Myopia Management for Children: Comparing the Most Effective Treatment Options
Myopia Awareness Week earlier this year passed with little public attention, which is unfortunate given the increasing prevalence of myopia in Australia and around the world. More children are becoming myopic—commonly known as short-sighted—at a younger age. In Australia, around 35% of the population is currently myopic, and this figure is projected to rise to approximately 50% by 2050.
The concern surrounding myopia extends far beyond the inconvenience of needing glasses or contact lenses. Myopia is associated with a significantly increased risk of serious ocular conditions such as retinal detachment, glaucoma, and myopic maculopathy. Alarmingly, it is not uncommon for optometrists and paediatric optometrists to now see children as young as seven developing myopia.
The Importance of Starting Myopia Management Early in Childhood
So what can be done to slow the progression of myopia and correct vision in children? Fortunately, there is a growing body of evidence supporting several effective treatment options. Over the past five to six years, treatments such as multizone and multifocal contact lenses, orthokeratology lenses1, spectacle lenses with lenslets, and low-dose atropine eye drops have proven effective in slowing myopia progression.
Early intervention is crucial. The earlier myopia control is initiated, the greater the potential to reduce the long-term risks associated with high myopia and preserve ocular health.
Comparing Myopia Treatment Options for Children: What Works and Why
Managing myopia is not one-size-fits-all. Each treatment option works differently and may suit some children better than others depending on age, lifestyle, and visual needs. Here's a brief comparison of the most common approaches:
Spectacle Lenses with Lenslets
These look like regular glasses but contain tiny lens segments that help reduce eye strain and manage focus. They’re non-invasive and easy to use, making them a good first option for younger children or those not ready for contact lenses.
Low-Dose Atropine Eye Drops
Applied once daily, these drops have been shown to slow eye growth and myopia progression, particularly in younger children. While effective, they may cause mild light sensitivity or require ongoing use over several years.
Orthokeratology (Ortho-K) Lenses
Ortho-K lenses are worn overnight and gently reshape the cornea while the child sleeps, providing clear vision during the day without glasses or contacts. They're particularly well suited to active children and those involved in sports. Research suggests similar levels of myopia control to multifocal lenses, with the added convenience of daytime freedom.
Multifocal Contact Lenses
These soft lenses are designed with different power zones to control how light focuses on the retina. They are worn during the day and are suitable for children who are comfortable with routine lens wear. Clinical studies show they can reduce myopia progression by around 30–50%.
Each option is supported by robust clinical evidence. In many cases, a combination of approaches—such as atropine and glasses, or Ortho-K paired with good visual habits—may offer the best outcome.
| Treatment | How It Works | Pros | Considerations |
|---|---|---|---|
| Spectacle Lenses with Lenslets | Tiny lens segments subtly redirect peripheral focus to slow eye growth | Easy to wear, non-invasive, familiar for children | May be less effective for higher levels of myopia |
| Low-Dose Atropine Eye Drops | Reduces the eye’s growth signals using a mild medicated drop | Simple daily use, strong evidence base | May cause light sensitivity; long-term use often needed |
| Orthokeratology (Ortho-K) Lenses | Worn overnight to reshape the cornea for clear daytime vision | Daytime freedom, ideal for sporty or active kids | Requires good hygiene habits and commitment to routine |
| Multifocal Contact Lenses | Multiple lens zones help manage retinal focus during wear | Dual purpose: corrects vision and slows progression | Requires adaptation; not all children are lens-ready |
Are Contact Lenses Safe for Children?
As we become more proactive in managing myopia, one common question arises: Are contact lenses safe and appropriate for children?
There is no strict minimum age for fitting a child with contact lenses. Instead, decisions should be guided by the child’s emotional maturity, hygiene practices, motivation, and ability to follow instructions. These are better indicators of readiness than age alone.
Research supports the safety of contact lens wear in children. A notable study by Bullimore and Richdale (2023)2 found that the risk of serious complications such as microbial keratitis in children is no higher than in adults—and in some cases, complications were even less frequent. Interestingly, younger children often demonstrate better compliance than older adolescents, in part due to closer parental supervision and involvement.
Parental support plays a significant role. If a parent is already a contact lens wearer, they may be more confident and supportive during the fitting and training process. If not, our optometrists provide thorough instructions on lens hygiene, insertion, and removal to ensure safe wear. Motivation—on the part of the child—is also key to success.
Contact Lenses as a Tool for Myopia Control
Contact lenses are more than just a convenient alternative to glasses. Certain designs, including multifocal and orthokeratology lenses, are specifically designed to not only correct vision but also slow the progression of myopia. This dual benefit makes them an ideal option for many children when appropriately prescribed and monitored.
Ultimately, successful contact lens wear in children depends more on individual readiness and support than on a specific age. When these factors align, contact lenses can be a safe, effective, and empowering solution for both vision correction and myopia control.
How to Choose the Right Myopia Management Plan for Your Child
The best way to decide on a treatment is through a personalised consultation with a paediatric optometrist. Here are a few considerations that may guide your decision:
Age and maturity: Younger children may start with spectacle lenslets or atropine drops, while older, more independent children may be well suited to contact lens wear.
Lifestyle and routines: For sporty or active children, Ortho-K can provide daytime freedom without glasses or lenses.
Parental involvement: Contact lens use requires good hygiene and support, especially in the early stages. The more involved a parent can be, the better the outcomes tend to be.
Comfort and motivation: A child’s willingness to participate in the chosen treatment often predicts long-term success.
Your optometrist will assess your child’s eye health, prescription, and daily activities to recommend the most appropriate option. The key is starting early, staying consistent, and working together to protect your child’s long-term vision.
References
Coverdale S, et al. The attitudes and clinical behaviour of eyecare practitioners towards fitting contact lenses for children and young people. BMJ Open Ophthalmology. 2024;9.
Lattery LJ, et al. Patient and parent perceptions of myopia modalities. Cont Lens Anterior Eye. 2023;46(2):101772.
Footnotes
Santodomingo-Rubido J, Villa-Collar C, Gilmartin B, Gutierrez-Ortega R. Myopia control with orthokeratology contact lenses in Spain: refractive and biometric changes. Invest Ophthalmol Vis Sci. 2012;53(8):5060–65. doi: 10.1167/iovs.11-8005 ↩
Bullimore MA, Richdale K. Incidence of Corneal Adverse Events in Children Wearing Soft Contact Lenses. Eye Contact Lens. 2023;49(5):204-211. ↩
