Myopia, commonly called nearsightedness, affects millions of people worldwide and is especially prevalent in children and young adults. While eyeglasses and contact lenses can correct blurry distance vision, other treatment approaches aim to slow down the worsening of this condition during the critical childhood years. Understanding your options—from traditional corrective lenses to innovative management strategies being studied in clinical settings—can help protect long-term eye health.

Understanding Treatment Goals for Nearsightedness

Managing myopia involves two distinct yet complementary approaches. The first focuses on restoring clear vision so you can see distant objects like road signs or classroom whiteboards without strain. The second, particularly important for children, aims to slow down how quickly the condition worsens over time. This second goal has become increasingly important as researchers have learned that higher levels of myopia increase the risk of serious eye problems later in life, including retinal detachment (when the light-sensitive tissue at the back of the eye pulls away from its normal position), glaucoma (increased pressure in the eye that can damage the optic nerve), and early cataracts (clouding of the eye’s natural lens).^[1][2]

Treatment decisions depend on several factors. These include the severity of nearsightedness, the age when it first appeared, how rapidly it is progressing, and whether one or both parents have myopia. For school-age children, myopia often starts between ages 6 and 14 and tends to worsen until the late teens or early twenties, when eye growth typically stabilizes. Adults whose myopia has stabilized may choose different correction methods than children whose eyes are still growing. Each person’s lifestyle—including hobbies, sports participation, and screen time habits—also influences which treatment approach makes the most sense.^[1][6]

Standard treatments approved by medical societies focus primarily on correcting vision. These include eyeglasses, regular contact lenses, and surgical procedures for adults. Meanwhile, ongoing research explores interventions designed specifically to slow myopia progression in children, with several options now showing promising results in clinical trials and real-world use.^[9]

Standard Vision Correction Methods

The simplest and most widely used method to correct myopia is eyeglasses. These lenses work by bending light rays entering the eye so they focus properly on the retina—the light-sensitive layer at the back of the eye that sends visual signals to the brain. Standard single-vision eyeglasses are considered the safest correction option, especially for children, because they carry virtually no risk of infection or complications. They are also easily adjusted as prescriptions change, which happens frequently during childhood as myopia progresses.^[1][2]

Regular contact lenses offer an alternative to glasses. They sit directly on the surface of the eye and provide a wider field of clear vision compared to eyeglasses, which can be beneficial for sports and active lifestyles. Contact lenses come in two main types: soft lenses made of flexible plastic that conforms to the eye’s shape, and rigid gas-permeable lenses made of firmer material that allows oxygen to pass through to the cornea. Soft lenses are often easier for new wearers to adapt to, while rigid lenses may provide sharper vision for some prescriptions. Both types require proper hygiene and care to prevent eye infections, which represent the main safety concern with contact lens wear. Daily disposable lenses, which are discarded after each use, carry the lowest infection risk.^[2][13]

For adults whose myopia has stabilized—typically after age 20—surgical options permanently reshape the cornea to improve focus. LASIK (laser-assisted in situ keratomileusis) is the most common procedure. During LASIK, a surgeon creates a thin flap on the cornea’s surface, then uses a laser to reshape the underlying tissue before replacing the flap. PRK (photorefractive keratectomy) works similarly but reshapes the cornea’s surface directly without creating a flap. PRK may be recommended for people with thinner corneas. Both procedures aim to reduce or eliminate the need for glasses or contacts, though they don’t address the underlying eye lengthening that caused myopia or reduce associated health risks.^[2][13]

Another surgical option involves implanting a prescription lens inside the eye, either between the cornea and iris or just behind the iris. These implantable collamer lenses (ICL) may be suitable for people with very high levels of myopia whose corneas are too thin for laser surgery. Unlike laser procedures that permanently alter corneal tissue, implantable lenses can potentially be removed if needed.^[2][13]

Approaches to Slow Myopia Progression in Children

Unlike standard vision correction, myopia management specifically targets the underlying eye growth that causes nearsightedness to worsen in children. Several approaches have emerged from clinical research, with varying amounts of scientific evidence supporting their effectiveness. These interventions don’t cure myopia or reverse existing nearsightedness, but they can slow the rate at which it progresses, potentially reducing the final level of myopia a child reaches by adulthood.^[9][12]

