UAB School of Optometry professor is joining a national network study to research myopia prevention in children. Myopia, commonly known as nearsightedness, is a global epidemic that affects over 2 billion people worldwide and up to 90 percent of the population in East Asia.

Safal Khanal, O.D., Ph.D., an assistant professor at the University of Alabama at Birmingham School of Optometry, will serve as the principal investigator at UAB Clinical Center for the $25 million NIH-funded, five-year multicenter clinical trial to combat childhood myopia. 

Myopia occurs when the eye grows excessively long for its optics. This stretches tissues at the back of the eye and causes blurred vision when viewing objects at a distance. Through the Delaying the Onset of Nearsightedness Until Treatment, or DONUT, study, researchers will evaluate whether daily use of low-concentration atropine eye drops can delay the onset of myopia in children.

The DONUT trial is co-led by Jeffrey J. Walline, O.D., Ph.D., from the Ohio State University College of Optometry and David A Berntsen, O.D., Ph.D., from the University of Houston College of Optometry. It represents the first United States study of its kind to test atropine as a preventive therapy for childhood myopia.

As one of the 14 clinic centers, UAB plans to enroll at least 45 children ages 6-11 years who are at high risk of developing myopia. Recruitment will occur in spring 2026. Participants will receive nightly 0.05 percent atropine or placebo drops for two years, allowing researchers to determine whether the treatment can delay or reduce the onset of nearsightedness. Children who become myopic during the trial will begin atropine treatment and receive annual vouchers for corrective lenses.

Researchers predict that daily instillation of atropine eye drops could reduce the proportion of children who develop myopia and slow excessive elongation of the eyeball that leads to myopia.

“The alarming rise of myopia worldwide represents one of the most serious public health challenges of our time,” Khanal said. “By delaying its onset in early childhood, we may be able to prevent progression to more severe forms that can lead to irreversible, sight-threatening complications later in life. Participating in this national collaborative effort reflects our commitment to advancing research that safeguards vision from childhood through adulthood. Findings from this study have the potential to transform early intervention strategies for children most at risk of developing myopia.”

Faculty members at the school include Nick Onken, O.D.; Katherine Weise, O.D.; Tamara Oechslin, O.D., Ph.D.; and Jaene Sims, O.D., Ph.D., who will play key roles in implementing the study locally at the UAB Clinic Center.