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Slowing Myopia Progression in Children: What the Evidence Shows

Myopia is no longer viewed as a simple refractive inconvenience. By 2050, nearly half of the world’s population is expected to be nearsighted, with close to one billion people affected by high myopia, levels associated with sight-threatening complications. New insights from a major review of the scientific literature underscore why early intervention matters, and what strategies are proving most effective in children and teens.

Université de Montréal Langis Michaud
Dr. Langis Michaud, OD

The findings come from the work of Langis Michaud, Professor at the Université de Montréal School of Optometry, who conducts one of the most extensive annual reviews of myopia research worldwide. Each year, Michaud analyzes more than 2,000 peer-reviewed articles to identify clinically relevant trends in myopia prevention and management.
(Source: Université de Montréal, January 2026)

From benign condition to public health concern

For decades, myopia was considered a straightforward refractive error, easily corrected with glasses. That perception has shifted dramatically. The World Health Organization now recognizes myopia as a preventable cause of blindness, while the U.S. National Academy of Sciences classifies it as a disease.

The concern lies in pathological eye elongation. As the eye stretches, ocular tissues become thinner and more fragile, increasing the risk of retinal detachment, glaucoma, early cataracts, and irreversible vision loss. Michaud often compares this process to fabric under tension: when the eye elongates beyond its natural limits, structural failure can occur.

Lifestyle factors that influence myopia risk

While genetics accounts for roughly 30 per cent of myopia risk, environmental factors play a substantial role—particularly in childhood.

A consistent finding across studies is the protective effect of time spent outdoors. At least two hours of daily outdoor activity has been shown to reduce the onset and progression of myopia, likely due to increased exposure to natural light and its role in stimulating retinal dopamine, a regulator of eye growth.

Screen habits also matter. Very close viewing distances, especially with smartphones and tablets, are associated with faster progression. Research supports limiting recreational screen time in young children, encouraging regular breaks, and maintaining appropriate viewing distances.

Emerging research is also exploring the links between myopia, inflammation, and metabolic health. Recent studies suggest that diet, physical activity, sleep, and even the gut microbiome may influence myopia progression through inflammatory pathways—an area that was barely considered five years ago.

Modern approaches to myopia control

Scientific understanding of eye growth has transformed how myopia is treated. It is now well established that the peripheral retina plays a key role in regulating axial elongation. As a result, modern myopia-control strategies aim to correct central vision while creating a controlled peripheral blur.

Evidence-based options include:

  • Orthokeratology, using overnight lenses to temporarily reshape the cornea
  • Multifocal soft contact lenses, designed with peripheral power profiles
  • Peripheral defocus spectacle lenses, increasingly available in Canada
  • Low-dose atropine, with 0.05% currently considered the most effective balance between efficacy and side effects

Conventional single-vision glasses and contact lenses are no longer recommended for myopia management, as they do not address peripheral retinal signaling.

Individualized care and clinical judgment

No single approach works for every child. Age, ethnicity, rate of progression, axial length, lifestyle factors, and family preferences all influence treatment decisions. In some high-risk cases, combination therapy may be warranted, while others respond well to optical interventions alone.

Compliance remains a decisive factor. Treatments are only effective when used consistently, making patient and parent education an essential part of myopia management.

Canada currently stands out for its regulatory environment, with several peripheral defocus spectacle designs approved by Health Canada—options not yet widely available in many other markets.

Proceeding with caution on emerging technologies

Not all proposed myopia treatments have proven safe. Michaud highlights serious concerns around red-laser devices, which have been linked to retinal damage in human studies. These devices are now classified as high-risk in China and are not authorized in Canada.

A growing priority for eye care

With global economic losses from myopia estimated at up to US $240 billion annually, the condition represents both a clinical and public-health challenge. Research at the Université de Montréal’s School of Optometry continues to demonstrate that evidence-based interventions can significantly slow myopia progression, reducing long-term risks even if the condition itself cannot be cured.

Source:
This article is based on reporting originally published by the Université de Montréal:
“Slowing the progression of myopia in children and teens” (January 20, 2026)
https://nouvelles.umontreal.ca/en/article/2026/01/20/slowing-the-progression-of-myopia-in-children-and-teens

Optik NOW acknowledges and credits the original source for its reporting and expert commentary.

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