A new review published by the International Myopia Institute (IMI) has compiled randomized controlled-trial evidence on interventions to delay onset and slow progression of myopia in children. The article surveyed 5 categories of intervention: optical correction, pharmacological treatment, environmental (behavioral) factors, light-based therapies and surgical approaches.

Among behavioral measures, increased time outdoors appears to reduce the risk of developing myopia by about 30% to 5% in at-risk children.  For progression after onset, optical interventions such as defocus-incorporated glasses or dual-focus contact lenses remain central, showing axial length slowing of approximately 0.2 mm to 0.3 mm over 1 to 2 years. Low-dose atropine (eg, 0.05%) also showed enhanced effect over lower concentrations, though side-effects remain a consideration. Emerging light-based therapy (repeated low-level red-light) demonstrated the largest single-year effect (up to ~0.4 mm axial slowing) in early trials, though long-term data are limited. The authors emphasize that combination approaches and long-term adherence merit further investigation.

The review concludes that managing myopia in children is no longer experimental. Effective, evidence-based options now exist and clinicians are urged to tailor intervention plans according to each child’s risk profile, lifestyle and response. 

Yam JC, Zhang XJ, Zaabaar E, et al. Interventions to Reduce Incidence and Progression of Myopia in Children and Adults. Prog Retin Eye Res. 2025 Oct 16:101410. doi: 10.1016/j.preteyeres.2025.101410