Myopia in Children: Why It's Increasing and Proven Ways to Slow Its Progression

Table of Contents

• Key Points
• What Is Myopia and Why Does It Matter?
• The Global Myopia Epidemic: Key Numbers
• Genetics vs. Environment: Why Some Children Develop Myopia
• Outdoor Time and Near Work: What the Research Shows
• The Pandemic Effect: Digital Devices and Myopia Risk
• Red Light Therapy: A New Home-Based approach
• Pharmacological Treatments: Atropine, Pirenzepine, and 7-Methylxanthine
• Atropine Eye Drops: The Most Studied Treatment
• Pirenzepine: A Selective Alternative
• 7-Methylxanthine: An Oral Tablet Option
• Optical, Contact Lens, and Surgical Options
• Clinical Implications: What This Means for Patients
• Limitations of Current Research
• Recommendations for Parents and Patients
• Frequently Asked Questions
• Source Information

Key Points

• Myopia prevalence is projected to rise from 1.4 billion in 2000 to 4.8 billion by 2050.
• Children with two myopic parents have up to a 43.6% risk of myopia, versus 7.6% with none.
• Atropine eye drops are the most studied treatment; 0.05% was optimal over 3 years in the LAMP study.
• Outdoor time is protective in most studies, but a 6,295-child trial found no significant association.
• Combining atropine with multifocal or bifocal lenses may slow progression more than either alone.

What Is Myopia and Why Does It Matter?

Myopia, commonly called nearsightedness or shortsightedness, is the most widespread refractive error in the world. In a myopic eye, the eyeball is typically too long (increased axial length), so when light enters the eye, the image of a distant object is focused in front of the retina instead of directly on it. The result is blurred distance vision that requires glasses, contact lenses, or surgery to correct.

The consequences of myopia go far beyond needing glasses. Uncorrected myopia impairs quality of life, reduces school performance, and limits future employability. Perhaps more concerning, even properly corrected myopia can lead to serious complications later in life.

These complications include staphyloma (an outpouching of the back wall of the eye), glaucoma, cataracts, choroidal neovascularization (abnormal blood vessel growth under the retina), and retinal problems such as tears, schisis (a splitting of retinal layers), and retinal detachment. Together, these complications carry significant economic implications for public health systems — a major reason why researchers worldwide are focusing on stopping myopia before it progresses.

The Global Myopia Epidemic: Key Numbers

The scale of the problem is staggering. In the year 2000, myopia affected approximately 1.4 billion people globally. By 2050, that number is projected to reach 4.8 billion — roughly half of the world's expected population.

While myopia is increasing everywhere, the highest rates are found among schoolchildren in East Asia, Singapore, China, Taiwan, and South Korea. A large European meta-analysis including 61,946 adults found that myopia prevalence rose from 17.8% (95% CI: 17.6–18.1) in people born between 1910 and 1939 to 23.5% (95% CI: 23.2–23.7) in those born between 1940 and 1979 (P<0.03). This demonstrates that the increase is not limited to Asia — it is a global phenomenon.

Sex and developmental stage also appear to matter. The Correction of Myopia Evaluation Trial (COMET) suggested that males show slower myopia progression than females. A Chinese study by Xu and colleagues found that girls who had not yet reached menarche (their first menstrual period) had a 13% higher risk of myopia when adjusted for exact age and behavioral risk factors — pointing to a possible hormonal influence on myopia development.

Genetics vs. Environment: Why Some Children Develop Myopia

The old saying "like parent, like child" holds true for myopia. The Northern Ireland Childhood Errors of Refraction (NICER) study showed that the risk of myopia is 2.91 times higher in children with one myopic parent and 7.79 times higher in children with two myopic parents. Another study placed the risk figures at 7.6%, 14.9%, and 43.6% for children with zero, one, or two myopic parents, respectively.

Myopia is classified into two categories. Syndromic myopia is linked to a known genetic mutation and occurs as part of broader conditions such as Marfan syndrome or congenital stationary night blindness. Nonsyndromic myopia has no single clear genetic mutation but is associated with variations (polymorphisms) in multiple genes. A large genome-wide association study called CREAM identified 24 gene locations (loci) associated with myopia, which together can increase the risk of developing myopia by up to 10-fold.

