<p>Myopia, particularly high myopia, poses a significant global public health burden. While low-concentration atropine is effective in controlling myopia progression, its conventional eye drop formulation is hampered by low bioavailability, poor patient compliance, and side effects, driving the need for advanced delivery systems. This review explores the contact lens-based drug delivery platform as a promising strategy to overcome these limitations. It synthesizes current evidence on the global myopia prevalence, atropine's pharmacology, and clinical efficacy, with a detailed analysis of the design principles for atropine-eluting lenses—encompassing material selection, drug-loading techniques, release mechanisms, and performance evaluation. The review systematically argues the superiority of this sustained-release system over traditional eye drops and discusses the remaining technical challenges, safety considerations, and future directions. We infer that integrating sustained drug delivery into a vision-correction device represents a transformative frontier in myopia management and has the potential to enhance efficacy, improve adherence, and reshape treatment paradigms.</p>