Author: Dr Val Phua
Estimated reading time: 10–12 minutes
Myopia Control Is About More Than Reducing Your Child’s Spectacle Prescription
When a child becomes short-sighted (myopic), many parents assume that updating their glasses each year is all that is needed.
However, simply prescribing stronger spectacles does not slow the progression of myopia.
Today, myopia management focuses on something much more important—slowing the growth of the eye. By reducing the rate at which myopia progresses, we aim to lower the lifetime risk of serious eye diseases such as retinal detachment, glaucoma, cataracts and myopic macular degeneration.
Fortunately, several evidence-based treatments are now available.
Why Is Slowing Myopia Important?
Myopia occurs because the eye becomes too long from front to back.
The longer the eye grows, the greater the degree of myopia—and the higher the lifetime risk of vision-threatening complications.
High myopia increases the risk of:
- Retinal detachment
- Myopic macular degeneration
- Glaucoma
- Cataracts
- Myopic traction maculopathy
The goal of myopia control is therefore not simply to improve vision today, but to protect eye health decades into the future.
Which Children Benefit from Myopia Control?
Treatment is generally considered for children who:
- Have developed myopia at a young age
- Show rapid progression
- Have one or both parents who are myopic
- Have increasing spectacle prescriptions
- Spend significant time on near work
- Spend relatively little time outdoors
Earlier intervention generally provides the greatest long-term benefit.
Current Evidence-Based Myopia Control Options
Low-Dose Atropine Eye Drops
Low-dose atropine is one of the most widely studied treatments for slowing childhood myopia.
Daily eye drops help reduce the rate of myopia progression while causing minimal side effects at lower concentrations.
Advantages
- Strong evidence supporting effectiveness
- Easy to use
- Well tolerated by most children
Possible Side Effects
- Mild light sensitivity
- Slight difficulty with near focusing (depending on concentration)
- Need for daily treatment
Orthokeratology (Ortho-K)
Orthokeratology uses specially designed contact lenses worn overnight to gently reshape the cornea while sleeping.
The lenses are removed each morning, allowing clear daytime vision without spectacles.
Research has also shown that orthokeratology can slow eye growth in many children.
Advantages
- No spectacles required during the day
- Effective myopia control
- Suitable for active children and sports
Considerations
- Requires excellent lens hygiene
- Regular follow-up is essential
- Small risk of contact lens-related infection
Defocus Spectacle Lenses
Modern spectacle lenses designed for myopia control use specialised optical designs that reduce the stimulus for excessive eye growth.
Examples include:
- Highly Aspherical Lenslet (HAL) technology
- Defocus Incorporated Multiple Segments (DIMS) technology
These lenses allow children to wear spectacles while helping slow myopia progression.
Advantages
- Simple and non-invasive
- Easy for younger children
- No contact lens care required
Soft Myopia Control Contact Lenses
Specially designed daily disposable soft contact lenses create peripheral defocus, helping slow the progression of myopia while providing excellent daytime vision.
They may be suitable for selected older children who are comfortable handling contact lenses.
Lifestyle Measures That Support Myopia Control
Treatment works best when combined with healthy visual habits.
Spend More Time Outdoors
Current evidence suggests that children should aim for approximately two hours of outdoor activity each day, where practical.
Bright natural light appears to help regulate normal eye growth.
Reduce Prolonged Near Work
Encourage children to:
- Take regular breaks
- Avoid prolonged continuous reading
- Maintain a comfortable reading distance
- Alternate near work with outdoor play
Limit Recreational Screen Time
Screens are often necessary for learning, but prolonged recreational screen use should be balanced with outdoor activity and other hobbies.
Which Treatment Is Best?
There is no single treatment that is ideal for every child.
The most appropriate option depends on:
- Age
- Degree of myopia
- Rate of progression
- Lifestyle
- Sporting activities
- Family preferences
- Eye health
Some children may even benefit from combination therapy, such as low-dose atropine together with orthokeratology or myopia control spectacle lenses.
Your ophthalmologist will recommend a personalised treatment plan based on your child’s individual needs.
How Often Should My Child Be Reviewed?
Children receiving myopia control treatment are usually reviewed every 6 to 12 months, although more frequent visits may be recommended during the initial stages of treatment or if progression is rapid.
Follow-up assessments typically include:
- Vision testing
- Refraction
- Axial length measurement (where available)
- Eye health examination
- Review of treatment response
Monitoring allows treatment to be adjusted if myopia continues to progress.
Frequently Asked Questions
Can myopia be cured?
No.
Current treatments slow progression but do not reverse existing myopia.
Should treatment begin immediately after myopia is diagnosed?
Early treatment often provides the greatest long-term benefit, particularly in younger children whose eyes are still growing rapidly.
Will my child still need glasses?
Usually yes.
Most myopia control treatments slow progression but do not eliminate the need for spectacles or contact lenses.
Is outdoor time still important if my child is already using atropine or special glasses?
Yes.
Healthy visual habits complement medical treatment and remain an important part of myopia management.
The Bottom Line
Childhood myopia is increasingly common, but it is no longer a condition that we simply observe as prescriptions become stronger each year.
Modern myopia management offers several evidence-based options—including low-dose atropine, orthokeratology, myopia control spectacle lenses and specialised contact lenses—that can slow eye growth and reduce the long-term risk of serious eye disease.
Combined with healthy visual habits, increased outdoor time and regular eye examinations, these treatments provide the best opportunity to protect your child’s vision for the future.
References
- International Myopia Institute. IMI Clinical Management Guidelines and White Papers.
- Brien Holden Vision Institute. Evidence-Based Myopia Control.
- American Academy of Ophthalmology. Myopia in Children.
- Singapore National Eye Centre. Childhood Myopia and Myopia Control.
- World Society of Paediatric Ophthalmology and Strabismus. Consensus Statement on Myopia Management.