Yet genes do not tell the whole story. Strong evidence suggests the environment plays a pivotal role in nonsyndromic myopia. Researchers have found associations with time spent outdoors, near work (like reading and screen use), the use of LED lamps for homework, population density, socioeconomic status, and the use of video terminals. In other words, modern lifestyles are actively driving the myopia epidemic in genetically susceptible children.

Outdoor Time and Near Work: What the Research Shows

One of the most studied questions in myopia research is whether spending time outdoors protects children's eyes — and whether hours of reading and screen time harm them. The findings are extensive but sometimes conflicting.

A research review by Eppenberg and Sturm analyzed data from 32,381 participants aged 6 to 18 years, drawn from two cross-sectional studies, seven prospective cohort studies, and three intervention studies published between October 2008 and January 2019. Five of the nine cross-sectional studies found an inverse association between outdoor time and myopia — meaning more outdoor time was linked to less myopia.

Specific studies reported these key findings:

• Dirani and colleagues: Children who spent more time outdoors had significantly lower myopia rates, with an odds ratio (OR) of 0.90 (95% CI: 0.84–0.96, P=0.004). Outdoor sports time was longer in non-myopic children (0.85 hours/day, SD 0.80) than myopic children (0.72 hours/day, SD 0.82, P=0.007).
• Sun and colleagues: Longer outdoor time reduced myopia risk with an OR of 0.74 (95% CI: 0.53–0.92, P<0.001).
• Jones-Jordan and colleagues: A study of 514 children found that non-myopic children did significantly more sports and outdoor activities than myopic children — 11.65 hours/week (SD 6.97) vs. 7.98 hours/week (SD 6.54), with P<0.001.
• Guggenheim and Saxena: Confirmed a later onset of myopia in children who spent more time outside, with relative risks of OR = 0.90 (95% CI: 0.45–0.96) and R = 0.54 (95% CI: 0.37–0.79; P=0.002).
• Wu and colleagues: Children encouraged to spend more time outdoors had a slower myopic shift, with an OR of 0.46 (95% CI: 0.28–0.77; P=0.003).

However, the picture is not uniformly clear. One large school-based, prospective, cluster-randomized trial involving 6,295 children — randomized into a control group (n=2,037), test group I (n=2,329, receiving 40 minutes of outdoor time per day), and test group II (n=1,929, receiving 80 minutes per day) — failed to demonstrate any significant association between outdoor time and myopia development or progression. Some other studies (Jordan-Jones, Ma, Hsu, and He) also reported no association.

Why the conflicting results? The authors point to several biases. Most studies relied on questionnaires to measure near work and outdoor activity — data that can be influenced by geography, culture, age, memory, and personal perception. Additionally, only some studies used complete cycloplegic refraction (eye drops that temporarily paralyze the focusing muscle for accurate measurement), and different drugs (tropicamide vs. cyclopentolate) were used, making results hard to compare.

Despite these inconsistencies, the overall weight of evidence supports the protective role of outdoor time. Two main mechanisms may explain it:

1. Light wavelength: Sunlight peaks at a wavelength of about 550nm, which matches the peak sensitivity of the human eye. Indoor light peaks at a longer wavelength, causing more light beams to focus behind the retina — a situation similar to what happens with a negative lens. This has been shown to stimulate eye growth and myopia.
2. Dopamine release: Sunlight stimulates the release of dopamine in the retina. In animal studies using day-old white Australorp cockerels, researchers placed a translucent diffuser over the birds' eyes and kept them on a 12:12 hour light/dark cycle. The birds developed excessive axial length (myopia) — but when the diffuser was removed for just 3 hours during the light period, axial growth stopped. Injecting dopamine directly into the vitreous (the jelly-like fluid inside the eye) blocked axial growth, while dopamine antagonists had the opposite effect.