Low-dose atropine eye drops represent one of the most studied myopia control treatments. Atropine is a medication traditionally used after eye surgery or injury, and in higher concentrations (1%) to temporarily dilate the pupil during eye examinations. However, researchers discovered that much lower concentrations can slow myopia progression without causing the significant light sensitivity and blurred near vision associated with higher doses. Multiple studies worldwide have shown that 0.01% atropine—a concentration 100 times weaker than the standard formulation—effectively slows eye growth in myopic children while producing minimal side effects. Because this low concentration isn’t commercially available, it must be prepared by specialized compounding pharmacies. The eye drops are typically used once daily at bedtime, usually for at least one to two years, though the optimal duration continues to be studied.^[10][11]

Specialized contact lenses designed to slow myopia progression have gained significant attention. Multifocal soft contact lenses feature different zones that correct vision at multiple distances simultaneously. While the center of the lens provides clear distance vision, the surrounding areas create a specific pattern of focus that researchers believe signals the eye to slow its elongation. Several designs have shown effectiveness in clinical trials. Most notably, MiSight contact lenses became the first FDA-approved treatment specifically for myopia control in the United States. These daily disposable soft lenses must be fitted by an eye care professional trained in their use and worn for at least five hours daily to be effective.^[11][12]

Orthokeratology, often abbreviated as Ortho-K, uses rigid gas-permeable contact lenses worn only during sleep. Overnight, these specially designed lenses gently reshape the cornea’s surface. Upon waking, the lenses are removed, and the person can see clearly throughout the day without glasses or daytime contacts. The reshaping effect is temporary—the cornea gradually returns to its original shape if lens wear stops—so the lenses must be worn every night to maintain both the vision correction and progression-slowing effects. Ortho-K requires more frequent fitting appointments than other contact lens types and carries the same infection risks as any contact lens wear, though proper hygiene minimizes these risks. Clinical evidence suggests Ortho-K can slow myopia progression, though the exact mechanisms remain under investigation.^[11][12]

Specially designed spectacle lenses represent the newest addition to myopia management options. Unlike standard glasses, these lenses incorporate hundreds of tiny “lenslets”—miniature lenses about 1 millimeter in size—scattered across the lens surface, or use light diffusion techniques. These design elements create a particular pattern of focus on the retina that appears to signal the eye to slow its growth. Recent clinical trials have shown that these advanced spectacle designs can significantly slow myopia progression compared to standard glasses, with the advantage that they work similarly to regular eyeglasses in terms of daily use and safety. Bifocal spectacle lenses, which have two distinct zones for distance and near vision, show a moderate effect on slowing progression, though they are less effective than the newer lenslet designs.^[12]

Research consistently shows that no single treatment clearly outperforms all others—specialized spectacle lenses, soft multifocal contact lenses, Ortho-K, and low-dose atropine appear to have roughly similar effectiveness in slowing myopia progression. The best choice for an individual child depends on many factors including age, prescription strength, lifestyle, hobbies, and family preferences. Some eye care professionals combine treatments, such as using atropine drops along with specialty glasses or contacts, though more research is needed to determine if combining approaches provides additional benefits.^[12]

Lifestyle Factors and Environmental Modifications

Beyond optical and pharmaceutical interventions, environmental factors significantly influence myopia development and progression. These lifestyle modifications complement other treatments and may help reduce risk, though they don’t replace prescription treatments for children whose myopia is already progressing rapidly.^[9][20]

Time spent outdoors emerges consistently as one of the most protective factors against myopia development. Multiple studies have found that children who spend at least two hours daily outdoors are less likely to develop myopia and experience slower progression if they already have it. Researchers believe that exposure to bright natural light—significantly brighter than indoor lighting even on cloudy days—may trigger beneficial changes in eye growth. The protective effect seems to come from outdoor time itself rather than physical activity, as indoor sports don’t show the same benefit. Encouraging outdoor play during recess, after school, or on weekends represents a simple, cost-free strategy that supports overall health while potentially protecting vision.^[8][20]

