When to start and when to stop myopia management in children

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Myopia management or myopia control describes the domain of childhood eye care which is concerned with slowing down the typical worsening of short-sightedness (myopia) which occurs in childhood. Myopia can also onset and progress in early adulthood, but generally the greatest risk of someone developing high levels of myopia occurs when myopia onsets in early childhood, especially before age 10. Myopia control is achieved by prescribing special types of spectacles, contact lenses or atropine eye drops to slow down progression.

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

Click here to read more about myopia.

Click here to read more about why you may not have heard about myopia control before.

Click here to read more about what myopia control is for children, and why it’s important.

Click on the relevant words to read more about spectacle, contact lens and atropine eye drops options for myopia control.

When should myopia management start?

As soon as possible! The research evidence indicates that the earlier a child becomes myopic, the faster their blurred distance vision and glasses prescription will continue to worsen. If we are going to have the biggest impact on slowing myopia progression and reducing the final amount of myopia your child ends up with, we should act quickly.

Every child with myopia is likely to show progression, or worsening, until proven otherwise. There’s no reason to ‘wait and see if they get worse’… the odds are that they will!

Sometimes parents can be hesitant to start a myopia management strategy because they feel their child is too young. Some children can take time to learn to be compliant with wearing their glasses; or be ready for options like contact lenses, but usually maturity is a better gauge of this than their age. Contact lenses especially are very safe for children to wear, and in fact appear to be safer when worn by children (aged 8-12) than teenagers! Click here to read more about contact lens safety in children.

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Figure 1 from Donovan and co-authors 2012 (link), indicating that younger children show faster annual progression (worsening) of myopia.

A very proactive eye care practitioner may even tell you about pre-myopia – where risk factors indicate your child is on the road towards becoming myopic. This is normally defined by a child being less long-sighted than they should be for their age, and/or particular eye muscle coordination problems and/or a family history of myopia. Click here to read more about why regular children’s eye exams are important, and why perfect sight may not be so perfect. A child with pre-myopia is likely to be advised to spend more time outdoors, which is the best evidence-based intervention to delay the onset of myopia. Click here to read more about the childhood visual environment – indoors and outdoors.

It’s important to note that there’s nothing currently available which can promise to STOP myopia progression. The current research and available options can work to SLOW DOWN myopia progression – click here to read more about myopia control treatment options.

When can myopia management stop?

When your child is an adult! Research indicates that about half of children with myopia stop worsening by age 16. But this means that half are still progressing. A large scale study over at least seven years of follow up (link) showed that:

Half of myopic children stabilize by age 16
Three-quarters will stabilize by age 18
90% will stabilize by age 21.

So it’s most likely that you and your child’s eye care practitioner will need to think about myopia management until your child finishes school and even college or university. Children who spend less than 3 hours a day on nearwork (reading and screen time ASIDE from school time, whether for homework or leisure) are more likely to stabilize by age 16. (link)

The myopia control strategy prescribed for your older teenager or young adult-aged child may differ than that prescribed in earlier childhood – contact lens options may become more suitable to both correct the blurred vision of myopia as well as control myopia progression. It is important to take into account their visual demands and personal factors in selecting the right strategy – for example, long hours of study, night driving and reduced or irregular sleep can all influence the best treatment choice.

Once myopia is stable, the young adult with myopia still needs regular eye exams to monitor their eye health, as higher levels of myopia bring with them higher risks of eye diseases and even vision impairment in adulthood. Click here to read more about why myopia management is important.


Contact lens options for myopia in children

What is myopia control for children – and why it’s important