Eye health resource
How Can You Help Keep Myopia From Worsening?
No treatment can guarantee that myopia will stop progressing, but evidence-based myopia management can slow progression in many children. Learn about outdoor time, Ortho-K, low-dose atropine, and myopia-control contact lenses.
Reviewed for accuracy by Justin Bazan, OD on .
No treatment can guarantee that a child's myopia will stop getting worse, but evidence-based myopia management can slow progression in many children. The goal is to give the child clear vision now while also trying to reduce how much nearsightedness develops over time.
That is different from simply prescribing stronger glasses whenever the prescription changes.
What Is Myopia Progression?
Myopia, or nearsightedness, usually occurs when the eye grows too long from front to back relative to its focusing power. Distant objects then focus in front of the retina and appear blurry.
Myopia often begins during childhood and may continue to progress while the eye is growing. The rate and duration vary from child to child.
Why Does Slowing Myopia Matter?
Every increase in myopia generally means a stronger prescription. Higher levels of myopia are also associated with greater lifetime risk of eye-health problems including retinal detachment, myopic macular degeneration, glaucoma, and cataract.
Myopia management cannot erase that risk, but reducing the amount of progression can reduce how myopic a child ultimately becomes.
What Causes Myopia to Worsen?
There is no single cause. Genetics and environment both contribute. Children with myopic parents are at higher risk, but family history is not destiny.
Less outdoor time and patterns of intensive near work are associated with myopia development and progression. Screens are one form of near work, but it is too simplistic to say that screens alone “cause” myopia.
Does More Outdoor Time Help?
Outdoor time is one of the strongest lifestyle factors associated with a lower risk of developing myopia. Regular outdoor activity is a healthy recommendation for children and may be especially valuable before myopia begins.
For a child who is already myopic and progressing, outdoor time remains worthwhile but should not be presented as a substitute for an indicated myopia-management treatment.
Myopia-Management Options at Park Slope Eye
Park Slope Eye currently offers several approaches depending on the child's prescription, age, eye health, lifestyle, and family preferences.
Ortho-K
Orthokeratology uses specially designed rigid gas-permeable lenses worn overnight. They temporarily reshape the corneal surface so the lenses can be removed in the morning and useful daytime vision can be maintained without ordinary daytime glasses or contacts.
Ortho-K can also slow myopia progression in many children. Because it involves overnight contact lens wear, careful hygiene, proper fitting, and scheduled follow-up are essential.
Low-Dose Atropine
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.
Atropine should not be explained simply as “relaxing focusing fatigue.” The mechanism behind its myopia-control effect is more complex and is still being studied. Concentration, expected benefit, possible light sensitivity or near-vision effects, and the follow-up plan should be discussed with the prescribing doctor.
Soft Myopia-Control or Multifocal Contact Lenses
Specially designed soft contact lenses can correct vision while also changing peripheral optical signals in a way intended to slow myopia progression.
Some products have specific FDA authorization for slowing pediatric myopia, while other lens designs may be used based on clinical judgment and evidence. The exact lens should be chosen for the child's prescription, eye health, age, and ability to wear contact lenses safely rather than assuming all multifocal contacts provide the same myopia-control effect.
What About Ordinary Single-Vision Glasses?
Ordinary single-vision glasses are excellent for correcting blurry vision but are not designed as a myopia-control treatment. They should still be prescribed accurately; deliberately undercorrecting myopia is not recommended as a progression-control strategy.
Newer spectacle-lens designs intended specifically for myopia management also exist. Availability and whether a particular product is appropriate can change, so treatment decisions should be based on current evidence and the child's individual needs.
How Do We Know Whether Treatment Is Working?
Myopia management requires follow-up. We compare prescription changes, vision, eye-health findings, lens performance when applicable, and the overall progression pattern over time.
Park Slope Eye does not currently offer axial-length measurement, so we do not imply that this metric is being collected in our office. If outside testing or referral would add meaningful information for a particular child, that can be discussed.
When Should a Child Be Evaluated?
Children who are squinting at distance, moving close to the television or classroom board, reporting distance blur, or showing a changing prescription should have a comprehensive eye examination.
For low-risk children, current pediatric guidance includes an assessment in the first year of life, at least one comprehensive exam between ages 3 and 5, and an exam before first grade with annual examinations thereafter. A child with progressive myopia or other risk factors may need additional follow-up.
Start With an Individual Plan
There is no single “best” myopia treatment for every child. Park Slope Eye offers myopia-management care using Ortho-K, low-dose atropine, and appropriate soft multifocal/myopia-control contact lenses.
If your child's nearsightedness is progressing, book an appointment so we can discuss the reasonable options, expected benefits, limitations, and follow-up.
Originally published . Substantially updated .