Which is the best option for myopia control?

• Standard, single-vision spectacles or contact lenses do not offer any protection against myopia and are not an effective treatment.
• Treatment options for myopia control in children and teenagers include specialized glasses and soft contact lenses, orthokeratology lenses, atropine eye drops, and light therapies. Each treatment works in different ways to slow the worsening of myopia.
• The optimal treatment depends on a variety of factors including the child’s prescription, eye health, lifestyle and preferences, and what is available in your region. Success also depends on consistent wear and healthy visual habits.

Myopia (near-sightedness) causes blurred vision for objects at a distance, but at higher degrees of myopia, even objects at an arm’s length or closer can appear blurry.

In the majority of cases, myopia develops during childhood (8-13 years), and typically worsens throughout the schooling years through to early adulthood, where it stabilizes.1 Although standard single-vision glasses and contact lenses offer a simple fix by correcting vision when the lenses are worn, these lenses do not protect against myopia progression. 

Myopia control describes the use of treatments that aim to slow the worsening of myopia, particularly in children and teenagers as their eyes are still developing. By slowing myopia progression, a child will end up with less myopia once they reach adulthood.2

Having less myopia comes with a wealth of benefits, like better quality vision and more stable lens prescriptions. Perhaps the biggest benefit of avoiding high myopia, is having significantly less risk of developing eye diseases such as retinal detachment and macular degeneration.3

Specialized glasses for myopia control have the ability to slow myopia progression and correct vision, at the same time. 

Unlike previous approaches like bifocal and progressive lenses, newer designs have shown high potential for treating myopia progression.4 The most effective lenses now use specially designed patterns, containing ‘mini-lenses’ that change how light is processed within the eye. When a child wears myopia control glasses, their eyes receive signals that help to promote normal eye growth.

There are a variety of effective myopia control lenses for glasses, including:

• Essilor Stellest
• HOYA MiYOSMART
• SightGlass Vision DOT
• Zeiss MyoCare and MyoCare S

Myopia control glasses look and feel like regular glasses, making them a simple and safe option for most children. Many children adapt quickly to wearing these lenses and enjoy clear, comfortable vision at all distances. Glasses are especially suitable for younger children, but active children may prefer to wear contact lenses.

Soft contact lenses for myopia control are specially designed to correct vision while also helping to slow the eye growth that causes myopia to worsen in children. 

Similar to myopia control glasses, myopia control soft contact lenses work by slightly changing how light is focussed in the eye, which helps to encourage normal eye growth. Different products achieve this in unique and innovative ways, such as dual-focus, concentric power rings, or extended-depth-of-focus optical designs.

There are several effective soft contact lenses for myopia control, including:

• CooperVision MiSight® 1 day
• Johnson & Johnson Abiliti™ 1-day
• Menicon Bloom Day
• VTI NaturalVue® Multifocal 1 day
• Mark’ennovy MYLO
• Seed 1dayPure EDOF
• CooperVision Biofinity® Multifocal (centre-distance only)

Soft contact lenses are a popular choice for older children and teens, because they offer clear vision without the need for glasses, making them convenient for sports and active lifestyles. Many children quickly adapt to wearing contact lenses and find them comfortable and natural, providing both vision correction and effective myopia control in one treatment.

Once children are taught how to handle contact lenses, they are safe and easy to use as long as proper hygiene is followed. 

Orthokeratology, often called ortho-k, is a treatment that uses specially designed rigid contact lenses worn overnight to gently reshape the front surface of the eye (the cornea). 

While sleeping, the lenses temporarily flatten the cornea so that vision is clear during the day without the need for glasses or daytime contact lenses. In addition to providing clear vision, this reshaping generates a myopia control effect that helps slow down the eye growth responsible for myopia progression. 

