The cost and benefits of myopia management

• Controlling myopia progression helps children enjoy clear, consistent vision and less eye strain.
• Lower levels of myopia lead to a decreased chance of serious eye complications, which can be financially and emotionally burdensome in the long run.
• Stable myopia means longer intervals between prescription updates, ultimately reducing eyewear costs over time.

Imagine your child who has been struggling to see distant objects has just been diagnosed with myopia (nearsightedness). Their newly prescribed glasses have instantly improved their distance vision. But a year later? Your child is squinting to see again and their prescription has now doubled. Alarmingly, this is becoming an increasingly common situation, as more young people in the world are developing myopia.

Myopia comes from uncontrolled eye growth and tends to progress in school aged children.³ Although myopia is a common eye condition, it brings an array of health risks to the eye⁴ that makes it more than just a vision problem. Even with proper corrective lenses or laser eye surgery, any degree of myopia – even mild myopia, increases the risk of moderate-to-severe vision loss, and this risk rises with more severe levels of myopia.⁵

Standard, single vision glasses or contact lenses offer a short-term fix, like plugging a small hole in a sinking boat: it keeps the immediate problem at bay but doesn’t prevent new leaks from forming. To learn more about myopia, see What is myopia?.

Definition

Myopia management is the evidence-based standard of care that encompasses the eye examination, prescription, treatment and follow-up of myopia across a person’s lifespan. Eye care guidelines and professional bodies in optometry and ophthalmology recognize the importance of actively managing myopia.

Treating myopia

Research has come a long way into developing treatments to combat myopia – called ‘myopia control’. The options for myopia control in children and teenagers include specialty glasses lenses, soft contact lenses (e.g. dual focus contact lenses), orthokeratology (ortho-k) and atropine eye drops. Each of these categories has effective options for slowing down progression.

Eye care has also shifted from simply correcting vision to a more proactive and holistic approach. Eye care practitioners are also equipped to discuss the ways to manage your child’s myopia through lifestyle changes. A child or teenager's vision, eye health and general health can be influenced by their visual environment - how much time they spend outdoors^7,8 and indoor activities such as screen time.^9,10 Learn more about this in The Childhood Visual Environment.

Making well-informed decisions to treat your child’s myopia progression can bring everyday benefits that last a lifetime. Let’s explore three key benefits of myopia management.

Stress-free daily life

A significant yet often overlooked perk of myopia management is its impact on a child’s daily vision. When myopia remains mild or progresses more slowly your child can perform their usual daily activities with more ease and comfort. New glasses and stronger prescriptions may be accompanied by a period of eye strain, which can last up to 4 weeks.¹¹ With a more stable prescription, less time is spent dealing with adjustments to glasses, and the lenses can work well for longer periods of time.

Activities that require clear vision and coordination like sports or dance become easier with less severe myopia.¹² Kids won’t have to use heavy glasses that might affect their performance, or worry about how long they need to spend putting in their contact lenses.

Preserving healthy vision

Myopia management is arguably more rewarding in the long-term than short-term, because every step in prescription that is slowed translates to a step in vision saved. As myopia worsens, the eyeball elongates, stretching the retina and other delicate tissues. This renders the eye vulnerable to developing serious eye diseases later in life, such as retinal detachment.⁴

Higher levels of myopia weaken the macula and amplify the risk of myopic macular degeneration, resulting in permanent blind spots and damage to vision.¹³ Glaucoma also becomes more common, as eyes with high myopia are less resilient to high pressure within the eye over time.¹⁴ Similarly, cataracts may develop earlier and more aggressively in people with high myopia.¹⁵

Each of these disorders carries considerable burden—financial, emotional, and practical—affecting a person’s independence and quality of life. Slowing progression is an investment towards preserving a child’s eye health when they’re older, sparing them from future medical procedures or complications. Even a modest reduction in final prescription equates to a noteworthy decrease in the likelihood of these vision-threatening issues.¹⁶

Lower level of final myopia 

Starting early offers the best opportunity to shape lifelong vision as well as eye health. In children who have been initially diagnosed, the myopia tends to get worse.¹⁷ When myopia worsens and the eye starts elongating, it doesn’t revert back to its original shape. In other words, it’s not possible to cure myopia naturally or even by surgical means. Read more in Can myopia be cured or reversed?.

The aim of myopia management is to minimize or prevent myopia progression. More years of myopia control treatment are likely to result in less final amount of myopia once the child becomes older.¹⁸ That’s why it is recommended to start myopia management as early as possible, to make the biggest impact on slowing myopia progression.¹⁸ Learn more about this in When should we start myopia control and when should we stop?.

Specialty lenses cost more to fit and manufacture compared to standard lenses, and atropine eye drops involve recurring medication expenses.¹⁹ This raises the question whether the higher upfront costs of myopia control are justified. It turns out that over the long-term myopia management actually saves money.

Comparing the costs

Experts concluded in 2022 that across a person’s lifetime, myopia management is generally better value-for-money than wearing standard single-vision correction (no treatment).²⁰ This is particularly true for children who are on track to developing myopia of moderate to high levels. Costs were calculated using the real-world cost of professional appointments, glasses and contact lenses, glasses frames, and eye medications in Australia and China.

The graphs below show how these costs compare.

Why myopia management ends up the cheaper option

To understand where the cost savings lie in myopia control, consider the pitfalls from only wearing traditional correction. Children wearing traditional correction will experience steadily worsening prescriptions, leading to frequent updates in glasses or contact lens strengths. If the child progresses to moderate or high myopia, more expensive or technical lenses are required to keep maintain clear and comfortable vision.²⁰ Severely nearsighted individuals may face higher lifetime expenses if eye complications arise, such as macular degeneration. Over the years, these costs add up.

At first glance, myopia management appears to be pricier than standard correction. The availability and costs of different treatments will vary between countries; but in general, myopia control carries higher upfront costs compared to standard single vision lenses.

While there may be ongoing costs in starting myopia management, these pay off with the long-term savings linked to slower prescription increases and reduced risk of expensive surgical treatments later in life.²¹ 

Discuss your child’s vision needs and lifestyle with your optometrist or eye doctor, to identify which myopia management method will be the most suitable for your child.