Objective To explore the safety and effectiveness of the comprehensive therapy of "Five-in-One" of traditional Chinese medicine combined with low concentration of atropine in the prevention and control of myopia in adolescents.

Methods Eighty adolescents diagnosed with mild myopia were included in the study. According to the wishes of the subjects and their guardians, they were divided into control group with 40 cases and traditional Chinese medicine intervention group with 40 cases. The control group received 0.01% atropine sulfate eye drops in both eyes once before bedtime every night, the traditional Chinese medicine intervention group underwent twice-weekly comprehensive therapy of "Five-in-One" of traditional Chinese medicine on the basis of local application of medication in the control group. Both groups received a 12-month intervention course. Follow-up visits were conducted before intervention and at 3, 6, and 12 months after treatment. The international standard visual acuity chart was used to examine the changes in unaided distance visual acuity before and after treatment in both groups. The changes of distant visual acuity of naked eye before and after treatment were measured in two groups. The changes in equivalent spherical lens power before and after treatment in both groups were measured by mydriatic refraction combined with a computer optometer. The changes in axial length before and after treatment were measured using an optical biometer. The adverse reactions after treatment in both groups were compared.

Results In the control group, the uncorrected distance visual acuity decreased compared with that before intervention as the treatment time prolonged, while was gradually increased in the traditional Chinese medicine intervention group compared with that before intervention (P < 0.05). At 12 months after treatment, the uncorrected distance visual acuity in the traditional Chinese medicine intervention group was higher than that in the control group (P < 0.05). With the prolongation of treatment time, the equivalent spherical lens power gradually increased in both groups (P < 0.05).At 12 months after treatment, the equivalent spherical lens power in the traditional Chinese medicine intervention group was lower than that in the control group (P < 0.05). The axial length gradually increased with the prolongation of treatment time in both groups (P < 0.05). At 6 and 12 months after treatment, the axial length in the traditional Chinese medicine intervention group was shorter than that in the control group (P < 0.05). After using 0.01% atropine, 8 children in the control group developed outdoor photophobia symptoms; after treatment with the comprehensive therapy of "Five-in-One" of traditional Chinese medicine combined with 0.01% atropine sulfate eye drops in the traditional Chinese medicine intervention group, 4 children developed outdoor photophobia symptoms, but the symptoms disappeared after 2 weeks of medication.

Conclusion The comprehensive therapy of "Five-in-One" in traditional Chinese medicine combined with low-concentration atropine is significantly more effective than low-concentration atropine alone in effectively controlling the progression of refractive myopia and reducing its adverse reactions.