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Near reading time is linked to progression of myopia

Myopia Control – How To Prevent Increases In Nearsightedness

Myopia or “nearsightedness” causes distance blur and has been increasing in prevalence at an alarming rate in children and adolescents over the past several years.  This increase in occurrence and magnitude of myopia is thought to be linked to increases in time spent viewing near objects including smartphones, tablets, laptops, and computer screens.

What Causes Myopia

In children, the two most common reasons for myopia are that either the cornea is too curved which causes light to focus in front of the retina or the axial length or front to back length of the eyeball is too long.  In most cases the shape of the cornea is relatively stable throughout life and so cases where myopia is increasing year over year are usually due to axial length elongation.

Kids using a tablet

How Can Myopia Be Prevented In Kids

A lot of parents wonder how they can stop their children’s eyesight from getting worse. Optometrists have noted that children who spend more time outdoors and less time doing near activities like reading or screen time tend to have lower incidence of myopia.  For example, children who spend time playing sports like soccer outdoors may be less likely to become myopic than those who spend a lot of time playing video games on their smartphones.   Practically speaking, we can’t eliminate near activities for children completely as reading, computer use, and device usage are all parts of everyday life and important for development.  The 20/20/20 rule is a basic way of breaking up near activities  – ensuring that a 20 second break to look 20 feet away is taken every 20 minutes during near viewing.  Another tip is to ensure that your child holds their reading material (including electronic devices) at approximately the distance of their wrists with their arms fully outstretched.


How To Stop Myopia From Increasing

Recent advances in technology have made it possible to reduce the progression of myopia in children.  There are several options available to stop eyesight from getting worse including orthokeratology (overnight contact lenses), specialty eyeglass lenses, specialty soft contact lenses, and prescribing medications such as atropine.    These options all effectively reduce myopia progression risk which in turn decreases the risk of eye diseases linked to high myopia such as retinal holes, tears, and detachments, glaucoma, and myopic macular degeneration. Myopia control technologies play a very important role in preventing future vision loss and potential blindness.  

Kids reading books at school

Ways To Decrease Myopia Progression


Orthokeratology is a process by which specialized rigid gas permeable contact lenses are worn overnight by children that temporarily reshape the corneal surface.  The lenses are worn overnight and taken out in the morning.  There are two beneficial results: the overnight corneal reshaping corrects the child’s vision and thus eliminates the need for glasses or contact lens wear during the day.  Furthermore, studies show that axial length elongation is reduced by approximately 36-56% in orthokeratology lens wearing patients. The mechanism behind the reduction in myopia increase in ortho-k patients is thought to be due to the peripheral defocus created by the lenses.  Examples of orthokeratology lenses include MOONLENS by Art Optical which is FDA approved for overnight wear in children to reduce myopia progression.

Myopia Control Eyeglass Lenses

In the past few years there have been big advances in eyeglass lens technology and now significant myopia progression decreases have been well documented. Hoya MiyoSmart lenses have shown to reduce myopia progression by an average of 60% while Essilor Stellest lenses have had similar results. Both lenses are available in Canada as of 2022 and the patient can select any eyeglass frame they like and have them fit in.  Another option are the Zeiss Myokids Pro lenses which may also significantly reduce myopia progression. Keep in mind that myopia control lenses must be custom made for each patient and can take approximately 1-2 weeks to finish.

Low Dose Atropine Treatment for Myopia Control

Low dose atropine (0.01 to 0.05%) has been used to reduce myopia progression for many years.  Studies show that low dose atropine will on average reduce nearsightedness from getting worse by approximately 60% on average. The drops must be prescribed by an eye doctor and are usually taken once a day.  Patients on atropine must be monitored regularly while on the medication.  Potential ocular side effects include light sensitivity and reading blur due to dilation of the pupil. Systemic side effects from atropine are rarely reported from low dose topical atropine but may include chest pain, urinary dysfunction, and behavioral changes among others.

Soft Contact Lenses For Myopia Control

Another new tool in stopping eyesight from getting worse are soft contact lenses specially designed for myopia control.  An example of this are Johnson and Johnson Abiliti daily soft contact lenses.  Unlike ortho-k lenses, soft contact lenses can’t be worn overnight.  Instead they have correct vision during the day time and also reduce myopia progression during the day.  

Which Is The Best Way To Prevent Your Child’s Eyesight From Getting Worse?

There are several advantages and disadvantages to each of the myopia control options discussed in this article and the technology is always changing.  To decide what the best option is for you or your child it’s best to speak to your optometrist at your next eye exam.

Disclaimer: Please note this article is not to be taken as medical advice and is solely for informational purposes. Please see your healthcare provider for diagnosis and treatment.

Dr. Shiv Sharma

Dr. Shiv Sharma is an Optometrist who specializes in family eye care, dry eye, and pediatric eye care. He obtained his Bachelor's degree in M.B.B. From Simon Fraser University in 2009 and his Doctorate of Optometry degree from the Southern College of Optometry in 2013. He is a strong advocate for innovation in optometry practice and consults for several ophthalmic industry companies.