What about near work? A meta-analysis covering studies published between April 1, 1989, and May 1, 2014, totaling 10,384 participants aged 6–18 years, found that near activities are associated with myopia, with a pooled OR of 1.14 (95% CI: 1.08–1.20). Children who did more near work were more likely to be myopic (OR = 1.85; 95% CI: 1.3–2.62; I² = 85%), and myopia risk increased by 2% (OR = 1.02; 95% CI: 1.01–1.03; I² = 42.8%) for every diopter-hour increase in near work per week.

The Generation R Study, conducted in Rotterdam, followed 5,074 children born between 2002 and 2006. Computer use at age 3 was significantly associated with myopia at ages 6 and 9 years (OR = 1.005, 95% CI: 1.002–1.010 and OR = 1.009, 95% CI: 1.002–1.017, respectively). Cumulative computer time in infancy also correlated with myopia at age 9 (OR = 1.005, 95% CI: 1.001–1.009). Interestingly, the study found that longer outdoor exposure reduced the effect of near-vision activities. However, a prospective study by Oner and colleagues found that only reading and writing had a negative association with annual myopic progression (r = −0.362, P = 0.010), while computer use, television watching, and outdoor activities showed no correlation. Yet other studies (Tan and colleagues) reported no statistically significant relationship between near activities and myopia progression in children.

The authors note that different near-vision activities may affect myopia differently depending on light levels, word sizes, and working distances. While accommodation (the eye's focusing mechanism) and convergence (eyes turning inward) during prolonged near work have long been suspected as triggers, a strong association between accommodation and myopia has not actually been found. Experimental studies suggest that forced hyperopic defocus (when light focuses behind the retina) is a significant stimulus for eye growth.

The Pandemic Effect: Digital Devices and Myopia Risk

The COVID-19 pandemic, which began in 2020, dramatically changed children's habits. Lockdown measures increased screen time and reduced outdoor activity, raising concerns among eye specialists about a surge in myopia.

Wong and colleagues reviewed studies on the association between computer, tablet, or smartphone use and myopia. Their conclusion: current evidence is inconclusive, but the majority of studies suggests a higher risk of myopia in people spending more time on digital screens. They argued that the pandemic period could potentially aggravate myopia by increasing exposure to digital devices, with possible long-term negative impacts on children's vision.

In response to this concern, the American Ministry of Education (U.S. Department of Education) recommends spending less than 20 minutes per day on electronic homework and prohibits phones and tablets in classrooms.

Red Light Therapy: A New Home-Based Approach

One of the most intriguing recent developments is exposure to red light at a 650nm wavelength, delivered at home using a desktop light therapy device. At the 12-month follow-up visit, the group given red light therapy had a 70% reduction in myopia progression, and 32% of patients in this group also had an axial length shortening of at least 0.05mm — meaning their eyeballs actually grew slightly shorter.

The authors caution that further studies with double-masking (where neither patients nor researchers know who receives treatment) and placebo-controlled groups are needed to confirm the long-term efficacy and safety, explore possible rebound effects, and determine optimal treatment strategies and underlying mechanisms.

Pharmacological Treatments: Atropine, Pirenzepine, and 7-Methylxanthine

Medication is one of the most powerful tools in the fight against myopia progression. The review covers three main drug strategies: atropine, pirenzepine, and 7-methylxanthine.

Atropine Eye Drops: The Most Studied Treatment

Atropine is a nonselective muscarinic antagonist — a drug that blocks certain nerve signals. Originally, doctors used it because it paralyzes the eye's focusing muscle (cycloplegia), since accommodation was thought to drive myopia. However, animal studies later revealed that atropine's effect on myopia is likely mediated by non-accommodative mechanisms.

Atropine has an affinity for all five subtypes of acetylcholine receptors, which are distributed throughout ocular tissues and scleral fibroblasts (cells in the white part of the eye). Studies in mice and humans have shown that these muscarinic receptor antagonists inhibit scleral cell proliferation and, in turn, suppress axial elongation of the eyeball.

