Myopia (short‑sightedness) is appearing earlier and progressing faster in many children. Rather than simply updating stronger glasses each year, myopia control aims to slow how quickly the prescription increases and how fast the eye grows in length. This helps lower the lifetime risk of complications such as retinal detachment, myopic maculopathy, glaucoma and early cataract.
Why slowing myopia matters
Every extra dioptre of myopia is associated with a longer eyeball and an increased chance of future eye disease. Slowing progression by even 1–2 prescription steps over childhood can meaningfully reduce this risk. Myopia control does not “cure” short‑sightedness, but it can keep the final prescription significantly lower than it would have been without treatment.
Spectacle lenses – Stellest and MiYOSMART
Modern myopia‑control spectacle lenses use specialised optics to reduce the signal that encourages the eye to keep elongating.
Essilor Stellest: A two‑year randomised clinical trial found Stellest lenses slowed myopia progression by about 0.80 D (55%) and axial elongation by 0.35 mm (51%) versus standard single‑vision lenses when worn for at least 12 hours a day. Longer‑term follow‑up suggests the effect is sustained over four to six years in children who continue wearing the lenses.
Hoya MiYOSMART: The original two‑year trial of the DIMS design reported a 52% reduction in myopia progression and a 62% reduction in axial elongation compared with single‑vision lenses. Observational data up to six years show most children maintain this slower rate of change while they keep wearing MiYOSMART.
In simple terms, both Stellest and MiYOSMART tend to halve the rate of myopia progression versus ordinary glasses when used as directed. They are non‑invasive and easy to adapt to, making them strong first‑line options for many children.
Low‑dose atropine – 0.01% versus 0.05%
Low‑dose atropine eye drops are usually used once at night and can be combined with glasses or contact lenses. Several large trials have shown that treatment effect is dose‑dependent.
The LAMP series of studies found 0.05% atropine produced the greatest slowing of myopia progression and axial elongation over three years, clearly outperforming 0.025% and 0.01% and placebo.
In pre‑myopic children, 0.05% drops significantly reduced both the incidence of myopia and the proportion with fast myopic shift at two years, whereas 0.01% behaved similarly to placebo in that trial.
A separate US randomised trial of 0.01% atropine alone showed only a small, clinically modest benefit over placebo after two years.
Clinically, this means 0.05% atropine is the more effective option when drops are chosen, while 0.01% should not be expected to provide strong control on its own. Side‑effects such as mild light sensitivity or near‑focus difficulties are more common at higher doses but are usually manageable.
Orthokeratology and soft myopia‑control contact lenses
Orthokeratology (Ortho‑K) uses specially designed rigid lenses worn overnight to reshape the cornea, providing clear unaided vision during the day. Multiple trials have shown Ortho‑K slows axial elongation by roughly 40–60% compared with single‑vision corrections in similar age groups. This option suits motivated families and active children who like being lens‑free during waking hours, but it requires excellent hygiene because lenses are worn while sleeping.
Daily disposable soft contact lenses with myopia‑control optics offer similar reductions in progression and eye growth to Ortho‑K and myopia‑control spectacles in head‑to‑head analyses, again typically around the 40–60% range compared with single‑vision corrections. They are convenient for sport and older children comfortable handling lenses.
Putting the evidence together for your child
Taken together, the best current evidence suggests that:
Stellest and MiYOSMART spectacle lenses can reduce myopia progression and axial elongation by about half when worn consistently.
0.05% atropine provides a meaningful pharmacological effect, whereas 0.01% often offers only modest benefit, particularly in pre‑myopes.
Ortho‑K and soft myopia‑control contact lenses provide similar levels of control to the specialised spectacle lenses.
The most appropriate strategy depends on the child’s age, baseline prescription, rate of change, personality and family preferences. In many cases, combining lifestyle advice (more outdoor time, sensible screen use) with one or more of these treatments provides the best balance between scientific evidence and day‑to‑day practicality.