Myopia control in children


  • Sukrita Aramrungroj -


Myopia has become a significant national and global health concern, as it is a leading cause of visual impairment and blindness worldwide. According to projections, by 2050, nearly half of the global population (49.8%) may be affected by myopia. This condition can lead to various complications and, in severe cases, even permanent visual impairment. Therefore, it is crucial to focus on myopia control to prevent the progression of this condition and its related complications. Myopia control modalities can be broadly categorized into three groups: activities modification, optical correction, and medication. In this review, each of these modalities will be discussed in detail.      


Flitcroft DI, He M, Jonas JB, Jong M, Naidoo K, Ohno-Matsui K, et al. IMI - Defining and Classifying Myopia: A Proposed Set of Standards for Clinical and Epidemiologic Studies. Invest Ophthalmol Vis Sci. 2019;60M20-M30.

Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology. 2016;1231036-42.

Matsumura S, Ching-Yu C, Saw S-M. Global Epidemiology of Myopia. In: Ang M, Wong TY, editors. Updates on Myopia: A Clinical Perspective. Singapore: Springer Singapore; 2020. p. 27-51.

Cai XB, Shen SR, Chen DF, Zhang Q, Jin ZB. An overview of myopia genetics. Exp Eye Res. 2019;188107778.

Tkatchenko AV, Tkatchenko TV, Guggenheim JA, Verhoeven VJ, Hysi PG, Wojciechowski R, et al. APLP2 Regulates Refractive Error and Myopia Development in Mice and Humans. PLoS Genet. 2015;11e1005432.

Verhoeven VJ, Buitendijk GH, Consortium for Refractive E, Myopia, Rivadeneira F, Uitterlinden AG, et al. Education influences the role of genetics in myopia. Eur J Epidemiol. 2013;28973-80.

Chakraborty R, Read SA, Vincent SJ. Understanding Myopia: Pathogenesis and Mechanisms. In: Ang M, Wong TY, editors. Updates on Myopia: A Clinical Perspective. Singapore: Springer Singapore; 2020. p. 65-94.

Smith EL, 3rd, Huang J, Hung LF, Blasdel TL, Humbird TL, Bockhorst KH. Hemiretinal form deprivation: evidence for local control of eye growth and refractive development in infant monkeys. Invest Ophthalmol Vis Sci. 2009;505057-69.

Smith EL, 3rd. Prentice Award Lecture 2010: A case for peripheral optical treatment strategies for myopia. Optom Vis Sci. 2011;881029-44.

Rose KA, Morgan IG, Ip J, Kifley A, Huynh S, Smith W, et al. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology. 2008;1151279-85.

Dirani M, Tong L, Gazzard G, Zhang X, Chia A, Young TL, et al. Outdoor activity and myopia in Singapore teenage children. Br J Ophthalmol. 2009;93997-1000.

Wu PC, Tsai CL, Wu HL, Yang YH, Kuo HK. Outdoor activity during class recess reduces myopia onset and progression in school children. Ophthalmology. 2013;1201080-5.

He M, Xiang F, Zeng Y, Mai J, Chen Q, Zhang J, et al. Effect of Time Spent Outdoors at School on the Development of Myopia Among Children in China: A Randomized Clinical Trial. JAMA. 2015;3141142-8.

Wu PC, Chen CT, Lin KK, Sun CC, Kuo CN, Huang HM, et al. Myopia Prevention and Outdoor Light Intensity in a School-Based Cluster Randomized Trial. Ophthalmology. 2018;1251239-50.

Huang HM, Chang DS, Wu PC. The Association between Near Work Activities and Myopia in Children-A Systematic Review and Meta-Analysis. PLoS One. 2015;10e0140419.

Li S-M, Ji Y-Z, Wu S-S, Zhan S-Y, Wang B, Liu L-R, et al. Multifocal Versus Single Vision Lenses Intervention to Slow Progression of Myopia in School-age Children: A Meta-analysis. Survey of Ophthalmology. 2011;56451-60.

