Myopia control for children: what parents need to know

A stronger prescription does not have to mean simply waiting for the next pair of glasses. Several treatments can slow childhood myopia progression. The right comparison starts with what each option does, what the studies measured and what the daily routine involves. 1 2

Clear vision and myopia control are different goals

Ordinary single-vision glasses help a child see distant objects clearly. Myopia control has a different aim: to slow the worsening of short-sightedness and the lengthening of the eye. It does not mean removing the myopia a child already has. 1 2

That distinction matters because longer, more myopic eyes have a higher risk of eye disease later in life, including retinal detachment, glaucoma and myopic maculopathy. The purpose of treatment is to reduce further progression, not to promise that a child will never need glasses. 2

When discussing progress, ask about both the prescription, measured in dioptres (D), and axial length, the front-to-back length of the eye measured in millimetres (mm). They describe related but different outcomes. 1

1. Myopia-control spectacle lenses

Some spectacle lenses use special optical designs intended to slow eye growth while correcting vision. These are not the same as ordinary single-vision lenses. Evidence applies to the tested design, not to every pair of glasses described as “myopia control”. 1 3

In a two-year Hong Kong trial, 183 Chinese children aged 8-13 were assigned to DIMS lenses or single-vision glasses; 160 completed the study. Among completers, average prescription progression was -0.41 D with DIMS lenses versus -0.85 D with single-vision glasses. Eye length increased by 0.21 mm versus 0.55 mm. 3

The practical advantage is a familiar glasses-based routine without contact-lens handling. The trade-off is that the evidence is design-specific, and correct fitting and consistent wear matter. A result from one design should not be applied to all specialist spectacle lenses. 1 3

2. Special soft contact lenses

Multifocal and dual-focus soft contact lenses are another option. The extra optical zones are intended to provide a myopia-control effect as well as clear vision. Ordinary single-vision contact lenses should not be assumed to do the same job. 1 2

The three-year BLINK trial enrolled 294 children aged 7-11. Adjusted average prescription progression was -0.60 D with high-add (+2.50 D) multifocal lenses, compared with -1.05 D with single-vision contact lenses. Adjusted eye growth was 0.42 mm versus 0.66 mm. These results apply to the tested lens and study population. 5

This may suit a child who prefers daytime contact lenses and can manage lens care with family support. Contact lenses bring handling demands and a risk of infection of the eye surface, so the care routine is part of the treatment, not an optional extra. 2

3. Orthokeratology (ortho-k)

Ortho-k uses specially fitted rigid lenses worn during sleep to temporarily reshape the front surface of the eye. The lenses are removed during the day. It can also slow eye growth, but the temporary change in vision is not a cure for myopia. 1 2

The two-year ROMIO trial assigned 102 children aged 6-10 to ortho-k or single-vision glasses; 78 completed the study. Among completers, mean eye length increased by 0.36 mm with ortho-k versus 0.63 mm with glasses. Five children discontinued ortho-k because of adverse events. 6

The appeal is reduced reliance on daytime glasses. The trade-off is overnight contact-lens wear, careful fitting and a strict care routine. Eye-surface infection is a material risk to discuss when weighing this option. 2

4. Low-concentration atropine eye drops

Atropine is a medication used in different concentrations to slow myopia progression. It does not replace the glasses or contact lenses needed for clear vision. Concentration matters: “low-dose atropine” is not one uniform treatment. 1 2 4

The one-year LAMP trial enrolled 438 children aged 4-12 and compared 0.05%, 0.025% and 0.01% atropine with placebo. Average progression was -0.27 D with 0.05% atropine versus -0.81 D with placebo; eye growth was 0.20 mm versus 0.41 mm. Of the three concentrations tested, 0.05% had the greatest effect over that year. 4

Drops avoid contact-lens handling, but they add a medication routine. Light sensitivity and near blur are possible, particularly at higher concentrations. The concentration, response and stopping plan need to be considered together, because progression can accelerate after stopping some treatments. 1 2

What about spending more time outdoors?

Outdoor time is especially useful when talking about delaying the onset of myopia. It is not interchangeable with treatment for a child who is already myopic. 1 7

In a Guangzhou school trial, an extra 40-minute outdoor class each school day, together with encouragement for families to spend more time outdoors, reduced new myopia over three years. Among eligible children without myopia at the start, 30.4% in the intervention group developed myopia, compared with 39.5% in the control group. That is an absolute difference of 9.1 percentage points, not a 9.1% reduction in an existing prescription. 7

The trial supports making outdoor time a regular part of childhood. It does not show that outdoor activity alone will stop progression once a child is short-sighted. 1 7

How to read treatment claims without being misled

Do not choose a treatment by comparing percentages from separate advertisements or trials. A one-year study in younger children and a three-year study in older children do not provide a fair head-to-head comparison. Different designs, starting prescriptions and control groups can change the apparent effect. 1

The 2025 International Myopia Institute review describes several effective options. The 2025 Cochrane review, which included 104 studies and 17,509 children and searched the evidence to February 2024, puts more weight on uncertainty: studies varied, most followed children for two years or less, and unwanted effects were not consistently reported. Both perspectives matter when interpreting an individual trial. 1 2

The figures above are trial averages, not a forecast for a particular child. The question is whether a suitable treatment, used consistently and checked over time, is slowing that child’s progression. 1 2

Questions to take to the next eye examination

• How much has the prescription changed, and do we have axial-length measurements to compare?
• Which options fit this child’s age, prescription, eye health and ability to manage the routine?
• What evidence supports the exact lens design or atropine concentration being offered?
• What are the likely unwanted effects, care requirements and full costs?
• When will progress be checked, and what would lead us to continue, change or stop the plan?

A useful plan names the treatment, the daily routine and how response will be measured. There is no single winner for every child; matching an evidence-backed option to the child and checking the response is more useful than chasing the largest advertised percentage. 1 2

Sources

1. Bullimore et al. IMI: Interventions for Controlling Myopia Onset and Progression 2025. International Myopia Institute / IOVS, 2025.
2. Lawrenson et al. Interventions to slow the progression of short-sightedness in children. Cochrane, 2025.
3. Lam et al. DIMS spectacle lenses: a 2-year randomised clinical trial. British Journal of Ophthalmology / PMC, 2020 (online 2019).
4. Yam et al. Low-Concentration Atropine for Myopia Progression (LAMP) study. Ophthalmology / PubMed, 2019.
5. Walline et al. The BLINK randomized clinical trial. JAMA, 2020.
6. Cho and Cheung. Retardation of Myopia in Orthokeratology (ROMIO) study. IOVS / PubMed, 2012.
7. He et al. Effect of time spent outdoors at school on the development of myopia. JAMA / PubMed, 2015.