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
In this article
Myopia is more significant than just needing glasses for blurred vision. Myopia regularly progresses in children and teenagers, affecting their quality of life and increasing eye health risks. Myopia control treatments can give kids better vision now, and healthier eyes in the long term.
- What is myopia?
- What is myopia control?
- Who is suitable for myopia control treatment?
- What are the benefits of myopia control?
- Myopia control is about quality of life
- Myopia control is about protecting eye health
- What else is important in myopia management?
- The bad news about myopia
- The good news about myopia
What is 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
To learn more see our page What is myopia?
What is myopia control?
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.
There are many treatment options available to slow myopia progression in children and teenagers, and some evidence for treatments in young adults. Read more in Which is the best option for myopia control?
Who is suitable for myopia control treatment?
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.
Children aged 6-10 years tend to show the most rapid progression, or worsening, of their myopia.6 This means it is crucial to start a myopia control treatment as soon as possible.7
Read more in our article When should we start myopia control and when should we stop?
What are the benefits of myopia control?
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
Myopia control is about quality of life
The short-term benefits of myopia control are better vision and quality of life.
With myopia control, children and teenagers will undergo less frequent changes in their prescription. With vision being more stable and deteriorating less between eye examinations, children and teenagers will have better vision for school, sport and other daily activities.
The long-term benefits of myopia control are reducing the risks of eye health problems and vision impairment across a person's lifetime.
Research has shown that more myopia leads to higher lifelong risks of eye diseases like cataract, retinal detachment and macular degeneration. Even low levels of myopia can increase the risk of eye diseases compared to someone who doesn't have myopia.8 Higher levels of myopia also increase the risk of suffering vision impairment in a person's lifetime.5
Each additional diopter of myopia (-1.00D or 4 steps of power) can affect vision-related quality of life and increases the risk of eye diseases occurring across a person's lifetime.9
Myopia control is about protecting eye health
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 myopic eye is longer, or more stretched, than a normally sighted eye due to excessive eye growth.
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
A table showing the increased risk of eye diseases with higher levels of myopia.8 The risk of these eye diseases for someone who is not myopic is ‘1’ – these are odds ratios, indicating the multiple of increased risk for that eye disease by the level of myopia. For example, a -1.00D myope has a 2.1x increased risk of cataract and a 3.1 x increased risk of retinal detachment compared to someone who is not myopic.
Laser eye surgery doesn't 'fix' myopia. It can fix the blurred vision from myopia but doesn't fix the excessive eye length which brings with it increased eye health risks in myopia. Even after an adult has laser surgery for myopia, their eye health will still be at increased risk from this excessive eye length, and require ongoing monitoring.
What else is important in myopia management?
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.
The bad news about myopia
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 about myopia
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.
- Mutti DO, Hayes JR, Mitchell GL, Jones LA, Moeschberger ML, Cotter SA, Kleinstein RN, Manny RE, Twelker JD, Zadnik K; CLEERE Study Group. Refractive error, axial length, and relative peripheral refractive error before and after the onset of myopia. Invest Ophthalmol Vis Sci. 2007 Jun;48(6):2510-9. doi: 10.1167/iovs.06-0562.
- Hou W, Norton TT, Hyman L, Gwiazda J; COMET Group. Axial Elongation in Myopic Children and its Association With Myopia Progression in the Correction of Myopia Evaluation Trial. Eye Contact Lens. 2018 Jul;44(4):248-259.
- Lee SS, Lingham G, Sanfilippo PG, Hammond CJ, Saw SM, Guggenheim JA, Yazar S, Mackey DA. Incidence and Progression of Myopia in Early Adulthood. JAMA Ophthalmol. 2022 Feb 1;140(2):162-169.
- Donovan L, Sankaridurg P, Ho A, Naduvilath T, Smith EL 3rd, Holden BA. Myopia progression rates in urban children wearing single-vision spectacles. Optom Vis Sci. 2012 Jan;89(1):27-32.
- Tideman JW, Snabel MC, Tedja MS, van Rijn GA, Wong KT, Kuijpers RW, Vingerling JR, Hofman A, Buitendijk GH, Keunen JE, Boon CJ, Geerards AJ, Luyten GP, Verhoeven VJ, Klaver CC. Association of Axial Length With Risk of Uncorrectable Visual Impairment for Europeans With Myopia. JAMA Ophthalmol. 2016 Dec 1;134(12):1355-1363.
- Tricard D, Marillet S, Ingrand P, Bullimore MA, Bourne RRA, Leveziel N. Progression of myopia in children and teenagers: a nationwide longitudinal study. Br J Ophthalmol. 2021 Mar 12:bjophthalmol-2020-318256.
- Gifford KL, Richdale K, Kang P, Aller TA, Lam CS, Liu YM, Michaud L, Mulder J, Orr JB, Rose KA, Saunders KJ, Seidel D, Tideman JWL, Sankaridurg P. IMI - Clinical Management Guidelines Report. Invest Ophthalmol Vis Sci. 2019 Feb 28;60(3):M184-M203.
- Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res. 2012 Nov;31(6):622-60.
- Bullimore MA, Brennan NA. Myopia Control: Why Each Diopter Matters. Optom Vis Sci. 2019 Jun;96(6):463-465. (link)
- Jonas JB, Ang M, Cho P, Guggenheim JA, He MG, Jong M, Logan NS, Liu M, Morgan I, Ohno-Matsui K, Pärssinen O, Resnikoff S, Sankaridurg P, Saw SM, Smith EL 3rd, Tan DTH, Walline JJ, Wildsoet CF, Wu PC, Zhu X, Wolffsohn JS. IMI Prevention of Myopia and Its Progression. Invest Ophthalmol Vis Sci. 2021 Apr 28;62(5):6.
- The impact of myopia and high myopia. Report of the Joint World Health Organization-Brien Holden Vision Institute Global Scientific Meeting on Myopia. 2015
- Tang Y, Wang X, Wang J, Huang W, Gao Y, Luo Y, Lu Y. Prevalence and Causes of Visual Impairment in a Chinese Adult Population: The Taizhou Eye Study. Ophthalmology. 2015 Jul;122(7):1480-8.
- Iwase A, Araie M, Tomidokoro A, Yamamoto T, Shimizu H, Kitazawa Y; Tajimi Study Group. Prevalence and causes of low vision and blindness in a Japanese adult population: the Tajimi Study. Ophthalmology. 2006 Aug;113(8):1354-62.
- Bullimore MA, Ritchey ER, Shah S, Leveziel N, Bourne RRA, Flitcroft DI. Ophthalmology. 2021 Nov;128(11):1561-1579.