The exact mechanism is still not fully established. Some studies show that atropine increases retinal dopamine, which may stimulate nitric oxide release as part of a signaling chain. Other research has suggested involvement of GABAergic signaling or alpha-2 adrenergic receptors. One hypothesis proposes that atropine's pupil-dilating effect increases UV exposure to the eye, controlling scleral growth through collagen cross-linking — though the authors note this theory conflicts with the fact that tropicamide (another pupil-dilating drug) does not control myopia progression.

The ATOM Study (Atropine in the Treatment of Myopia): This landmark randomized, double-masked, placebo-controlled trial in Singapore enrolled over 400 children aged 6 to 12 years. Children received 1% atropine eye drops for two years, followed by a one-year suspension. After two years, the results demonstrated a 77% reduction in myopia progression compared with the placebo group (−0.28 ± 0.92 diopters vs. −1.20 ± 0.69 diopters, P<0.001). However, there was no significant change in axial length compared to baseline (−0.02 ± 0.35mm). During the washout phase, stopping atropine caused a rebound effect in both refraction and axial length, but the final progression remained lower in the atropine-treated group than in the control group.

The downside of 1% atropine is significant side effects: photophobia (light sensitivity), blurred vision, and reduced accommodation. Many children required bifocal or progressive lenses just to read comfortably while on treatment.

Shih and colleagues' dose-response study: A two-year study of 200 Taiwanese children treated with 0.5%, 0.25%, or 0.1% atropine found a dose-dependent reduction in myopia progression: 61%, 49%, and 42% respectively, compared with children treated with tropicamide as a control (annual progression of −0.04 ± 0.63D, 0.45 ± 0.55D, and 0.47 ± 0.91D in the 0.5%, 0.25%, and 0.1% atropine groups, respectively, versus −1.06 ± 0.61D in the control group).

The ATOM2 Study: This follow-up trial evaluated lower doses — 0.5%, 0.1%, and 0.01% atropine — instilled for 24 months, followed by a 12-month washout. The results showed a dose-related effect, with higher doses producing greater inhibition of myopia progression: −0.30 ± 0.60D, −0.38 ± 0.60D, and −0.49 ± 0.63D in the 0.5%, 0.1%, and 0.01% groups, respectively. The difference between the 0.01% and 0.5% groups was statistically significant (P = 0.02), as were differences between other concentrations (P = 0.05).

After stopping treatment, however, a greater rebound effect occurred in eyes treated with higher concentrations, while the 0.01% group experienced only a slight increase. After 36 months, myopia progression in the 0.01% group was −0.72 ± 0.72D, while the 0.5% and 0.1% groups progressed by −1.15 ± 0.81D and −1.04 ± 0.83D, respectively (P<0.001). The authors concluded that the lowest concentration (0.01%) appears to be the safest choice, causing fewer adverse effects while retaining similar efficacy to higher doses.

The LAMP Study (Low-concentration Atropine for Myopia Control): More recently, Yam and colleagues compared 0.05%, 0.025%, and 0.01% atropine eye drops and described a dose-related effect. Atropine 0.05% was the most effective at limiting both spherical equivalent (degree of myopia) and axial elongation. After two years, the efficacy of 0.05% atropine was double that of 0.01% atropine.

LAMP Phase 3: The most recent report, covering the third year of use, confirmed that continuing atropine achieved a better effect at all concentrations compared with a washout (treatment-stopping) regimen. Specifically, 0.05% atropine remained the optimal concentration over 3 years. The differences in rebound effects were clinically small across all three concentrations. Importantly, the younger the child when treatment stopped, the larger the rebound; children who stopped at an older age and at a lower concentration experienced smaller rebounds. This is likely explained by the slower natural (physiological) progression of myopia at older ages.

Combination therapy: Studies combining atropine with multifocal or bifocal lenses found lower rates of myopic progression with both 1% and 0.5% atropine plus multifocal/bifocal lenses, compared with placebo plus single-vision lenses.

In summary, atropine eye drops — alone or combined with other treatments — are proven to reduce myopic progression. Mild side effects (pupil dilation, photophobia, near blur) are common. To date, atropine treatment has been widely adopted in Asian countries such as Taiwan and Singapore.

