What are the best myopia control options for my child?

TLDR: Several evidence-based treatments can slow myopia progression in children by 40 to 70 percent, including orthokeratology, MiSight contact lenses, Stellest spectacle lenses, and atropine eye drops — with the best option depending on the child's age, lifestyle, and degree of myopia.

Why Myopia Control Matters

When a child is diagnosed with myopia, many parents view it as a simple inconvenience correctable with glasses. In reality, childhood myopia is a progressive condition: the eye continues to elongate throughout the school years, and the higher the final prescription, the greater the lifetime risk of retinal detachment, glaucoma, myopic macular degeneration, and early cataracts. Myopia control — the term for treatments specifically designed to slow the progression of myopia rather than simply correct it — is one of the most important tools available in modern pediatric eye care.

The goal is not to cure myopia but to limit how high the prescription gets. Each diopter of reduction in final myopia meaningfully reduces the associated disease risks. A child who might have reached -7.00 or -8.00 diopters with glasses alone might be guided to a -3.00 or -4.00 outcome with proactive treatment — a difference that matters across their entire lifespan.

Orthokeratology (Ortho-K)

Orthokeratology involves specially designed rigid gas-permeable contact lenses that are worn during sleep. The lenses gently reshape the cornea overnight, providing clear vision throughout the day without glasses or daytime contact lenses. Beyond vision correction, ortho-k has been shown to slow axial elongation — the underlying mechanism of myopia progression — by approximately 40 to 60 percent compared to standard single-vision glasses.

Ortho-k is an excellent option for active children who play sports or have lifestyles that make glasses inconvenient. It is suitable for children as young as 6 to 8 years old when properly fitted and monitored. Many families are initially surprised that children adapt quickly and enjoy the freedom of glasses-free daytime vision. The lenses are cared for daily like any contact lens and replaced on a regular schedule. Ortho-k requires consistent wear — skipping nights causes the corneal reshaping to reverse within a day or two — and regular monitoring by an experienced optometrist.

MiSight 1-Day Contact Lenses

MiSight 1-day contact lenses are daily disposable soft contact lenses that serve two purposes simultaneously: they correct distance vision and they slow myopia progression through a technology called ActivControl. The lens creates a dual-focus effect — a central zone corrects the refractive error while a surrounding zone creates peripheral defocus that slows axial elongation.

MiSight is FDA-approved for myopia control and is the first contact lens to receive this designation. Clinical trial data from the three-year MiSight study showed an average reduction in myopia progression of approximately 59 percent compared to single-vision contact lenses, along with a 52 percent reduction in axial elongation. The daily disposable format makes them extremely convenient — no cleaning solutions required, reduced risk of lens-related complications, and a fresh pair each day. MiSight lenses are FDA-approved for children ages 8 to 12 at initiation, though they are commonly used in older children as well.

Stellest Spectacle Lenses

Stellest lenses, manufactured by Essilor, are a spectacle-based myopia control option that represents a major advance for families who prefer glasses over contact lenses. The lenses use a technology called H.A.L.T. (Highly Aspherical Lenslet Target), which creates a constellation of lenslets within the lens that produce a volume of myopic defocus in front of the peripheral retina, slowing the signal that drives axial elongation.

Clinical data from a three-year study in China showed that Stellest lenses slowed axial elongation by 67 percent on average compared to standard single-vision lenses in children who wore them at least 12 hours per day. For families whose children are not ready for contact lenses, Stellest offers a highly effective option that looks and functions like ordinary glasses.

Atropine Eye Drops

Low-dose atropine eye drops — typically 0.01 to 0.05 percent concentration — have become one of the most widely used myopia control strategies globally, particularly in Asia. Atropine is a muscarinic antagonist that, at very low doses, slows myopia progression through mechanisms that are not fully understood but appear to involve the retina rather than the eye's focusing system.

Research shows that low-dose atropine reduces myopia progression by approximately 50 to 77 percent depending on dose, with the 0.05 percent concentration offering the strongest effect with minimal side effects. Side effects are generally mild — slight light sensitivity and minor near blur — and are far less pronounced than the effects of the full 1 percent dose used for pupil dilation. Atropine drops are often used in combination with other treatments (ortho-k or MiSight) for children with rapidly progressing myopia.

Choosing the Right Approach

There is no single best myopia control treatment — the right choice depends on the child's age, prescription level and rate of progression, lifestyle, motivation, and family preferences. Some children benefit most from a single treatment; others do best with a combination, such as ortho-k plus low-dose atropine for rapid progressors.

The most important step is to begin myopia control early — ideally at the first signs of progression — and to monitor the results carefully every 6 months. Myopia control is an ongoing, individualized process, not a one-time decision. A knowledgeable pediatric optometrist who specializes in myopia management will help your family navigate these options with up-to-date, evidence-based guidance.

Ready to Protect Your Child's Vision?

At Lumen Vision, we specialize in pediatric optometry, vision therapy, and myopia control. Our team is passionate about catching vision problems early and giving every child the visual foundation they need to thrive. We proudly serve families across the region with comprehensive, compassionate eye care.

Call us at 701-404-9096, visit us online at www.lumen.vision, or schedule your child's appointment directly at scheduleyourexam.com/v3/index.php/6654.