From the Guidelines
The most effective strategies for myopia control combine optical interventions, pharmaceutical treatments, and lifestyle modifications while addressing education and financial barriers. Low-dose atropine eye drops (0.01-0.05%) applied once daily represent the most evidence-backed pharmaceutical approach, slowing myopia progression by 50-60% with minimal side effects, as demonstrated in recent studies 1. Specialized contact lenses, including multifocal soft lenses and orthokeratology (overnight rigid lenses), offer 30-50% reduction in progression but require proper fitting and maintenance, as shown in studies such as 1 and 1. For families with financial constraints, increasing outdoor time to at least 2 hours daily is a free, evidence-based intervention that can reduce myopia onset by 30-40% through increased light exposure and reduced near work, supported by findings from 1 and 1. Educational barriers can be addressed through school-based screening programs and community outreach to identify at-risk children early. When considering costs, atropine is generally more affordable than specialized lenses, though some insurance plans may cover optical interventions. A stepped approach often works best: starting with increased outdoor time and reduced screen time, then adding low-dose atropine, and considering specialized lenses if financially feasible. Regular eye examinations every 6-12 months are essential to monitor progression and adjust treatment accordingly, as recommended in 1. The underlying mechanism for these interventions involves slowing abnormal eye elongation by modifying peripheral retinal defocus and reducing accommodative stress during near work. Some key points to consider include:
- The importance of early identification and intervention for myopia control, as emphasized in 1.
- The need for proper fitting and maintenance of specialized contact lenses to ensure safety and efficacy, highlighted in 1 and 1.
- The potential risks and benefits of different interventions, including antimuscarinic agents, multifocal spectacles and contact lenses, and orthokeratology, discussed in 1 and 1.
- The role of lifestyle modifications, such as increased outdoor time and reduced screen time, in preventing myopia onset and slowing progression, supported by findings from 1 and 1.
From the Research
Effective Strategies for Myopia Control
The most effective strategies for myopia control involve a combination of education and addressing financial barriers.
- Education campaigns have been shown to increase uptake of myopia control measures, suggesting that addressing knowledge gaps can be more effective than reducing financial barriers alone 2.
- Studies have found that interventions such as increased outdoor time, orthokeratology, and low-dose atropine can be effective in slowing myopia progression 3, 4, 5, 6.
Environmental and Behavioral Interventions
Environmental and behavioral interventions, such as increased outdoor time, have been shown to be effective in preventing the onset of myopia if implemented successfully in schools and homes 3, 6.
- These interventions are generally regarded as safe and can be implemented at a low cost.
- However, their effectiveness may depend on individual factors such as age, ethnicity, and rate of myopia progression 6.
Pharmacological and Optical Interventions
Pharmacological and optical interventions, such as low-dose atropine and orthokeratology, have been shown to be effective in slowing myopia progression 4, 5, 6.
- These interventions may be associated with adverse effects and can be expensive, making them less accessible to some individuals 3, 2.
- However, they can be effective in reducing myopia progression and may be a viable option for individuals who are at high risk of myopia progression.
Barriers to Myopia Control
Despite the availability of effective interventions, there are several barriers to myopia control, including:
- Limited knowledge and awareness of myopia control among optometrists and the general public 2.
- Financial constraints and limited access to myopia control interventions 3, 2.
- Time restrictions and limited availability of myopia control therapies 2.
- The need for a unified consensus on strategies for myopia control and a personalized approach to myopia management 3, 6.