Pirenzepine: A Selective Alternative

Pirenzepine is a selective M1 muscarinic receptor antagonist — a more targeted version of atropine. Several studies have demonstrated its effectiveness in controlling myopia progression in children. A study of myopic Asian children treated with pirenzepine 2% gel twice daily found a 44% reduction in myopic progression compared with the control group.

In a parallel-group, placebo-controlled, double-masked, randomized trial by Siatkowski and colleagues, children treated with 2% pirenzepine gel had a 41% reduction in myopic progression compared with placebo (0.58D vs. 0.99D after two years). However, the difference in axial length between the groups was not statistically significant. This United States-based trial found pirenzepine was well tolerated, with only mild to moderate adverse effects. Unfortunately, pirenzepine is currently not available as a treatment option for myopia.

7-Methylxanthine: An Oral Tablet Option

7-Methylxanthine, a nonselective adenosine antagonist, is used as a myopia treatment only in Denmark. Oral administration increases scleral collagen fibril diameter, amino acid content, and scleral thickening in rabbits — effects that could theoretically stiffen the eye wall and slow elongation.

A trial evaluated 400mg of 7-methylxanthine once daily in children compared with placebo. The results showed a modest effect (22%) on myopia progression in children with moderate axial growth rates at baseline, but no effect in individuals with rapidly progressing myopia. The treatment appeared safe, with no ocular or systemic side effects reported.

Optical, Contact Lens, and Surgical Options

Beyond medication, several optical strategies are available. These include bifocal and progressive addition spectacle lenses, soft bifocal/multifocal contact lenses, extended depth of focus (EDOF) lenses, and orthokeratology (corneal reshaping) contact lenses. According to the review's overall assessment, orthokeratology and peripheral defocus contact/spectacle lenses offer moderate efficacy in slowing myopia progression, while bifocal or progressive addition spectacles and increased outdoor activities have lower efficacy. These optical strategies are particularly relevant for children who cannot tolerate or do not wish to use daily eye drops.

Refractive surgery is generally reserved for special situations in children — specifically, for treating anisometropic amblyopia (lazy eye caused by a large difference in refractive error between the two eyes). The review explains that when a significant refractive difference exists between the eyes, spectacle correction can cause aniseikonia (images of different sizes in each eye) and interfere with stereopsis (3D depth perception). Glasses with high refractive errors can also create a narrower field of view, prismatically induced aberrations, and social stigma for children.

Contact lenses offer better quality of vision and a larger field of view, but poor compliance can be an issue due to intolerance and difficulty with insertion and removal.

In a study by Paysse, factors associated with failure of traditional amblyopia therapy include:

• Age older than 6 years
• Poor compliance with treatment
• Inadequate parental understanding
• Initial visual acuity of 20/200 or lower
• Presence of astigmatism greater than 1.5 diopters

Children with craniofacial or ear abnormalities, hearing aids, or neurobehavioral disorders may refuse to wear spectacles, placing them at risk of very poor vision in the amblyopic eye because conventional treatment is more challenging.

Only about two-thirds of cases of anisometropic amblyopia achieve good visual outcomes with conventional treatment. If myopic anisometropia exceeds 6 diopters, the chance of achieving a best-corrected visual acuity of 20/40 or better is only 25%.

Surgical options studied for this scenario include laser vision correction such as photorefractive keratectomy (PRK), laser-assisted subepithelial keratectomy (LASEK), laser-assisted in situ keratomileusis (LASIK), and phakic intraocular lens implantations (lenses placed inside the eye in front of or behind the iris, without removing the natural lens). The review notes that the application of refractive surgery for anisometropic amblyopia in children remains unclear, and more evidence is needed before firm recommendations can be made.

Clinical Implications: What This Means for Patients

For parents of myopic children, the take-home message is encouraging: myopia progression is not inevitable. Several evidence-based options exist to slow it down.

