Eye health resource
Myopia Control Options: Ortho-K, Atropine, and Soft Contact Lenses
Compare the three myopia-management options Park Slope Eye currently offers: Ortho-K, low-dose atropine, and soft multifocal or myopia-control contact lenses.
Reviewed for accuracy by Justin Bazan, OD on .
Myopia control, also called myopia management, is care designed to slow how quickly a child's nearsightedness progresses. It is different from simply making blurry distance vision clear with ordinary glasses or contact lenses.
Park Slope Eye currently offers three main approaches: Ortho-K, low-dose atropine, and appropriate soft multifocal or myopia-control contact lenses. All three have evidence supporting their use, but they differ substantially in daily routine, contact-lens involvement, side effects, and what makes a child a good candidate.
No treatment can guarantee that myopia will stop progressing. The goal is to reduce progression when possible while keeping the child seeing clearly and using a treatment that fits the child's eyes, maturity, lifestyle, and family preferences.
Quick Comparison: Which Myopia-Control Option Is Which?
Ortho-K
What it is: specially designed rigid gas-permeable contact lenses worn overnight and removed in the morning.
Daily-life advantage: many children can see clearly during the day without ordinary glasses or daytime contacts.
Best fit when: the child and family are comfortable with overnight lens wear, careful cleaning, handling, and regular follow-up.
Main trade-offs: it requires contact-lens maturity, consistent hygiene, and sleeping in a lens that has been specifically fitted for overnight use. No contact lens is risk-free.
Low-Dose Atropine
What it is: a low-concentration atropine eye drop generally used once daily for myopia management.
Daily-life advantage: no contact-lens handling is required, and the child's regular glasses can continue to provide vision correction.
Best fit when: a family prefers a medication-based approach or contact lenses are not a good fit.
Main trade-offs: atropine for myopia control is used off-label in the United States, response varies, and some children may experience light sensitivity or near-vision effects depending on concentration and individual response.
Soft Myopia-Control or Multifocal Contact Lenses
What they are: soft daytime contact lenses designed with more than one optical power or treatment zone so they can correct vision while changing optical signals related to myopia progression.
Daily-life advantage: they provide daytime vision correction and myopia management in the same lens.
Best fit when: the child is ready for daytime contact lenses and can follow safe wear, handling, and replacement instructions.
Main trade-offs: lens comfort, prescription range, corneal health, tear film, handling ability, and safe contact-lens habits all matter.
Is One Option Proven to Be Best?
No single treatment is best for every child. Current myopia research supports multiple effective approaches, including orthokeratology, soft myopia-control contact lenses, atropine, and certain myopia-control spectacle designs.
The right question is usually not “Which treatment wins?” but “Which evidence-based treatment is most appropriate for this child and most likely to be used correctly and consistently?”
What Is Myopia?
Myopia means nearsightedness. In a myopic eye, distant objects focus in front of the retina instead of directly on it. This commonly happens because the eye has grown too long from front to back relative to its focusing power.
Myopia often begins in childhood and can continue to progress while the eye is growing. Genetics matter, but environment and visual habits also play a role.
Why Does Slowing Myopia Matter?
A stronger myopic prescription can mean greater dependence on glasses or contact lenses. More importantly, higher levels of myopia are associated with greater lifetime risk of retinal detachment, myopic macular degeneration, glaucoma, and cataract.
Myopia management does not eliminate those risks. The aim is to reduce how myopic the child ultimately becomes.
How Does Ortho-K Work?
Ortho-K uses specially designed rigid gas-permeable lenses worn while sleeping. The lens temporarily changes the shape of the corneal surface. After the lens is removed in the morning, many patients can see clearly for much of the day without ordinary correction.
Its myopia-control effect is separate from the daytime freedom from glasses. Because it involves overnight contact-lens wear, careful fitting, hand hygiene, cleaning, water avoidance, and scheduled follow-up are essential.
Learn more in All About Ortho-K Lenses and How Overnight Contact Lenses Work to Control Myopia.
How Does Low-Dose Atropine Work?
Low-dose atropine eye drops may be prescribed off-label in the United States to help slow myopia progression in appropriate children. “Off-label” means the medication is being used for a purpose that is not specifically listed on its FDA-approved label.
The treatment should not be explained as simply “paralyzing the focusing muscles.” The biological mechanism of myopia control is more complex and continues to be studied. Concentration, expected benefit, possible side effects, and follow-up should be individualized.
How Do Soft Myopia-Control Contact Lenses Work?
Specially designed soft contact lenses can correct distance vision while also changing peripheral or multifocal optical signals in a way intended to slow myopia progression.
Some products have specific FDA authorization for pediatric myopia control, while other multifocal designs may be used based on clinical evidence and professional judgment. The lens should be selected for the child's prescription, corneal health, age, lifestyle, and ability to wear contacts safely.
What About Myopia-Control Glasses?
Newer spectacle-lens designs specifically intended for myopia management also exist, and current research supports some of these designs. Park Slope Eye's current myopia-management options are Ortho-K, low-dose atropine, and soft multifocal or myopia-control contact lenses, so we do not imply that every treatment discussed in the broader literature is currently offered here.
Ordinary single-vision glasses are still excellent for correcting blurry distance vision. They simply are not, by themselves, a myopia-control treatment.
Can Lifestyle Help?
Regular outdoor time is associated with a lower risk of developing myopia and remains a useful recommendation for children. Near-work habits may also matter, but it is too simplistic to say that phones or computers alone cause myopia.
For a child who is already myopic and progressing, healthy visual habits and outdoor time remain worthwhile, but they should not be presented as a substitute for an indicated myopia-management treatment.
How Do We Choose Among Ortho-K, Atropine, and Soft Contacts?
We look at the whole child rather than only the prescription. Factors can include:
- age and maturity;
- current prescription and how quickly it has changed;
- corneal and ocular-surface health;
- contact-lens readiness and hygiene;
- sports, school, sleep, and daily routine;
- comfort with eye drops or lens handling;
- family preferences and ability to maintain follow-up; and
- how the child responds once treatment begins.
Combination treatment can sometimes be considered in myopia management, but it is not automatically better for every child and should be individualized rather than used simply because two treatments exist.
How Do We Know Whether Myopia Control Is Working?
Myopia management requires follow-up. We compare prescription changes, visual acuity, eye-health findings, contact-lens performance when applicable, and the child's overall progression pattern.
Park Slope Eye does not currently offer axial-length measurement. We therefore do not imply that axial length is being tracked in our office. If outside testing or referral would add useful information for a particular child, that can be discussed.
Does My Child Need a Comprehensive Eye Exam First?
Yes. A comprehensive eye exam is required before starting myopia management at Park Slope Eye. If a comprehensive examination was completed elsewhere within about three months, we can generally use it as long as we receive a copy of the complete exam record. An eyeglass prescription by itself is not enough. If we do not have documentation of the recent comprehensive examination, we will need to perform one before proceeding with myopia-management care.
Learn more about myopia management and Ortho-K at Park Slope Eye, children's eye exams, or book an appointment online.
Originally published . Substantially updated .