Screen time and prolonged close work have attracted attention as potential myopia risk factors, though the evidence is more complex than for outdoor time. Extended periods focusing on smartphones, tablets, computers, or reading materials may contribute to myopia development and progression, particularly when these activities replace outdoor time. Some large studies have noted correlations between high screen use and increased myopia rates, with one finding that excessive smartphone use combined with computer work was associated with an approximately 80% higher myopia risk. The mechanism may involve constant focusing on nearby objects, which places sustained demand on the eye’s focusing system. However, for many children and adults, completely avoiding screens isn’t realistic given educational and work requirements.^[1][4]

The 20-20-20 rule offers a practical compromise for managing screen time: every 20 minutes, look at something at least 20 feet (about 6 meters) away for at least 20 seconds. This brief break allows the eye’s focusing muscles to relax. Additionally, maintaining a reasonable distance from screens and reading materials—at least the length from elbow to hand when the arm is extended—and ensuring good lighting conditions may reduce eye strain, though more research is needed to determine if these practices actually slow myopia progression.^[15][20]

Regular comprehensive eye examinations form the foundation of myopia management. For children at risk—those with one or both parents who have myopia, or who show early signs of nearsightedness—yearly eye exams allow early detection and intervention. Some eye care professionals recommend twice-yearly exams for children with rapidly progressing myopia, as this allows more frequent monitoring and timely adjustment of treatment approaches. Early childhood eye exams, even before school age, can identify children who are likely to become myopic, creating opportunities for preventive strategies before significant myopia develops.^[10][15]

Most Common Treatment Methods

• Eyeglasses
  • Standard single-vision lenses that correct blurry distance vision by bending light to focus properly on the retina
  • Considered the safest correction method with virtually no risk of complications
  • Easily adjusted as prescriptions change during childhood
  • Newer specialized designs with lenslets or diffusion technology that can slow myopia progression in children
  • Bifocal lenses showing moderate effects on slowing progression
• Contact Lenses
  • Standard soft or rigid gas-permeable lenses for vision correction with wider field of clear vision than glasses
  • Multifocal soft contact lenses designed to slow myopia progression, including FDA-approved MiSight daily disposables
  • Orthokeratology (Ortho-K) rigid lenses worn overnight to temporarily reshape the cornea, allowing clear daytime vision without correction and slowing progression
  • Require proper hygiene to prevent eye infections, with daily disposables carrying the lowest risk
• Atropine Eye Drops
  • Low-dose formulations (typically 0.01%) used once daily at bedtime
  • Slow myopia progression in children with minimal side effects compared to higher concentrations
  • Prepared by specialized compounding pharmacies as commercial low-dose formulations aren’t widely available
  • Typically used for one to two years or longer, with treatment duration still being studied
• Surgical Procedures
  • LASIK surgery using laser to reshape the cornea permanently after creating a thin surface flap
  • PRK surgery reshaping the cornea surface directly without creating a flap, suitable for thinner corneas
  • Implantable collamer lenses placed inside the eye for people with very high myopia or thin corneas
  • Generally reserved for adults after myopia has stabilized, typically after age 20
  • Correct vision but don’t reduce eye health risks associated with eye lengthening
• Lifestyle Modifications
  • Spending at least two hours daily outdoors in natural bright light
  • Following the 20-20-20 rule for screen breaks: every 20 minutes, look 20 feet away for 20 seconds
  • Maintaining appropriate distance from screens and reading materials
  • Regular comprehensive eye examinations, yearly or twice yearly for at-risk children
  • Early childhood eye exams before school age to identify at-risk children

Clinical Trials and Emerging Research

While several myopia control treatments have already reached clinical practice, researchers continue investigating why these interventions work and how to make them more effective. Understanding the biological mechanisms behind myopia progression remains a major focus. Studies explore how signals from the retina influence eye growth, why outdoor light exposure provides protection, and which specific optical designs most effectively slow progression. This foundational research aims to develop even better treatments in the future.^[9]

