
Side effects
In the trial, the most common side effects were sensitivity to light (23.4% of children), eye irritation (9.9%) and blurred vision (7.8%). Other common ones listed in the SmPC are headache, eye pain, a feeling of something in the eye and larger pupils. About 0.4% of children stopped the drops because of a side effect during the 36-month study.
Atropine widens the pupil, so bright light can be uncomfortable and close focusing harder; the SmPC says this effect can last up to 14 days and that photochromic lenses can help. Where blurred vision happened, it cleared by itself during treatment in about 69% of children.
Tell the prescriber if your child has a heart condition or high blood pressure, Down’s syndrome or spastic paralysis, and take care in very hot weather or when your child has a fever: the SmPC asks for extra caution in each of these.
Cost, NHS and where to get it
Neither of the clinic groups we work with publishes a price for Ryjunea. Blue Fin Vision offers it at its clinics in London, Hertfordshire and Essex as part of a consultant-led children’s myopia service that starts with a paid assessment, so ask it in writing for the assessment fee and the cost of the drops and the follow-up visits. Sapphire Eye Care does not offer children’s myopia care.
Blue Fin Vision says patient finance is available at its locations, subject to the applicable terms. Eye Surgery Clinic does not lend money or arrange finance.
On the NHS: the College of Optometrists says Ryjunea remains privately funded across the UK until the relevant national bodies complete their review.
Insurance: check with your insurer whether your policy covers a children’s myopia assessment or treatment before you book.
If your child needs their eyesight corrected as an adult, our guides to laser eye surgery, EVO ICL for high myopia and SMILE Pro explain the options.
Frequently asked questions
Sources
- Santen UK Limited (electronic medicines compendium): Ryjunea 0.1 mg/ml eye drops, solution: summary of product characteristics (updated 16 September 2026)
- College of Optometrists: MHRA approves first licensed low-dose atropine treatment for childhood myopia in the UK (10 November 2025)
- Santen: Santen receives UK approval for Ryjunea (approval dated 30 October 2025)
- Blue Fin Vision: Myopia management for children (read 19 September 2026)
General information, not personal medical advice: the prescriber decides whether Ryjunea suits your child. We only publish the prices of the clinic groups we work with, and neither publishes a price for Ryjunea.