Myopia management for children: the three options explained

If your child's short-sight prescription has increased by more than 0.50 dioptres in the past year, it is worth asking whether anything can be done to slow that progression. The answer, in many cases, is yes. Three interventions have reasonable clinical evidence behind them. None of them reverses existing myopia, and none of them works for every child. This article explains what each involves.

MiSight daily contact lenses ¶

MiSight lenses are soft daily disposables with a dual-focus optical design. The central zone corrects the child's distance vision; the surrounding zones create a myopic defocus signal at the peripheral retina, which is thought to slow the elongation of the eyeball that drives myopia progression.

Clinical trial data published by CooperVision showed an average reduction in progression of around 59% over three years compared to a control group wearing standard single-vision lenses. The results vary between individuals. Some children respond well; others show less benefit.

The lenses are suitable for children from age 8 upward who can manage insertion and removal reliably. We include a fitting appointment, a two-week trial, and six-monthly aftercare visits in the fitting fee.

Orthokeratology ¶

Orthokeratology involves wearing rigid gas-permeable lenses overnight. The lenses gently reshape the cornea while the child sleeps, providing clear unaided vision during the day. The myopia management effect comes from the same peripheral defocus mechanism as MiSight.

We do not fit orthokeratology lenses at Cedar Vision Works, but we refer to a colleague in the region who does. If this option seems appropriate for your child, we will discuss it at the consultation and provide a referral letter.

Low-dose atropine eye drops ¶

Atropine drops at a concentration of 0.01% have been used in several East Asian countries for myopia management for a number of years. The mechanism is not fully understood, but the drops appear to slow axial elongation independently of their effect on accommodation.

In the UK, low-dose atropine for myopia management is available through specialist prescribers. We can discuss whether this option is appropriate and refer to a prescriber if so. It is not something we prescribe ourselves.

The right option depends on the child's age, prescription, lifestyle, and how they feel about contact lenses. We spend the full 45 minutes of the consultation working through this with families rather than recommending the same solution to everyone.