Clinical trials examining different concentrations of atropine continue worldwide. Researchers seek to determine the optimal concentration that provides maximum benefit with minimal side effects, as well as how long treatment should continue for lasting effects. Some studies explore whether starting atropine earlier, before myopia becomes severe, provides better outcomes. Others investigate what happens when treatment stops—whether myopia progression rebounds to the rate it would have been without treatment, or whether the benefits persist.^[9][10]

Advanced spectacle lens designs continue to evolve through clinical testing. Researchers are studying different patterns and distributions of lenslets, varying the size and number of these tiny optical elements to optimize the signal sent to the retina. Some trials compare different designs head-to-head to determine which provides the greatest slowing effect. Studies typically follow children for two to three years to measure how much their myopia progresses with different lens types, comparing results to standard single-vision lenses.^[12]

Contact lens research explores new multifocal designs and investigates which children respond best to different lens types. Some clinical trials test whether certain prescription ranges, ages, or progression rates predict better outcomes with particular lens designs. Researchers also study whether combining optical treatments—such as wearing multifocal contacts during the day while using low-dose atropine drops at night—provides additive benefits beyond single treatments alone. These combination therapy trials represent an active area of investigation.^[9][12]

Much of this research occurs in countries experiencing particularly high myopia rates, including China, Singapore, and other parts of East Asia, though studies also take place in Europe, Australia, and North America. Researchers collaborate internationally to share findings and develop treatment guidelines. Large-scale trials often involve multiple clinical centers across different countries to enroll sufficient numbers of children and ensure results apply to diverse populations. Some trials specifically examine whether treatments work equally well across different ethnic groups, as myopia rates and risk factors vary among populations.^[9]

Looking ahead, researchers are investigating entirely new approaches. Some explore whether specific nutrients or supplements might influence eye growth, though no dietary interventions have yet shown clear benefits. Others study genetic markers associated with myopia to better predict which children face highest risk and might benefit most from early aggressive intervention. Investigations into the role of circadian rhythms and sleep patterns in eye growth represent another emerging research direction. These studies remain in early phases, and none have yet produced treatments ready for clinical use.^[9]

Making Treatment Decisions

Choosing among myopia management options requires considering multiple factors specific to each child and family. Age plays an important role—younger children might adapt more easily to certain contact lenses but may find it harder to consistently use eye drops. Very young children might do better with spectacle options initially, transitioning to contact lenses as they mature and can handle lens insertion and care independently. The child’s current prescription strength and how quickly it’s changing also influence recommendations, as some treatments have been studied more extensively in specific prescription ranges.^[12]

Lifestyle considerations matter significantly. Active children involved in sports might prefer contact lenses or Ortho-K over glasses, while children who tend to lose or break glasses frequently might benefit from overnight Ortho-K lenses. Family routines influence success with treatments requiring daily adherence, such as atropine drops or daily disposable contacts. Cost represents another practical consideration, as some myopia control treatments may not be covered by insurance and require ongoing expenses for lens replacements or compounded medications.^[11][12]

Safety profiles differ among options. Spectacles carry virtually no safety risks, making them the most conservative choice. Contact lenses of any type require proper hygiene to prevent infections, though serious complications remain rare when lenses are used as directed. Atropine drops have an excellent safety record at low concentrations, though some children experience mild light sensitivity even at 0.01%. Discussing these trade-offs with an eye care professional helps families make informed decisions aligned with their priorities and comfort levels.^[10][12]

Response to treatment varies among individuals. While clinical trials show average slowing effects across groups of children, some individuals respond better than others to any given treatment. Regular monitoring through eye exams allows eye care professionals to assess whether the chosen approach is working effectively. If myopia continues progressing rapidly despite treatment, switching to a different option or combining multiple approaches might be warranted. This personalized monitoring and adjustment process represents an essential component of successful myopia management.^[12]

For adults with stable myopia, decision-making focuses primarily on vision correction preferences rather than progression control. Eyeglasses remain the simplest, safest option, while contact lenses offer lifestyle benefits for many people. Surgical correction appeals to those wanting to eliminate dependence on corrective lenses, though candidates must understand that surgery corrects vision without addressing the underlying eye structure changes or reducing associated health risks. Not everyone qualifies for surgery—factors like corneal thickness, prescription stability, and overall eye health determine eligibility.^[13]