What is myopia control and why it’s important

• Myopia is a progressive eye disorder which affects vision, quality of life and increases eye health risks across a person's lifetime
• Myopia typically starts before age 10 and then deteriorates every few to several months until it stabilizes in the late teens or early 20s
• Myopia control treatments are available to slow down the progression, or worsening, of childhood myopia. These include special types of spectacle lenses (glasses), soft contact lenses, ortho-k contact lenses and atropine eye drops
• Myopia control has short-term benefits of better vision between eye exams and long-term benefits of protecting eye health
• Considering your child or teenager's time spent outdoors and screen time are also important factors in managing myopia

Myopia causes blurred vision for far distance objects, but as myopia increases, the blur can start to be noticed even at arm's length or closer. It is also known as short-sightedness or near-sightedness.

Myopia typically starts developing before age 10, and then progresses or worsens every few to several months in children and teenagers. It is caused by the eyes growing too quickly and too long for the normal rate of eye growth. In children, the eyes are meant to grow steadily until the teenage years, then stabilize. In myopia, though, the eyes grow too quickly leading to rapid and continual deterioration of vision and continued eye growth through the teenage years and even in early adulthood.^1-3 This ongoing deterioration is called myopia progression.

Myopia has traditionally been corrected by spectacles (glasses) or contact lenses, which fix the focus of the eye to create clear vision while they are worn, but do not fix the myopia. This simple correction option - single vision glasses or contact lenses - have been found to offer no protection against myopia progression.⁴

Myopia is not just about a pair of glasses. Once myopia in children and teenagers onsets, it typically progresses or worsens every few months until the late teenage or early adulthood years.²

Myopia progression brings with it:

• Increasingly blurred vision
• The need for frequent changes in spectacle or contact lens prescription
• Increased risk of eye diseases and vision problems over a person’s lifetime⁵

'Myopia control' has become the increasingly adopted term to describe the use of treatments aimed to slow progression of myopia. These treatments include special types of spectacle lenses (glasses), soft contact lenses, ortho-k and atropine eye drops. Myopia control is particularly important for children, because this is the stage in life when myopia is most likely to progress or worsen quickly.²

Myopia control is also important in teenagers as their vision can still be worsening, albeit at a slower rate than in younger children. Around half of teenagers reach stability of their myopia progression around age 16,² but this means half are still progressing, so ideally myopia control treatment should continue into early adulthood.

Young adults can also suffer myopia progression, albeit at a slower rate than children and teenagers. Recent data indicates that young adults can also newly experience myopia in their 20s, even after a childhood of normal vision.³

Myopia control or myopia management are terms used interchangeably to describe the extra clinical care required for children and adults with myopia. Generally, myopia control means slowing down myopia progression with spectacle, contact lens or atropine eye drop treatments. Myopia management can be a term taking in the whole picture including discussing other lifestyle and environmental factors which can trigger myopia progression, and also managing eye health.

Myopia control treatments have been mostly researched in children from around age 6 through to 16. There is less evidence for effective treatments for kids younger than this, or for teens and young adults older than this. Read more in Which is the best option for myopia control?

The appearance of myopia in young children under 6 years of age is less usual and can be associated with concerning general health conditions. To understand more about myopia in this age group, read our article Progressive myopia in babies and toddlers and how to manage it.

Someone with myopia has to wear glasses or contact lenses to correct their blurred distance vision. However if you have lower myopia, you’re more functional in the mornings before you put your glasses or contact lenses on; you can cope a little better without them rather than being disabled without them. Also, if your child does decide to have laser eye surgery to correct their myopia in adulthood, a lower prescription means both more likelihood of them being suitable, and better visual outcomes after surgery.⁹

The short-term benefits of myopia control are better vision and quality of life.

The long-term benefits of myopia control are reducing the risks of eye health problems and vision impairment across a person's lifetime.

Myopia in children and teens may just seem like it's just about needing a pair of glasses. However, as childhood myopia worsens, the eye is growing at an accelerated rate. The eyes are meant to grow in childhood, at a regular rate up until age 10 to 12. However if they grow too quickly or don’t stop at age 10 to 12, then a child becomes myopic.¹

This excessive growth of the eye stretches the retina – the light sensitive layer lining the back of the eye – and the stretching increases risk of eye diseases and vision impairment occurring across your child’s lifetime.⁵

A normal eye length is 22 to 24mm. When the eye grows to longer than 26mm, the risk of your child suffering vision impairment in their lifetime is 25%. If the eye grows to more than 30mm, which can occur in very high myopia, the risk skyrockets to 90%.

Myopia control is about slowing down this excessive eye growth, ideally to the normal rate expected in childhood. Even at levels of myopia traditionally thought of as quite ‘low’, there are increased risks of eye diseases compared to someone who is not myopic – see the table below.⁸

There is much research showing that a child or teenager's visual environment can increase their risk of myopia onset and progression. The visual environment includes considering the following factors:¹⁰

• How much time does your child or teen spend outdoors? Increasing outdoor time to around 2 hours per day on average can help delay myopia.
• How much time do they spend on screens and/or reading? Holding books or screens too close and long durations of use without breaks increases myopia risk.

Your optometrist or eye doctor will also talk about goals for outdoor time and screen or near work time to help manage your child's myopia. These can be important factors to ensure the best possible outcomes with myopia control treatments.

It’s important to see myopia for what it really is – a health condition of the eyes which increases risk of vision problems and eye diseases.^5,8 It’s not just about a pair of glasses, and it can’t just be ‘fixed’ with laser surgery because once the eye grows too long, this can't be reversed and the eye health risk will always be a concern.

The number of children and adults with myopia is increasing around the world. Myopia is a lifelong condition and increases risk of potentially sight threatening conditions in later life, leading the World Health Organization to classify myopia as a global health concern.¹¹

Myopic macular degeneration, an eye disease which affects central vision, is already the leading cause of vision impairment in working-aged adults in China and Japan, where levels of myopia are very high.^12,13 

The good news is that this story can be different for your child, and for this generation of kids, with myopia control.

There are numerous myopia control treatments now available for children and teenagers. These treatments can't promise to stop myopia progression but have much evidence for slowing it down. By slowing down myopia progression, your child or teenager is likely to end up with a lower final amount of myopia than they would have without treatment^.7,14

When myopia stops progressing in the late teens or early 20s,^2,3 with a lower final amount of myopia, your child will have better vision-related quality of life, an easier path to laser eye surgery (should they want it) and lower risk for eye health and vision problems for the rest of their life.^9,14

Talk to your optometrist or eye doctor about which options are available in your country and suitable for your child or teenager.

Your child’s eye care practitioner or eye doctor (optician, optometrist or ophthalmologist) may use the following Infographic from MyopiaProfile.com to summarize the ‘why’ of myopia management, including the short-term and long-term goals, and the lifetime eye health risks which come with increasing levels of myopia. We developed the Infographics because using pictures in health communications has been shown to improve learning and application of advice between health professionals, patients and their parents or carers.¹⁵ 

This is part of a set of four infographic panels which describe visual environment advice, treatment options, contact lens wear in kids, and why myopia management is essential.