Ma JX, Tian SW, Liu QP. Effectiveness of peripheral defocus spectacle lenses in myopia control: a Meta-analysis and systematic review. Int J Ophthalmol. 2022;151699-706.

Sankaridurg P, Donovan L, Varnas S, Ho A, Chen X, Martinez A, et al. Spectacle lenses designed to reduce progression of myopia: 12-month results. Optom Vis Sci. 2010;87631-41.

Li SM, Kang MT, Wu SS, Meng B, Sun YY, Wei SF, et al. Studies using concentric ring bifocal and peripheral add multifocal contact lenses to slow myopia progression in school-aged children: a meta-analysis. Ophthalmic Physiol Opt. 2017;3751-9.

Al-Ghoul KJ, Sun Y, Xu F, Zhang T, Liu M, Wang D, et al. Orthokeratology to Control Myopia Progression: A Meta-Analysis. Plos One. 2015;10e0124535.

Lipson MJ, Brooks MM, Koffler BH. The Role of Orthokeratology in Myopia Control: A Review. Eye Contact Lens. 2018;44224-30.

Zhou X, Pardue MT, Iuvone PM, Qu J. Dopamine signaling and myopia development: What are the key challenges. Prog Retin Eye Res. 2017;6160-71.

Huang J, Wen D, Wang Q, McAlinden C, Flitcroft I, Chen H, et al. Efficacy Comparison of 16 Interventions for Myopia Control in Children: A Network Meta-analysis. Ophthalmology. 2016;123697-708.

Chua WH, Balakrishnan V, Chan YH, Tong L, Ling Y, Quah BL, et al. Atropine for the treatment of childhood myopia. Ophthalmology. 2006;1132285-91.

Tong L, Huang XL, Koh AL, Zhang X, Tan DT, Chua WH. Atropine for the treatment of childhood myopia: effect on myopia progression after cessation of atropine. Ophthalmology. 2009;116572-9.

Chia A, Chua WH, Cheung YB, Wong WL, Lingham A, Fong A, et al. Atropine for the treatment of childhood myopia: safety and efficacy of 0.5%, 0.1%, and 0.01% doses (Atropine for the Treatment of Myopia 2). Ophthalmology. 2012;119347-54.

Chia A, Chua WH, Wen L, Fong A, Goon YY, Tan D. Atropine for the treatment of childhood myopia: changes after stopping atropine 0.01%, 0.1% and 0.5%. Am J Ophthalmol. 2014;157451-7 e1.

Chia A, Lu QS, Tan D. Five-Year Clinical Trial on Atropine for the Treatment of Myopia 2: Myopia Control with Atropine 0.01% Eyedrops. Ophthalmology. 2016;123391-9.

Yam JC, Jiang Y, Tang SM, Law AKP, Chan JJ, Wong E, et al. Low-Concentration Atropine for Myopia Progression (LAMP) Study: A Randomized, Double-Blinded, Placebo-Controlled Trial of 0.05%, 0.025%, and 0.01% Atropine Eye Drops in Myopia Control. Ophthalmology. 2019;126113-24.

Yam JC, Li FF, Zhang X, Tang SM, Yip BHK, Kam KW, et al. Two-Year Clinical Trial of the Low-Concentration Atropine for Myopia Progression (LAMP) Study: Phase 2 Report. Ophthalmology. 2020;127910-9.

Yam JC, Zhang XJ, Zhang Y, Wang YM, Tang SM, Li FF, et al. Three-Year Clinical Trial of Low-Concentration Atropine for Myopia Progression (LAMP) Study: Continued Versus Washout: Phase 3 Report. Ophthalmology. 2022;129308-21.

Yeao A. PD, Drobe B., Koh P. Myopia and Effective Management Solutions. Points de Vue, International Review of Ophthalmic Optics. 2016.

Russo A, Boldini A, Romano D, Mazza G, Bignotti S, Morescalchi F, et al. Myopia: Mechanisms and Strategies to Slow Down Its Progression. Journal of Ophthalmology. 2022;20221-20.






Review Article