Ortho-k products that have been designed specifically for myopia control include:

• CooperVision DreamLite® MC
• Paragon CRT®
• Johnson & Johnson Abiliti™ Overnight Therapeutic Lenses
• Menicon Bloom Night

Ortho-k is a popular choice for active children and teens because it provides freedom from glasses or contact lenses during the day. There are significant benefits for water sports and active lifestyles, and since the contact lenses are only worn overnight, there is minimal risk of the lenses getting lost or broken. 

Ortho-k lenses are safe and effective for myopia control, with a strong track record in research that dates back many years.4,5 Compared to other treatments, ortho-k users require more frequent follow-up visits with an optometrist, to ensure the lenses continue to fit well and the eyes remain healthy.

When atropine eye drops are used for myopia control, they are prescribed at very low concentrations (0.01%–0.05%).6,7 Unlike glasses or contact lenses, atropine does not correct blurred vision, so children still need to wear their usual lenses for clear vision.6

It is not certain how atropine slows myopia progression, but research suggests that atropine affects how chemical signals are conducted in the retina – the light sensitive layer at the back of the eye. 

Atropine can be effective for treating children with worsening myopia, or when glasses or contact lens-based treatments alone aren’t sufficient. Studies have discovered that when atropine is combined with other myopia control treatments, especially ortho-k, the effects of myopia control can be further enhanced.8

At low doses, atropine is well tolerated and comes with minimal side effects. Some children may notice mild light sensitivity or slight difficulty focusing up close, but these effects are temporary and can be managed with tinted lenses if needed.

Repeated low-level red light (RLRL) therapy is a new and promising approach to slowing myopia progression, though it has been used for decades as an alternative treatment for amblyopia (lazy eye).

RLRL therapy uses a specialized device to deliver red light from the visible spectrum (650 ± 10 nm) to control eye growth and myopia progression. Aside from its innovative approach, it has gained a lot of interest for being effective at controlling myopia and eye growth.9,10 It is supported by a growing body of research from around the world, including in China, Australia, Japan, US, UK, and Singapore.

Current light therapy options include:

• Eyerising Myopia Management Device

RLRL therapy is convenient and easy to use, as it is performed at home under the guidance of an eye care professional. In the case of the Eyerising International RLRL device, the device is used for 180 seconds at a time, twice a day, for 5 days per week. 

Like atropine, RLRL therapy does not involve vision-correcting lenses, so it is normally used either in combination with glasses or contact lenses, or as a standalone treatment.

RLRL therapy is safe when used correctly, but possible side effects include temporary afterimages in vision. Children starting RLRL treatment should have their eye health monitored regularly.

The best myopia control treatment is the one that:

• Is effective at controlling myopia
• Can be used consistently
• Fits a child’s individual needs

Based on current research evidence, the top treatments in each category are able to achieve similar levels of effect.5,6,11-15 Most of these are proven to slow myopia progression in children and teenagers by at least half, compared to kids wearing standard lenses. The treatments listed are supported by clinical trials generally involving kids from around 6–16 years old. If your child falls outside of this age range, the treatment may still work, so long as expectations are reasonable.

Consistent use is key to getting the most out of myopia control. Glasses and contact lenses are go-to options because they both correct blurred vision and help control myopia progression at the same time. Unlike atropine or light therapies, these treatments don’t require significant changes to daily routine. Wearing the lenses as often as possible leads to the most effective results.

The best option for your child also depends on your child’s capacity, preferences, and lifestyle. For example, younger children may find handling contact lenses more challenging, although they can typically handle them well from age 6–8. Teenagers may find the atropine not as easy to tolerate, as it can cause mild vision-related side effects. Soft contact lenses and ortho-k are great options for children involved in sports and extracurricular activities.

Managing myopia involves more than treatment alone. Just like regular exercise can strengthen the effects of medication for weight control,16 good lifestyle habits can enhance the success of myopia management. Encouraging more outdoor time and practising healthy habits during screen time and close work can further protect a child’s vision and eye health.

The range of treatments available can vary between regions and different practitioners. For personalized advice, talk to your optometrist or eye doctor.