Atropine eye drops are the most thoroughly studied intervention. The dose matters: higher concentrations (1%, 0.5%) are more powerful but cause more side effects like light sensitivity and blurry near vision. Lower concentrations (0.01%–0.05%) offer a better safety profile with still-meaningful efficacy. The LAMP study identified 0.05% atropine as the optimal concentration over 3 years, offering twice the effectiveness of 0.01%. The ATOM2 study, however, favored 0.01% as the safest long-term choice with fewer side effects and the least rebound after stopping. These different findings highlight the need for individualized treatment decisions with an eye care professional.

Combination therapy — atropine combined with multifocal or bifocal lenses — appears to offer additional benefit over either treatment alone. This may be a good option for children with more rapid progression.

Outdoor time remains a simple, free, and universally available recommendation, even though its effect size is modest. Most studies support that more time outdoors (ideally over 14 hours per week) reduces both the risk of developing myopia and the rate of progression.

The evidence for digital device use is less definitive but concerning, especially in light of pandemic-related lockdowns. Parents can reasonably limit recreational screen time and ensure breaks from near work.

Limitations of Current Research

The authors of the review are careful to point out several important limitations in the evidence base:

• Questionnaire reliance: Nearly all studies on outdoor time, near work, and screen use collected data through questionnaires, which are subject to memory bias, cultural differences, and varying interpretations. This could explain the conflicting results between different studies.
• Measurement bias: Refraction measurements were not standardized across studies. Only some used full cycloplegic refraction (with paralyzing eye drops), and different types of drops (tropicamide vs. cyclopentolate) were used, making reliability and comparability of data questionable.
• Conflicting outdoor time evidence: The largest randomized trial (6,295 children) failed to find a statistically significant association between outdoor time and myopia progression, suggesting that the effect may be smaller than observational studies imply, or that other factors (such as light intensity) matter more than simply time spent outside.
• Rebound phenomena: Atropine withdrawal causes rebound myopia progression, particularly with higher doses. The optimal tapering strategy has not yet been definitively established.
• Incomplete understanding of mechanisms: The exact pathways by which atropine, dopamine, and light exposure influence scleral growth remain incompletely understood. Theoretical models clash on key points (such as whether pupil dilation and UV exposure play a role).
• Research gaps: Red light therapy and 7-methylxanthine need larger, properly masked, placebo-controlled trials to confirm their safety and long-term effectiveness. Pirenzepine is currently unavailable, limiting its clinical utility regardless of research results.

Recommendations for Parents and Patients

Based on the evidence presented in this review, here are practical steps parents can consider:

1. Encourage daily outdoor time. Aim for at least 14 hours per week (about 2 hours per day) of outdoor activity in natural daylight. Even if the effect is modest in some studies, it is safe, free, and has numerous other health benefits.
2. Discuss atropine treatment with a pediatric ophthalmologist. If your child shows rapid myopia progression, low-dose atropine (ranging from 0.01% to 0.05%) may be appropriate. Ask about the specific benefits, side effects, and the expected rebound risk when treatment eventually stops.
3. Consider combination approaches. For children at higher risk, atropine combined with multifocal or bifocal spectacles, or with peripheral defocus contact lenses / orthokeratology, may offer better control than either treatment alone.
4. Limit screen time and encourage frequent breaks. Follow the U.S. Department of Education guideline of less than 20 minutes per day on electronic homework where possible, and avoid phones/tablets in the classroom. For recreational use, ensure regular breaks from near viewing.
5. Monitor near work habits. This review found a 2% increase in myopia risk for every diopter-hour of near work per week. Ensure adequate reading distance, good lighting, and periodic visual breaks during study sessions.
6. Be aware of your family history. Children with two myopic parents carry a dramatically higher risk (up to 43.6% in one study), so earlier and more frequent eye examinations may be warranted.
7. Don't ignore amblyopia risk. If one eye has a significantly higher prescription than the other, prompt treatment matters. Traditional therapy succeeds in only about two-thirds of cases, and outcomes are poorer in older children, in those with high astigmatism, or when initial vision is very low (20/200 or worse).
8. Guard against known risk factors for treatment failure. Ensure treatment starts early (before age 6 where possible), maintain compliance, and make sure parents fully understand the treatment plan.

