Myopia control in children – what if it’s not working?

| |

It’s important to note that there’s nothing currently available which can promise to STOP myopia worsening in children (also called myopia progression). The current research and available options can work to SLOW DOWN myopia worsening – by about a third to a half on average, depending on the option selected and your child’s individual factors.

Generally, the younger a child is, the faster their myopia will progress. Especially under the age of 10, it’s realistic to expect your child’s myopia to still progress a little, even if they are under the best myopia management care. You can read more about this in the blog on when to start and when to stop myopia management.

Sometimes, though, a child’s myopia will progress faster than expected, even when a myopia control treatment option has been prescribed. There are many reasons why this can occur – here are some considerations and things to discuss with your child’s eye care professional.

The treatment isn’t ideal for your child

Remember that research results report averages; your child may be one who falls above the average in terms of myopia progression. Perhaps your child should be prescribed a stronger dosage of atropine eye drops, or changed from spectacle to contact lens options to increase the effectiveness of the treatment.

Not wearing or using the treatment enough

Perhaps your child isn’t wearing their spectacles or contact lenses enough, or having long breaks from wearing them over school holidays. Perhaps they’re blinking out the atropine eye drop and it’s not absorbing onto the eye. It’s important to investigate the reasons why with your eye care practitioner, to determine a successful strategy moving forward.

Eye muscle teaming and coordination

Particular eye muscle teaming disorders can be linked with faster progression of myopia. For example, a turned or lazy eye can mean a child doesn’t use that eye 100% of the time, which often leads to faster worsening of myopia. Your eye care practitioner may recommend additional strategies to manage eye teaming problems.

Higher myopia

Most myopia control studies investigating special spectacle lens, contact lens or atropine eye drop options are undertaken on children aged 6-14, with lower levels of myopia up to around -5.00 or -6.00. If your child is outside of this range – especially if they have myopia greater than this – they may not respond as expected by the ‘averages’ reported in research studies. They may need a different treatment or combination of treatments to achieve better efficacy, and the expectations for their treatment may not be the same as for children with lower myopia.

Too much screen time

If your child is wearing the best fitting Orthokeratology contact lenses in the world, but still spends all of their spare time staring at a screen and doesn’t go outside, the treatment effectiveness can be reduced. Any of the myopia control treatment options will have their best chance if your child’s visual environment – time spent outdoors and what they do with their eyes indoors – is also appropriately managed as best you can. Click here to read more about the visual environment.

What you can do about it

These issues can sometimes feel out of your control, and difficult for your child’s eye care practitioner to influence – especially higher myopia and the visual environment. An honest discussion between your child’s eye care practitioner, yourself and your child is typically the best way to work out the issue, ensure accurate expectations and find the best treatment strategy for your child’s myopia.


Close work and screen time in kids

Spectacle lens options for myopia in children