Every child is different, and myopia management should be individualized. A pediatric eye care specialist can help determine the most appropriate strategy based on the child's age, rate of progression, family history, personal tolerance of treatments, and lifestyle. Regular follow-up visits are essential to adjust treatment as the child grows.

Frequently Asked Questions

What is myopia and why is it more than just needing glasses?

Myopia, or nearsightedness, occurs when the eyeball is too long, causing distant objects to look blurry. Even with glasses, myopia can later lead to serious eye problems like retinal detachment, glaucoma, cataracts, and staphyloma. Uncorrected myopia also affects school performance and quality of life.

How much does family history increase a child's risk of myopia?

Risk is higher when parents are myopic. One study found children with one myopic parent had 2.91 times higher risk, and with two myopic parents, 7.79 times higher. Another study reported myopia rates of 7.6%, 14.9%, and 43.6% for children with zero, one, or two myopic parents.

Does spending time outdoors actually slow myopia progression in children?

Most studies suggest more outdoor time lowers myopia risk and slows progression. For example, one study found outdoor time reduced risk with an odds ratio of 0.74, and another found slower myopic shift with odds ratio 0.46. However, a large trial of 6,295 children found no significant association, so the effect may be modest.

How effective is atropine eye drop treatment for myopia, and what are the side effects?

Atropine is the most studied myopia treatment. In the ATOM study, 1% atropine reduced progression by 77% versus placebo. Lower doses like 0.01%–0.05% are also effective with fewer side effects. Common side effects include light sensitivity and blurred near vision, and higher doses cause more side effects.

What is red light therapy for myopia, and how well does it work?

Red light therapy uses a home device emitting 650nm wavelength light. In a study at 12 months, it reduced myopia progression by 70%, and 32% of children had axial length shortening of at least 0.05mm. The authors say more double-masked, placebo-controlled studies are needed to confirm long-term safety.

Can myopia progression be slowed by special glasses or contact lenses?

Yes. Orthokeratology and peripheral defocus contact or spectacle lenses have moderate effectiveness. Bifocal or progressive addition spectacles have lower effectiveness. These options help children who cannot use daily eye drops. Combining atropine with multifocal or bifocal lenses may give additional benefit over either treatment alone.

What practical steps can parents take to manage their child's myopia?

Encourage at least 14 hours weekly of outdoor time. Limit recreational screen time and take breaks from near work. Discuss low-dose atropine with a pediatric eye specialist if progression is rapid. Consider combination approaches for higher risk. Be aware of family history and ensure early, regular eye exams.

My child's myopia is progressing quickly and we've been advised to start atropine eye drops — when should we seek a second opinion?

When a child shows rapid progression and atropine is proposed, a second opinion can help clarify the dose and approach. Concentrations range from 0.01% to 0.05%; 0.05% was optimal over three years in one trial, while 0.01% caused the least rebound after stopping. Higher doses control progression more but cause more light sensitivity and blurred near vision. Combination therapy with multifocal or bifocal lenses may add benefit. A second opinion can also weigh orthokeratology, defocus lenses, or outdoor time. Diagnostic Detectives Network provides independent expert second opinions.

Source Information

Original Article: "Myopia: Mechanisms and Strategies to Slow Down Its Progression"

Authors: Andrea Russo, Alessandro Boldini, Davide Romano, Giuseppina Mazza, Stefano Bignotti, Francesco Morescalchi, and Francesco Semeraro

Journal: Journal of Ophthalmology, Volume 2022, Article ID 1004977, 20 pages

Publication Date: Published June 14, 2022 (Received February 2, 2022; Accepted May 29, 2022)

DOI: https://doi.org/10.1155/2022/1004977

Affiliations: Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Brescia, Italy; Centro Oculistico Bresciano, Brescia, Italy

Note: This patient-friendly article is based on peer-reviewed research. The original is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. It is a topical review article, meaning it synthesizes findings from multiple previously published studies rather than reporting a single new experiment. This translation is intended for educational purposes and does not replace professional medical advice.